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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]
In the citing paper
“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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Coping Strategies Among Spouses of Alcohol dependents at Gokarneswor, Kathmandu, Nepal
Pandey, S., & Shrestha, K. (2020) · JOURNAL OF MENTAL HEALTH AND CLINICAL PSYCHOLOGY · doi:10.29245/2578-2959/2019/1.1186 · Cited by 5
Evaluating the Performance of Community Mental Health Centers in Iran: Strengths and Challenges
Taban, M., Hajebi, A., Gholami, M., & Naserbakht, M. (2021) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.27.2.747.4 · Cited by 5
Gonzalez, R. N., Regmi, P., Aryal, N., & Akudjedu, T. N. (2021) · Journal of Manmohan Memorial Institute of Health Sciences · doi:10.3126/jmmihs.v7i1.43155 · Cited by 5
“It is responsible for the largest proportion of the burden of disease 25.”
Shami, M. O., Alqassim, A. Y., Khodari, B. H., Names, A. A., Shami, J. A., Alamer, A. A., Moafa, A. M. Q., Hakami, R. O., Almuhaysin, G. S., Shajry, R. M., et al. (2022) · Journal of Pharmaceutical Research International · doi:10.9734/jpri/2022/v34i40a36255 · Cited by 5
“Despite this, mental health disorders remain the leading cause of disability and a major public health concern around the globe due to rising in its prevailing, illness progression, and treatment challenges [2,3].”
BackgroundRibić, E., Sikira, H., Kulenović, A. D., Pemovska, T., Russo, M., Jovanović, N., Radojičić, T., Repišti, S., Milutinović, M., Blazevska, B., et al. (2022) · BJPsych Open · doi:10.1192/bjo.2022.539 · Cited by 5
Zbukvic, I., Nicholas, J., Hamilton, C., Manrique, P. C., Crlenjak, C., & Purcell, R. (2022) · Global Implementation Research and Applications · doi:10.1007/s43477-022-00058-z · Cited by 6
“Developing the capacity of systems that support youth mental health is a global priority, and countries across the world have focused on building workforces and services needed to achieve this (Wainberg et al., 2017).”
BackgroundKanagasabai, U., Franklin, P. C., Nuta, C. J., Cherue, A. K., Haq, H. A., Thompson, D. I., & Tubman, V. N. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001705 · Cited by 5
“The benefits of integrating mental health services into specialized services for non-communicable diseases has been demonstrated in HIV/AIDS care [24].”
BackgroundMental Health Nurses Overcoming Adversity: A Discursive Review
Cleary, M. L., West, S., & Hungerford, C. L. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2236698 · Cited by 5
“…into the ongoing professional development of all health workers, to promote the delivery of safe and high-quality mental health care worldwide (Wainberg et al., 2017); and to educate people and communities on the role and contribution of mental health nurses, to minimize the stigma still…”
BackgroundShe, X., Tong, L., Wang, H., Lan, L., Wang, M., Abbey, C., Singh, M. K., & Rozelle, S. (2023) · JAACAP Open · doi:10.1016/j.jaacop.2023.08.004 · Cited by 5
“58 In China, children face many systemic challenges, such as rapid urbanization with increased competition; loosening family structure; and widening urban-rural health inequities starting from perinatal care, to water and sanitation, to nutrition and education.”
Madden, E., Prior, K., Gückel, T., Bock, S. G., Bryant, Z., O’Dean, S., Nepal, S., Ward, C., & Thornton, L. K. (2023) · Journal of Health Communication · doi:10.1080/10810730.2023.2278617 · Cited by 5
“Despite the prevalence and impact of these disorders, research-to-practice gaps continue to slow the effective implementation of evidence-based practice and policy (Jorm & Malhi, 2013; Proctor et al., 2009; Wainberg et al., 2017; Wiltsey Stirman, Gutner, Langdon, & Graham, 2016).”
BackgroundAbbott, P., Nixon, G., Stanley, I., & D’Ambruoso, L. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1309649 · Cited by 7
Sangraula, M., Greene, M. C., Castellar, D., Hoz, J. C. F. D., Diaz, J., Meriño, V., Miller-Suchet, L., Cristobal, M., Coneo, A. M. C., Morales, L., et al. (2023) · Intervention · doi:10.4103/intv.intv_4_23 · Cited by 5
Self-citationSaleem, M., & Afzal, H. (2024) · International Conference on Engineering & Computing Technologies (ICECT) · doi:10.1109/icect61618.2024.10581373 · Cited by 5
“Throughout the world, mental health needs are quite high but there are scanty responses to them [42], [43], [44], [45]& [47].”
