Last September twenty students from around the world enrolled in the first Global Mental Health (GMH) MSc, a Master’s-level course taught jointly by the London School of Hygiene and Tropical Medicine and King’s College Institute of Psychiatry. For the first few weeks, our visiting lecturers would begin their talks with a show of hands, trying to figure out their audience.
“Who here is a psychiatrist or psychologist? A general nurse or doctor? Anyone from neuroscience? Social studies? Who am I missing?”
There was always someone missing. The American NGO worker who specializes in malaria in Ethiopia. The British history graduate who had worked in community residential facilities for mental health outpatients in London. A classmate and I would usually raise our hands at “social studies” and squeak, “Anthropology? Geography?” This was not going to be easy.
Global mental health is a new field, and the MSc is a very new program. No one quite knew what to expect from our hodgepodge assembly of students. Group-work activities dredged up examples from Mexico, France, Spain, Finland, Sweden, South Korea, Malaysia, Trinidad, Nigeria. Clinical and human rights perspectives bumped up against public health approaches and invocations of medical imperialism. Ongoing critiques of global mental health as a field, as well as divisions within the field, were reenacted as we responded to our lecturers and to one another, drawing on diverse experiences and expertise.
What was remarkable, however, was what happened when the day’s lectures were over. Classroom debates were carried out to London’s pubs or into the homes of classmates over potluck dinners. Articles were circulated over email or posted to the GMH Facebook. Students gave lunchtime lectures on positive psychology and clinical diagnostic procedures—not for credit, just for the fun of it.
This may seem like a rather saccharine storyline, one of those touchy-feely narratives that admissions officers like to tell about universities as meeting grounds for people from different cultures and backgrounds to exchange ideas. But for global mental health, this is a notable achievement.
A recent conference at the Royal Society of Medicine entitled “The World in Denial? Global Mental Health Matters” ended with an urgent appeal against discord. In the final panel discussion, Dr. Matthew Muijen, Europe’s Mental Health Program Manager at the WHO, sat poignantly between Dr. Derek Summerfield and Professor John Copeland as they reignited an earlier debate “for” and “against” global mental health. “What would a health minister say listening to this?” Muijen pleaded, asking what the future of our field will be if we can’t learn to work together across ideological and disciplinary boundaries, to present a clear message to policy-makers and the public about what global mental health is and what exactly is on our agenda.
In her closing remarks, Professor Sue Bailey from the Royal College of Psychiatrists offered the following advice to the panel: “Take it to the pub, gentlemen.”
I laughed, sitting among several classmates in the audience. GMHers take it to the pub. And the café, library, occasional movie or museum tour or birthday party. We don’t bring the same perspectives to the table and we don’t always agree, but some hopeful consensuses have emerged: a focus on human rights and equitable access to evidence-based care; a sensitivity to local context; and perhaps most importantly, an agreement that we can no longer waste valuable time, resources, and credibility on acrimonious “for” and “against” arguments when there is so much at stake.