In reading Tina Rosenberg's commentary in The New York Times, entitled "A depression fighting strategy that could go viral," dated 12/04/14, I see that this is expansion to access for treatment needs to be much broader and bigger than simply equally physical health care. In poorer countries, there is no access to mental health care at all. For example, Rosenberg reports that Liberia and Sierra Leone each have only a single psychiatrist. One psychiatrist! For the entire country.
Thankfully, researchers are setting up solutions for this disturbing crisis. As Rosenberg writes, "Depression is the most important thief of productive life for women around the world, and the second-most important for men." Something much bigger than a single psychiatrist or a mental health parity act is needed.
To solve this problem, researchers are looking to short treatment education for a broad many. Those trained then implement treatment to people faced with major depressive disorder, post-partem depression, as well as anxiety. Specifically, college students and high school graduates trained for only two weeks in group interpersonal therapy successfully led groups for depressed women in Ugandan villages. At six months, only 6% of those treated still had major depression (Bolton et al., 2003). Similar work is being disseminated in South Asia and rural Pakistan. A more recent study in Goa, India had people with no health background attend an eight-week course in interpersonal psychotherapy to work alongside physicians to treat mental health disorders and it, too, was successful (Patel et al., 2010).
It is important to broaden access to mental health care in the United States, making it as much a given as treatment for a broken bone, high blood pressure, cancer, or an autoimmune disorder. It is even more imperative to make such treatment viable in countries that currently lack the resources. Researchers are training peers, those who number many AND get the culture and lifestyle and expectations of the patients' worlds. As Rosenberg aptly puts in her title: this strategy is meant to go viral.
Bolton, P., Bass, J., et al. (2003). Group interpersonal psychotherapy for depression in rural Uganda. Journal of the American Medical Association, 289, 3117-3124.
Patel, V., Weiss, H.A., et al. (2010). Effectiveness of an intervention led by lay health counsellors for depression and anxiety disorders in primary care in Goa, India (MANAS): A cluster randomized controlled trial. Lancet, 10, 61508-5.