BackgroundBrooke‐Sumner, C., Sorsdahl, K. R., Lombard, C. J., Williams, P. P., & MYERS, B. J. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020539 · Cited by 5
Raghavan, V., Ramachandran, P., Mohan, G., Chandrasekaran, S., Paul, V., Pattabiraman, R., Mohan, M., Iyer, S. N., THARA, R., & Singh, S. P. (2020) · Early Intervention in Psychiatry · doi:10.1111/eip.12979 · Cited by 5
“The majority of individuals with psychotic disorders live in low and middle income (LMIC) countries, where resources are scarce and access to health care extremely limited (Rathod et al., 2017; Wainberg et al., 2017).”
BackgroundJiang, Z., Wang, J., Yu, X., Li, C., Shao, Y., & Wang, Z. (2020) · Medicine · doi:10.1097/md.0000000000022274 · Cited by 5
“According to estimates by Chisholm et al, anxiety and depression cost the world US$925 billion in productivity losses each year.([17])”
MethodZanardo, A. B. R., & Ventura, C. A. A. (2022) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.5638.3553 · Cited by 5
(2021) · ADIKTOLOGIE Journal · doi:10.35198/01-2021-004-0004 · Cited by 5
Pauley, A., Thatcher, E. C., Sarafian, J. T., Zadey, S., Shayo, F. M., Mmbaga, B. T., Sakita, F. M., Boshe, J., Vissoci, J. R. N., & Staton, C. A. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001900 · Cited by 4
A Resident-Based Telepsychiatry Supervision Pilot Program in Liberia
Katz, C. L., Washington, F. B., Sacco, M., & Schuetz‐Mueller, J. (2018) · Psychiatric Services · doi:10.1176/appi.ps.201800363 · Cited by 5
The Hippocratic account of Mental Health: Humors and Human Temperament
Tsagkaris, C., & Kalachanis, K. (2020) · Mental Health Global Challenges Journal · doi:10.32437/mhgcj.v3i1.83 · Cited by 5
“Rationalizing mental illness and establishing a trust between specialized healthcare practitioners and the public is a challenge that contemporary scientists face (Wainberg et al., 2017).”
BackgroundChildhood Behavioral and Mental Health Problems in JordanPreprint
Nasir, A. K., Nasir, L., & Masri, A. T. (2020) · medRxiv · doi:10.1101/2020.05.26.20113910 · Cited by 5
International REACH Forgiveness Intervention: A Multi-Site Randomized Controlled TrialPreprint
Ho, M. Y., Worthington, E. L., Cowden, R. G., Bechara, A. O., Chen, Z. J., Gunatirin, E. Y., Joynt, S., Khalanskyi, V. V., Korzhov, H., Kurniati, N. M. T., et al. (2023) · doi:10.31219/osf.io/8qzgw · Cited by 5
Essential Design Principles for a Family Digital Mental Health Intervention: A Delphi Study
Welsh, E. T., Cloud, Z. C. G., Boyd, J., & McIntosh, J. E. (2025) · Journal of Marital and Family Therapy · doi:10.1111/jmft.70045 · Cited by 4
Bridging the mental health gap in Chad: a call to action
Bedingar, E. K. N. (2025) · BMJ Global Health · doi:10.1136/bmjgh-2025-019878 · Cited by 4
Gurrieri, R., Russomanno, G., Gambini, M., Pescini, E., Sità, G., & Marazziti, D. (2025) · Psychiatry Research Communications · doi:10.1016/j.psycom.2025.100231 · Cited by 6
Strategies to Safeguard Mental Health Among Medical and Allied Health Trainees: A Narrative Review
Obeagu, E. I. (2025) · Advances in Medical Education and Practice · doi:10.2147/amep.s564964 · Cited by 4
Maran, P. L., Gabirondo, P., Vlaic, A., Alonzo-Castillo, T., Rojo, T., Zaldua, C., Vendrell-Serres, J., Ramos‐Quiroga, J. A., Braquehais, M. D., & Rodríguez‐Urrutia, A. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121563 · Cited by 4
Okesanya, O. J., Ogaya, J. B., Ahmed, M. M., Lamem, M. F. H., Kab, T., Elhadi, Y. A. M., Musa, S. S., Eshun, G., Oso, T. A., & Lucero‐Prisno, D. E. (2026) · Advances in Public Health · doi:10.1155/adph/3240636 · Cited by 4
The global outbreak of Oropouche virus: surveillance of global trends
