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Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective
Open accessAbstract
Purpose of review Globally, the majority of those who need mental health care worldwide lack access to high-quality mental health services. Stigma, human resource shortages, fragmented service delivery models, and lack of research capacity for implementation and policy change contribute to the current mental health treatment gap. In this review, we describe how health systems in low- and middle-income countries (LMICs) are addressing the mental health gap and further identify challenges and priority areas for future research.Recent findings Common mental disorders are responsible for the largest proportion of the global burden of disease; yet, there is sound evidence that these disorders, as well as severe mental disorders, can be successfully treated using evidence-based interventions delivered by trained lay health workers in low-resource community or primary care settings. Stigma is a barrier to service uptake. Prevention, though necessary to address the mental health gap, has not solidified as a research or programmatic focus. Research-to-practice implementation studies are required to inform policies and scale-up services. Four priority areas are identified for focused attention to diminish the mental health treatment gap and to improve access to high-quality mental health services globally: diminishing pervasive stigma, building mental health system treatment and research capacity, implementing prevention programs to decrease the incidence of mental disorders, and establishing sustainable scale up of public health systems to improve access to mental health treatment using evidence-based interventions.
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“it became apparent in our framework refinement process that, particularly in mental health, stigma (e.g. self-stigma, family/community stigma, provider stigma, organizational or institutional-level stigma) is a force that can exert powerful influences on perceptions of mental health issues and treatments across all social actors and processes—including those in the intervention domain [39–42].”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [42]
Experimental — accuracy not yet measuredIn the citing paper
“existing models of mental health care will not adequately expand to meet the demand”
From The Opportunities and Risks of Large Language Models in Mental Health (2024) · cites this paper as [4]
In the citing paper
“Further, these studies seldom address sustainability by evaluating the mental health research-to-practice gap or leveraging human resources not dependent on research funding.4”
From Technology and implementation science to forge the future of evidence-based psychotherapies: The PRIDE scale-up study (2021) · cites this paper as [4]
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“This has led to a widely recognized mental health treatment gap, whereby more individuals are diagnosed with mental health problems than those who receive treatment [14, 15].”
From Explaining adults’ mental health help-seeking through the lens of the theory of planned behavior: A scoping review (2022) · cites this paper as [15]
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Aldridge, L. R., Kemp, C. G., Bass, J., Danforth, K., Kane, J. C., Hamdani, S. U., Marsch, L. A., Uribe-Restrepo, J. M., Nguyen, A. J., Bolton, P. A., et al. (2022) · Implementation Science Communications · doi:10.1186/s43058-022-00301-6 · Cited by 50
“In mental health, as in many areas of health, the gap between evidence and practice is typically greatest in LMIC [6] and implementation science has been recognized as the next step in the evolution of global mental health [7, 8].”
Mental Disorders and Mental Health Promotion in Police Officers
Santre, S. (2024) · Health Psychology Research · doi:10.52965/001c.93904 · Cited by 63
Mutamba, B. B., Kane, J. C., de Jong, J. T. V. M., Okello, J., Musisi, S., & Kohrt, B. A. (2018) · Psychological Medicine · doi:10.1017/s0033291718000193 · Cited by 50
“The implementation of evidence-based interventions for mental, neurological and substance use (MNS) disorders can reduce the substantial treatment gap in low- and middle-income countries (LMICs), where up to 90% of those in need do not have access to mental health services (Whiteford et al. 2013; Wainberg et al. 2017)…”
Propelling the Global Advancement of School Mental Health
Weist, M. D., Hoover, S., Daly, B. P., Short, K. H., & Bruns, E. J. (2023) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-023-00434-7 · Cited by 65
“Factors such as stigma, shortages of qualified mental health professionals, and fragmented service delivery models contribute to the current mental health treatment gap (Wainberg et al., 2017).”
BackgroundZhang, X., Li, Y., Wang, J., Mao, F., Wu, L., Huang, Y., Sun, J., & Cao, F. (2023) · Journal of Medical Internet Research · doi:10.2196/41298 · Cited by 53
“The shortage of mental health services is a major challenge in mental health care in low-and middle-income countries [39].”
Customizing Emotional Support: How Do Individuals Construct and Interact With LLM-Powered Chatbots
Zheng, X., Li, Z., Gui, X., & Luo, Y. (2025) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3706598.3713453 · Cited by 74
“However, not everyone can access such tailored professional care due to financial, time, and location constraints [12, 67, 93].”
