Innovative strategies for closing the mental health treatment gap globally.
OBJECTIVE
In the field of global mental health, an enormous gap between what we know and what we do exists in the delivery of clinical care. Creative and effective strategies that surmount the barriers to provision of mental healthcare are essential to improve the lives of millions affected by mental illness. This article provides a review of three classes of innovative strategies currently being developed and implemented to diminish the mental health treatment gap globally.


RESULTS
This review provides recent evidence related to the feasibility of implementation and efficacy for the following three classes of innovation that show promise for building clinical capacity and expanding mental health coverage: integration of mental health services into primary care; expansion of human capacity through task sharing and training of nonspecialists; and innovative use of technological platforms to enhance access, cut costs, and reduce stigma.


CONCLUSIONS
The strategies outlined in this review hold great potential for enhancing mental health treatment services, and address some of the major barriers globally to accessing mental healthcare, such as scarcity of resources (infrastructure, capacity, and funding) and stigma. Despite much evidence supporting the efficacy of these models, thorough studies that test their feasibility, acceptability, utility, and effectiveness in various contexts, including low-income and middle-income countries, are required. Moreover, these innovations require social support and political will in order to be successfully implemented and scaled-up such that they have a meaningful impact on the burden of disease associated with mental illness worldwide.
aGlobal Mental Health Program, Columbia University, New York, New York, USA bDepartment of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil cInstitute of Neuroscience, University College Hospital Ibadan, Ibadan, Nigeria.
Tahilia J
TJ
Rebello
Andrea
A
Marques
Oye
O
Gureje
Kathleen M
KM
Pike
D014943:Global Health / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration / Q000592:standards*