Sharma, R., Sharma, K., Balusamy, B., Malviya, R., Sivasankaran, A., & Sundram, S. (2026) · Tropical Diseases Travel Medicine and Vaccines · doi:10.1186/s40794-026-00297-0 · Cited by 4
Fréel, S., Punski‐Hoogervorst, J. L., Hoeboer, C. M., Ruzek, J. I., Beardmore, L., Olff, M., & Javakhishvili, J. D. (2026) · BMJ Global Health · doi:10.1136/bmjgh-2025-022708 · Cited by 6
“6 36 Significant challenges also remain in MHPSS research and implementation in conflict settings, specifically surrounding evidence-based psychological interventions aimed at addressing stress and stress-related disorders in contexts of active armed conflict.”
Sarfraz, Z., Sarfraz, A., & Amin, S. Z. (2024) · Archives of Women s Mental Health · doi:10.1007/s00737-024-01428-2 · Cited by 4
“The difficulty of establishing follow-up with women may be particularly challenging in rural areas within LMICs (Wainberg et al. 2017).”
Therapeutic potential of transient receptor potential (TRP) channels in psychiatric disorders
Sharma, V., Sharma, P., & Singh, T. G. (2024) · Journal of Neural Transmission · doi:10.1007/s00702-024-02803-0 · Cited by 4
“Despite advances in medicine and psychotherapy, many patients still experience terrible symptoms and inadequate relief (Wainberg et al. 2017).”
Holmes, L., Fenta, T. B., Haile, A., Lith, L. M. V., Burgess, S., Vandermark, J., Babalola, S. O., Amare, H., Tilahun, A., Shattuck, D. C., et al. (2025) · Studies in Family Planning · doi:10.1111/sifp.70000 · Cited by 4
Mahjani, B., Kępińska, A. P., Smout, S., Cohen, L., Caballero, M., Buxbaum, J. D., & Grice, D. E. (2025) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20230383 · Cited by 4
Zhang, C. Q., Li, X., He, L., Xu, B., Wu, Y. T., He, J., Wang, W., & Lu, Z. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1617081 · Cited by 4
“The role of mental health resources in shaping KAP outcomes is poorly defined, and the generalizability of existing findings is constrained by small, single-center samples (21, 22).”
Fulford, K. W. M., & van Staden, W. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-815063-4.00003-4 · Cited by 4
Frequency of Depression, Anxiety and Stress among Medical Students of Rawalpindi and Islamabad
Khattak, H. G., Arshad, H., Anwar, K., Taj, S., Iftikhar, M., Ilyas, S., & Ali, M. Q. (2022) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs22161061 · Cited by 4
Holliday, N. M., & Mulear, V. (2023) · Journal of Homosexuality · doi:10.1080/00918369.2023.2206935 · Cited by 4
“There are additional physical health disparities for LGBTQ+ people, including increased risk of physical violence, lack of access to culturally competent healthcare providers, and increased burden of HIV (Institute of Medicine, 2011; Madrigal-Borloz, 2019; Rowe et al., 2017; Wainberg et al., 2017).”
BackgroundFour Steps to Add Critical Thinking to the Mental Health Nursing Toolkit
Cleary, M. L., West, S., & Hungerford, C. L. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2212813 · Cited by 4
“…all the headway that has been made in mental health care over recent times, mental health systems continue to be ill-equipped to respond to consumers’ needs (World Health Organisation, 2022) and based more on the needs of providers rather than consumers (Wainberg et al., 2017; van Os et al., 2019).”
BackgroundClimate change-related mass migration requires health system resilience
Clark‐Ginsberg, A., & Chandra, A. (2023) · Environmental Research Health · doi:10.1088/2752-5309/ace5ca · Cited by 5
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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