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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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“Moreover, treatment challenges include overall access to providers and feasibility in treatment delivery, especially for psychotherapeutic options, and lack of treatment adherence (7).”
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“Moreover, mental disorders pose a major public health issue globally due to their high prevalence, complex causal factors, disease progression, and difficulties with management [2,3].”
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“However, mental health and human rights services have not been systematically integrated into the public health system and they have rarely been assessed for effectiveness [17]; one of the contributing factors here is the limited research capacity for such intervention research [18].”
A stepped care approach to mental health in Singapore: challenges and opportunities
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“Despite growing awareness and increasing demand for mental health support, service delivery often remains fragmented, hindered by enduring stigma, and constrained by manpower and financial resources [3, 4].”
Zeeshan, M., Hu, J., Mao, C., Danish, A., Xiong, Y., Irshad, M. S., Dao, V., & Liu, Z. (2025) · RSC Advances · doi:10.1039/d5ra04137f · Cited by 12
Are we missing the mark? Relationships of psychosocial issues to outcomes after injury
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“Psychiatric illness and substance-use disorders are a leading cause of disability in the United States and worldwide.([1,2]) In trauma patient populations, rates of psychiatric illnesses have reportedly reached as high as 45%.”
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Bobbili, S. J., Carrara, B. S., Fernandes, R. H. H., & Ventura, C. A. A. (2022) · Primary Health Care Research & Development · doi:10.1017/s1463423622000251 · Cited by 11
“This global burden of disease is exacerbated by the mental health treatment gap, where only a small portion of people affected by MISUP receive much needed treatment (Wainberg et al., 2017; Evens-Lacko et al., 2018).”
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Chronic environmental diseases: burdens, causes, and response
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“21 Compared with the status quo, an enhanced implementation package including champions and external supervision would be more cost-effective than champions alone in terms of cost per remission at 3 and 12 months.”
The Helping Hand in Ukraine: feasibility and potential impact
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“Stigma is an important issue in the global mental health community as it is a significant contributing factor to lack of access to mental health services (Wainberg et al., 2017).”
BackgroundResultTwelve-month outcomes of a destigmatizing theatrical intervention in rural Uganda
Lee, Y. J., Christ, R., Blackwell, S., Kazungu, R., Krause, A., Monnig, E., Ssekalo, I., Iheanacho, T., & Rosenheck, R. (2023) · Current Psychology · doi:10.1007/s12144-023-05427-x · Cited by 15
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“The mental health treatment gap is largest in low resourced settings where up to 90% do not receive evidence-based care [1, 2].”
BackgroundThe Role of AI Counselling in Journaling for Mental Health Improvement
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“Mental health concerns are a global challenge, affecting individuals across demographics and geographical locations [5].”
BackgroundGlobal magnitude and temporal trends of stroke attributable to lead exposure from 1990 to 2021
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“These interventions align with WHO’s Mental Health Gap Action Program (mhGAP-IG), which provides clinical recommendations for evidence-based treatment [24].”
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“The increasing need for accessible, affordable, and scalable mental health care cannot be satisfied by the existing approach, which relies on in-person consultations and treatments [4].”
Psychological Burden and Coping Strategies Among Pakistani Adults: A Cross-Sectional Survey Study
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“Mental health conditions are highly prevalent worldwide, yet often remain undiagnosed or undertreated, significantly impairing individuals’ quality of life (QoL) [32].”
Sustainability of AI-Assisted Mental Health Intervention: A Review of the Literature from 2020–2025
Carrasco, D. K. E., Alcántara, M. D. R. P., Várgas, C. G. A. P., Espino, B. M. S. C., Valdera, L. J. D., Cabrera, C. V., Carrasco, M. E., Valdera, A. K. D., & Córdova, L. M. A. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22091382 · Cited by 8
“[8,39,40,43] Resource Allocation and Sustainability: Significant financial and human resources are required for successful AI implementation.”
Faro, A., Tejada, J., & Al‐Delaimy, W. K. (2025) · JMIR Public Health and Surveillance · doi:10.2196/72591 · Cited by 13
“Even before the pandemic, high CMD prevalence underscored the need for tailored national and global strategies [1,10-12].”
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A Dual-Stage Pseudo-Labeling Method for the Diagnosis of Mental Disorder on MRI Scans
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“Their high prevalence gradually poses a huge pressure on the health center services [1], [2].”
BackgroundChild protection system involvement in children of incarcerated mothers: A linked data study
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“Given the increasing prevalence of mental health problems and the difficulties of therapeutic management, this problem constitutes a threat to global public health [3].”
BackgroundGenerating better implementation evidence to improve mental health care everywhere
Wainberg, M. L., Gouveia, L., & McKinnon, K. M. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00090-7 · Cited by 8
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“Due to the shortage of qualified mental health providers in many regions of the world, alternative treatment options are of great importance [9].”
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“18,33 Additionally, research designed to assess the neuropsychiatric effects of different ART regimens and algorithms that predict likelihood of ART discontinuation are required.”
The COVID-19 pandemic and pediatric mental health: advocating for improved access and recognition
Dalabih, A. R., Bennett, E., Javier, J. R., Shah, S. I., Raphael, J. L., Patel, M. S., Davis, J. W., Pursley, D. M., Cheng, T. L., Devaskar, S. U., et al. (2022) · Pediatric Research · doi:10.1038/s41390-022-01952-w · Cited by 8
“identified four priority areas to diminish the mental health treatment gap and to improve access to highquality mental health services globally: (1) diminishing mental health stigma, (2) building treatment and research capacity, (3) implementing prevention programs, and (4) establishing a sustainable scale-up of publi…”
Background
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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