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Global Mental Health: Five Areas for Value-Driven Training Innovation

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Abstract

Objective

In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training.

Methods

Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation.

Results

Priority values included humility, ethical awareness of power differentials, collaborative action, and “deep accountability” when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds.

Conclusions

Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.

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Acknowledgments

The authors are grateful to the participants of the 2015 Society for the Study of Psychiatry and Culture annual meeting workshop on training in global mental health (April 23–25, Providence, Rhode Island, USA). The authors thank Anvita Bhardwaj for her assistance with workshop transcription.

Author information

Authors and Affiliations

  1. Duke Global Health Institute, Duke University, Durham, NC, USA

    Brandon A. Kohrt

  2. Yale School of Medicine, New Haven, CT, USA

    Carla B. Marienfeld

  3. Yale University, New Haven, CT, USA

    Catherine Panter-Brick

  4. Center for Global Health, Massachusetts General Hospital, Boston, MA, USA

    Alexander C. Tsai

  5. Global Mental Health Program, Columbia University/New York State Psychiatric Institute, New York, NY, USA

    Milton L. Wainberg

Authors
  1. Brandon A. Kohrt
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  2. Carla B. Marienfeld
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  3. Catherine Panter-Brick
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  4. Alexander C. Tsai
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  5. Milton L. Wainberg
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Corresponding author

Correspondence to Brandon A. Kohrt.

Ethics declarations

Compliance with Ethical Standards

The study met criteria for institutional review board exemption.

Funding

The authors acknowledge salary support for Dr. Kohrt through K01MH104310 and Dr. Tsai through K23M096620.

Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Kohrt, B.A., Marienfeld, C.B., Panter-Brick, C. et al. Global Mental Health: Five Areas for Value-Driven Training Innovation. Acad Psychiatry 40, 650–658 (2016). https://doi.org/10.1007/s40596-016-0504-4

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  • DOI: https://doi.org/10.1007/s40596-016-0504-4

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