The newly founded Duke Center for Global Mental Health held its augural conference Tuesday, bringing together a diverse group of scholars, practitioners and community leaders to discuss pressing issues in the field.
The conference, titled Building a Global Mental Health Community: Research, Policy and Practice Across Disciplines, featured panel discussions, research symposia and a poster session with experts from various disciplines.
“This is an area overall in global health that has been long underserved and long understudied,” said Chris Beyrer, Gary Hock distinguished professor in global health and director of the Global Health Institute. “… The time really is now to bring mental health front and center in our global health efforts and in our efforts to ensure health equity.”
A community-based approach to care
A key focus of the panel discussion was the importance of developing community-centered models for mental health care.
Kathryn Whetten, professor in the Sanford School of Public Policy and director of the Center for Health Policy and Inequalities Research, shared her work training teachers and community health workers in Kenya to deliver trauma-informed care. Whetten found that once trained, these community members were able to deliver necessary mental health interventions with high “fidelity.”
She also stressed the importance of researchers knowing who the “informal leaders” of a community are when adapting successful models of care, noting that such insights could be applied to communities in the U.S.
Luke Smith, psychiatrist and executive director of El Futuro, a community-based nonprofit that aims to improve mental health care for the Latino community, highlighted the importance of providers staying connected to the communities they serve. He recalled his family’s concerns that he would lose touch with his roots while interning at the “esteemed” institutions of Duke and the University of North Carolina at Chapel Hill.
“You’re going to get too big for your britches, and you're going to go off to that training environment and become somebody who can't talk to your people anymore,” he said of their warning.
To remedy this, he emphasized how team meetings with diverse community members such as social workers and students can foster “cultural humility … [and] professional humility, where we're teaching people to step back and consider something fresh for the first time.”
Faculty, students and community partners were also invited to participate in the center’s research symposia and poster panels, which highlighted faculty research across a broad array of topics from refugee mental health to the detrimental influence political polarization has on mental well-being.
Professor of Romance Studies Deborah Jenson traced the roots of modern outpatient psychiatry and community-focused mental health efforts back to Haitian psychiatrist Louis Mars.
Building on this theme, Irene Felsman, assistant clinical professor in the School of Nursing, and Thakur Mishra, manager of the refugee wellness program at Church World Service, highlighted the success of storytelling as a therapeutic alternative for refugees. They explained that cultural stigmas and language barriers often prevent refugees from benefiting from typical western mental health interventions because they rely on unfamiliar language. As a result, refugees face difficulties accessing interpreters.
“They're not able to use interpreters, or [the interpreters are] not available, or they don't understand mental health counselors,” Felsman said.
Still speaking to the role of societal dynamics in providing effective mental health care, David Eagle, assistant research professor of global health, discussed his research on how political polarization affects the mental well-being of clergy members.
His analysis found that “political mismatch and conflict can lead to increased occupational stress, which in turn affects mental health.” Eagle emphasized the need to recognize political polarization as a social determinant of health, adding that understanding political dynamics in the workplace is “crucial, as they reflect broader societal trends that can influence mental health across various professions and different contexts.”
A new research effort
Although the Duke Center for Global Mental Health was established earlier this year, it does not mark the beginning of global mental health work at Duke. Instead, it’s a “renewed effort” to explore intersections between research, policy and practice and embrace creative collaborations within the global mental health field.
Eve Puffer, Pamela and Jack Egan associate professor of psychology and neuroscience and the center’s director, noted that the center now has “over 50 faculty affiliates,” a number that is continuing to grow.
“We don't just want the focus on academic research, but also on the practice and policy elements,” Puffer said. “… Duke is unique in the global mental health space because often global mental health is done in medical schools or schools of public health, and we have the opportunity to do it in this space where we have [the] Trinity [College of Arts & Sciences], we have the School of Medicine and people who build bridges all the time.”
Maeve Salm, clinical research coordinator at the center, highlighted the importance of “connecting researchers to policymakers” to ensure that tangible change results from the research.
“A lot of times, research is just published in academic journals, which is fabulous, but then [it] also doesn't often get implemented or into the hands of people who really need it,” she said.
Much of the center’s work thus far has been focused on investing in mental health research in low- and middle-income countries, which are often disproportionately impacted by factors such as economic instability, insufficient health care resources and climate change.
Salm shared that the center has an ongoing grant aiming to increase mental health research at partner sites in four East African countries, including Rwanda, Uganda, Kenya and Tanzania.
“We’ve started working on that to really support leading researchers who do global mental health research in those countries [to] collaborate with one another because oftentimes the way that funding is structured is usually high-income country to low-income country in terms of funding accessibility,” she said. “We want to support [them] funding-wise but have it be their ideas.”
Although the center is still in its early stages, Salm noted that there are already several projects lined up for the coming months, including research surrounding climate change and mental health, collaborations with Mental Health Innovation Network Asia Hub and most recently “a new Bass Connections project with a special call for supporting the Middle East … [through] emotional support for children of Palestine.”
In addition to fostering collaboration across different disciplines and communities, the center also aims to connect students from the undergraduate to postdoctoral level with faculty mentors.
“Global mental health has become a really hot topic … so we need more people to be trained up on different mental health practices [and] therapies,” Salm said. “… That can look like mentorship in terms of research methods, and it can also look like what folks call ‘capacity building’ — really like a shared, mutual knowledge generation around therapeutic practices [and] what's working well.”
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Rebecca Fan is a Trinity sophomore and a staff reporter for the news department.
Ananya Pinnamaneni is a Trinity first-year and a staff reporter for the news department.