Zhang, Z., Li, N., Chen, R., Lee, T., Gao, Y.-X., Yuan, Z., Nie, Y., & Sun, T. (2021) · Neurobiology of Stress · doi:10.1016/j.ynstr.2021.100333 · Cited by 51
“Then we used the Ribosomal Database Program (RDP) classifier 2.2 for ASV taxonomy classification (Wang et al., 2007).”
InfluentialDing, K., Wang, S., Xu, W., Lin, L., Liao, D., Chen, H., Tan, W., Huang, J., Hou, C., & Jia, F. (2022) · Asia-Pacific Psychiatry · doi:10.1111/appy.12520 · Cited by 47
“Individuals with lower mental health awareness may be more inclined to seek general medical care rather than specialized mental health care (Wainberg et al., 2017).”
BackgroundUsing network analysis to identify central symptoms of college students' mental health
Ma, S., Yang, J., Xu, J., Zhang, N., Kang, L., Wang, P., Wang, W. J., Yang, B. X., Li, R., Xiang, D., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.05.065 · Cited by 52
Supporting youth mental health with arts-based strategies: a global perspective
Golden, T. L., Ordway, R. W., Magsamen, S. H., Mohanty, A., Chen, Y., & Ng, T. W. C. (2024) · BMC Medicine · doi:10.1186/s12916-023-03226-6 · Cited by 73
“Despite the extent of this crisis, major gaps persist in the resources needed to investigate and address youth mental health, including shortages of mental health professionals [18–20].”
BackgroundHook, K., & Bogdanov, S. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100182 · Cited by 45
“Second, a main difficulty in mental health research often revolves around financing, particularly achieving and sustaining funding [2].”
BackgroundInfluentialAccess to mental health for Black youths in Alberta
Salami, B. O., Denga, B., Taylor, R. L., Ajayi, N., Jackson, M., Asefaw, M., & Salma, J. (2021) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.41.9.01 · Cited by 59
“36 Our data analysis encompassed several steps: (1) familiarizing ourselves with data through repeated readings of the transcripts; (2) generating initial codes; (3) searching for themes based on identified codes; (4) reviewing, expanding and refin ing identified themes; (5) defining and nam ing the themes; and (6)…”
MethodThe clinical impact of pharmacist services on mental health collaborative teams: A systematic review
Davis, B., Qian, J., Ngorsuraches, S., Jeminiwa, R., & Garza, K. (2020) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2020.05.006 · Cited by 31
“Inclusion criteria were as follows: (1) pharmacists were included on mental health collaborative team defined as two or more health care providers working together to provide mental health care to patients, (2) mental health clinical outcomes were measured with a validated tool, and (3) the article was written in Engl…”
Malta, M., de Jesus, J. G., LeGrand, S., Seixas, M., Benevides, B., Silva, M. D. D., Lana, J. S., Huynh, H. V., Belden, C. M., & Whetten, K. (2020) · Global Public Health · doi:10.1080/17441692.2020.1767676 · Cited by 53
Greene, M. C., Huang, T. T. ‐., Giusto, A. M., Lovero, K. L., Stockton, M. A., Shelton, R. C., dos Santos, P., Saúte, F., & Wainberg, M. L. (2021) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000306 · Cited by 41
Self-citationKruk, M. E., Kapoor, N. R., Lewis, T. P., Arsenault, C., Boutsikari, E. C., Breda, J., Carai, S., Croke, K. G., Dayalu, R., Fink, G., et al. (2023) · The Lancet Global Health · doi:10.1016/s2214-109x(23)00499-0 · Cited by 45
Nature-based interventions for vulnerable youth: a scoping review
Overbey, T. A., Diekmann, F., & Lekies, K. S. (2021) · International Journal of Environmental Health Research · doi:10.1080/09603123.2021.1998390 · Cited by 45
“…disciplines can increase the potential for collaborative research efforts and help build capacity of residential and community-based programs to implement research studies, disseminate findings, and add to the evidence base (Cunningham et al. 2015; Thompson et al. 2017; Wainberg et al. 2017).”
BackgroundIslam, M. I., Yunus, F. M., Isha, S. N., Kabir, E., Khanam, R., & Martiniuk, A. L. C. (2022) · Scientific Reports · doi:10.1038/s41598-022-09352-0 · Cited by 39
Tabbaa, L., Ang, C. S., Siriaraya, P., She, W. J., & Prigerson, H. G. (2020) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2020.1848161 · Cited by 41
“Although there is abundance of empirical evidence supporting the efficacy of therapies, many people, for a variety of reasons (i.e. due to stigma, lack of access), do not pursue them, and for those who do, adherence is often low (Marrero et al., 2020; Wainberg et al., 2017).”
