By Jessica Spagnolo and Anne-Marie Turcotte-Tremblay
Two important global health conferences were held in Canada exactly one year apart. In November 2015, the Canadian Society for International Health hosted the 22nd Canadian Conference on Global Health (CCGH), and in November 2016, Health System Global hosted the 4th Global Symposium on Health Systems Research (HSR 2016). These conferences are internationally acclaimed in the field of global health, and aim to convene researchers, activists, policy-makers, health care professionals, decision-makers, educators, and advocates who work in this field.
Global mental health, particularly for the most marginalized in resource-limited settings, is an under-represented area of global health research, and, interestingly enough, this is mirrored by its low representation at the two conferences. To illustrate this, we conducted a content analysis of the programs from the 22nd CCGH and HSR 2016 using keywords such as “mental health,” “mental illness,” “depression,” “anxiety,” and “schizophrenia.” These terms were also translated into French and Spanish in order to be searched in the titles and descriptions of the scientific presentations. We found that oral presentations amounted to 3% at the 22nd CCGH, and 0.5% at HSR 2016. In addition, poster presentations amounted to 3% at the 22nd CCGH, and 3.4% at HSR 2016. These presentations were representative of the major interests in global mental health, such as transcultural psychiatry, capacity building by training and education, mental health law and policy, as well as recovery and rehabilitation.
The above numbers suggest an under-representation of content in global mental health, which is worth highlighting because:
- It is estimated that by 2030, mental illness will be the leading cause of disease burden, disability, and years lost to disability worldwide.
- Mental illness is linked to important targets of global health, such as the annihilation of tuberculosis and HIV/AIDS
- Maternal depression has a significant role to play in children’s socioemotional and cognitive development.
- People living with severe mental illness are more likely to die prematurely, and this excess mortality is mainly due to physical ailments/ illness.
Given the above evidence, why is there such a low representation of global mental health at the 22nd CCHG and HSR 2016? Firstly, it is possible that researchers or experts working in global mental health are more likely to submit abstracts and present their work at conferences in the realms of psychology rather than health system strengthening, a main focus of the 22nd CCGH and HSR 2016. However, now more than ever an emphasis should be put on building health system capacity for the integration of mental health services, for example, at the level of primary or community-based settings given the lack of mental health specialists and resources, particularly in low- and middle-income countries (LMICs). This disparity in access to appropriate mental health care has caused a need to reform the overall health system by shifting the focus from specialists to non-specialists working in primary or community-based settings who can meet mental health needs.
Secondly, the low representation of global mental health research at the 22nd CCGH and HSR 2016 may be due to a lack of research investment in this area, particularly in LMICs. While this funding disparity has been targeted in recent years by initiatives like Grand Challenges Canada, the continual support towards global mental health research should be a focus. This support should also include the opportunity to share results in realms that have a wide target audience. Without this support and continual investment in global mental health research, it will be difficult for researchers and experts to conduct high quality research in the area and to participate in such conferences.
Given the above challenges regarding the involvement of global mental health at internationally acclaimed global health conferences, how can global mental health, and the scarce research in this field, be encouraged to take a more prominent place at global health conferences? A number of solutions can be envisioned. Through encouraged and sustained collaboration, efforts, and exchanges between global health and mental health researchers as well as experts at global health conferences, research in this field may be developed. Promoting keynote speakers in global mental health at internationally acclaimed global health conferences may also raise awareness of the field, and consequently encourage more global mental health researchers and experts to participate in such conferences.
Internationally acclaimed global health conferences can be key forums in fostering a space that encourages the field of global mental health by ensuring that there is room for collaboration between researchers in global health and mental health. Such a space can be used to fuel much needed awareness of global mental health to those who are also concerned with health equity.
Image: © Health Systems Global, 2016. Delegates listen to a plenary session at the Fourth Global Symposium on Health Systems Research in Vancouver, Canada.