The world is caught in the grip of a mental health crisis. From rising climate anxiety in rich countries like the United States to intense trauma in conflict zones like Ukraine and Gaza (especially among children), psychological suffering has spread, and traditional healthcare services can't keep up. . This leaves tens of millions of people facing the risk of serious pathologies and suicide.
Today, more than 25% of the world's population report feelings of social isolation and loneliness, and more than 150,000 people Between 15 and 29 years old die by suicide every year. Climate change threatens to raise these devastating figures. As inform According to the American Psychiatric Association, climate change can “lead to job loss, force people to move, and affect social cohesion and community resources, all of which have consequences for mental health.” Likewise, contemplating climate change and its consequences for both “national security and individual well-being” can cause “significant distress.”
No group is safe. Young people fear for their future, older people grieve the destruction of the world of their childhood, and climate activists and scientists suffer emotional exhaustion and despair. And this is without considering the post-traumatic stress and depression experienced by those already affected by climate-related disasters, particularly in vulnerable developing economies.
Traditionally, a psychiatric patient begins individual therapy with a trained physician. But even the health systems of rich countries are not in a position to offer this type of services in the dimension that is needed: in the United States, more than 150 million people live in areas with a shortage of mental health professionals. In a few years, the country could lack some 31,100 psychiatrists.
Zimbabwe, a country of 16 million inhabitants, has only 13 psychiatrists and 20 clinical psychologists
The situation is even worse in poor and conflict-affected countries, where it is often very difficult to access traditional psychiatric interventions, if they exist at all. Let's consider my home country, Zimbabwe: despite being a country of 16 million inhabitants, it has barely 13 psychiatrists and 20 clinical psychologists.
The consequences of this shortage became more evident in 2019, when the cyclone Idai devastated parts of Zimbabwe. The storm's strong winds and heavy rains—and the massive flooding and landslides it unleashed—produced hundreds of deaths, displaced some 60,000 people and destroyed 50,000 homes. The cyclone also decimated unharvested crops, destroyed seed stocks and killed livestock, leaving people without food and livelihoods. All of this contributed to mental health problems, including post-traumatic stress disorder.
Barely a year later, things got much worse: the Covid-19 pandemic forced nationwide lockdowns that further undermined people's socioeconomic well-being. The resulting mental health problems far exceeded the health care system's ability to manage them.
But that doesn't mean Zimbabwe didn't have any options. The project Friendship Bankwhich I founded, trains community volunteers without any prior medical or mental health training to provide talk therapy from wooden benches in parks in the 10 provinces of the country. So far we have trained more than 2,000 grandmothers to provide advice to their local communities.
The program works. In 2016, a randomized clinical trial determined that patients with common mental disorders and indicators of depression who received counseling from Friendship Bank had a significant decrease in symptoms. Communities with access to Friendship Bank services also experienced improvements in other areas, from HIV results until maternal and child health. And the grandmothers who provide the therapy say they feel favored by a stronger sense of belonging and resilience.
Other countries with fewer resources have also come implementing new scalable models to provide low cost psychiatric care and high quality to communities where it did not previously exist. A pioneer in this matter is Sangath, an NGO based in the Indian state of Goa that trains ordinary people to provide psychological treatment, particularly in areas with little access to mental health services. Clinical trials have consistently shown that these “lay counselors” are effective in addressing a wide range of mental health disorders, from depression and anxiety to disorders related to alcohol consumption.
In the same way, StrongMinds trains “mental health facilitators” to provide free group therapy to low-income women and adolescents with depression in Uganda and Zambia. The organization reports a strong impact, especially with regard to the support communities affected by climate-related environmental disasters. And this impact is only going t
o grow: StrongMinds founder and CEO Sean Mayberry hopes the program will reach 335,000 people this year.
Western models of psychiatric care make too intensive use of resources that must be deployed around the world, particularly in Africa and South Asia, where rapidly growing populations and accelerating climate risks pose immense challenges. But well-designed community initiatives are effective, low-cost, and highly scalable. Beyond improving mental health and individual resilience, these programs strengthen community cohesion and foster collective problem-solving, which will become increasingly important as the climate crisis intensifies.
Addressing the global mental health crisis will indeed require greater commitment from the international community. The Special Initiative for Mental Health of the World Health Organization, which sought to offer greater access to mental health services in its six regions in the period 2019-2023, was a step in the right direction. But the program must continue and must be expanded. Meanwhile, local and national governments and philanthropies should embrace new local strategies that have demonstrated their ability to help communities cope with increasing risks to their lives, livelihoods and well-being.
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