BackgroundThe Economics of Treatment for Depression
Stecher, C. D., Cloonan, S., & Domino, M. E. (2023) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-061022-040533 · Cited by 43
Pharmacogenomic Biomarkers and Their Applications in Psychiatry
Kam, H., & Jeong, H. (2020) · Genes · doi:10.3390/genes11121445 · Cited by 37
“The World Health Organization (WHO) estimates that about 25% of the population around the world will suffer from at least one mental disorder at some time in their lives [1,2].”
BackgroundArnold, T. L., Haubrick, K. K., Klasko-Foster, L. B., Rogers, B. G., Barnett, A. P., Sanchez, N. A. R., Bertone, Z., & Gaudiano, B. A. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.05.005 · Cited by 41
Murwanashyaka, J. D. D., Ndagijimana, A., Biracyaza, E., Sunday, F. X., & Umugwaneza, M. (2022) · BMC Endocrine Disorders · doi:10.1186/s12902-022-01133-0 · Cited by 37
Wainberg, M. L., Gouveia, M. L., Stockton, M. A., Feliciano, P., Suleman, A., Mootz, J. J., Mello, M., Fiks Salem, A., Greene, M. C., Bezuidenhout, C., et al. (2021) · Evidence Based Mental Health · doi:10.1136/ebmental-2020-300199 · Cited by 33
Self-citationKraft, C. M., Morea, P., Teresi, B. B., Platts‐Mills, T. F., Blazer, N. L., Brice, J. H., & Strain, A. (2020) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2020.11.021 · Cited by 36
Uphoff, E., Purgato, M., Churchill, R. C., & Barbui, C. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013458 · Cited by 36
Understanding Mobile Health and Youth Mental Health: Scoping Review
Ding, X., Wuerth, K., Sakakibara, B., Schmidt, J., Parde, N., Holsti, L., & Barbic, S. (2023) · JMIR mHealth and uHealth · doi:10.2196/44951 · Cited by 30
“Mental health disorders are the leading cause of disability worldwide and are considered a global public health challenge [1,2].”
Cosh, S., McNeil, D. G., & Tully, P. J. (2020) · Qualitative Research in Sport Exercise and Health · doi:10.1080/2159676x.2020.1765852 · Cited by 45
Li, X., Jiang, T., Sun, X., Yong, X., Ma, X., & Liu, J. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.061 · Cited by 34
Source Free Semi-Supervised Transfer Learning for Diagnosis of Mental Disorders on fMRI Scans
Hu, Y. F., Huang, Z.-A., Liu, R., Xue, X., Sun, X., Song, L., & Tan, K. C. (2023) · IEEE Transactions on Pattern Analysis and Machine Intelligence · doi:10.1109/tpami.2023.3298332 · Cited by 34
“M ENTAL health problems, including autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), etc., have become a global concern and troubled over 17% of the adult population [1].”
BackgroundNeria, Y., Markowitz, J. C., Amsalem, D., Levi‐Belz, Y., Roe, D., Lurie, I., Bitan, D. T., Wainberg, M. L., & Mendlovic, S. (2025) · Israel Journal of Health Policy Research · doi:10.1186/s13584-025-00682-8 · Cited by 34
Self-citation
Metadata
- Authors
- Wainberg, M. L., Scorza, P., Shultz, J. M., Helpman, L., Mootz, J. J., Johnson, K. A., Neria, Y., Bradford, J.-M. E., Oquendo, M. A., & Arbuckle, M. R.
- Affiliations
- Columbia University Irving Medical Center (US)
- University of Miami (US)
- Corresponding author
- Wainberg, Milton L.
- ORCID
- Venue
- Current Psychiatry Reports
- Published
- 2017-04-19
- Volume
- 19
- Issue
- 5
- Pages
- 28-28
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- PMC
- PMC5553319
- OpenAlex
- W2606586703
- Cited by
- 875
- References
- 105
- Citations by year
- 2026: 117 · 2025: 179 · 2024: 148 · 2023: 138 · 2022: 111 · 2021: 71 · 2020: 73 · 2019: 24 · 2018: 11 · 2017: 1
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32MH096724)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- global mental health, mental health treatment gap, access to mental health care, mental health stigma, common mental disorders, severe mental illness, lay health workers, community mental health services, primary care, mental health prevention, implementation research, research capacity building, low- and middle-income countries, mental health policy
- MeSH terms
- Mental Disorders, Health Personnel, Humans, Mental Health, Mental Health Services, Public Health, Global Health
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