Judith Bass and Dixon Chibanda, co-Editors-in-Chief of Cambridge Prisms: Global Mental Health, say the time is ripe to “expand the umbrella” of what a mental health journal should be.

On a global basis, mental health is an issue almost unimaginable in its scale.

The World Health Organisation (WHO) recently estimated that some 300 million people suffer from depression worldwide, and that every 40 seconds someone commits suicide with causes including mental health afflictions, such as depression. Indeed, the WHO says that, among those aged 15 to 29, suicide is a ‘leading cause of death’ – and that the majority of these are in low- or middle-income countries.

Furthermore, the WHO reckons that depression and anxiety are costing the global economy an astonishing $1 trillion each year – not to mention, of course, the knock-on effect on the families, friends and communities of those afflicted.

It has long been recognised that depression has many causes: poverty, abuse, conflict, violence, isolation and loneliness among them. Generally speaking depression can be treated, and suicide averted, given the appropriate resources – but, worldwide, there are not enough trained psychiatrists and psychologists to do the job. In poorer states the situation is extreme; low-income countries have, on average, just 1.4 psychiatrists or psychologists per million of the population, according to World Bank definitions. As an example, in Zimbabwe in 2020 there were just 17 psychiatrists, with 13 practising in-country, for a population of some 15 million people – with the inevitable result that at least 90% of those requiring a psychiatric consultation do not receive it.

The Covid-19 pandemic has brought the issue into sharper focus than ever. Every country has seen the effects of the pandemic in terms of social, emotional and health issues, but the impacts have been most harsh for those living in socio-economically deprived communities – whether in lower-income countries or in deprived sections of the population in the West. Meanwhile, the importance of good mental health on a global scale has been recognised as an important pillar of the United Nations Sustainable Development Goals, with the WHO also acknowledging that “there can be no health or sustainable development without mental health”.

Global mental health

It is against this backdrop that in January 2023 Cambridge University Press launches Cambridge Prisms: Global Mental Health (GMH), a fully open-access journal publishing papers with a broad application of “the global point of view” of mental health issues. The field of global mental health – defined by the Editors-in-Chief and Senior Editors of Cambridge Prisms: Global Mental Health  as “population-oriented research that seeks to understand the etiology, prevention, promotion, and treatment of mental and behavioural health problems with a strong emphasis on ‘knowledge generation’ which is relevant, transferable and generalisable to different populations and settings” – is still emerging, reflecting a movement of advocacy and shared research driven by a need to close treatment gaps and disparities in care, access, and capacity.

Cambridge Prisms GMH seeks to cultivate and grow this emerging distinct discipline, and the new knowledge and paradigms that should come from it. The editors-in-chief – Professor Judith Bass of the Johns Hopkins Bloomberg School of Public Heath in Maryland, USA, and Dr Dixon Chibanda, Associate Professor at the Centre for Global Mental Health and founder of the Friendship Bench project in Zimbabwe – bring very different perspectives reflecting the diversity of the field and a necessity to make global mental health truly ‘global’ in nature.

Dixon is a psychiatrist with a public health background who transitioned to focus on public mental health. After the tragic loss of a patient who took her own life, in 2007 he founded the Friendship Bench Project – which involves training grandmothers in the basics of cognitive behavioural therapy (CBT) so that they can in turn provide therapy to their communities in the humble setting of a park bench. The project was launched with 14 grandmothers; today they number more than 1,000, who have delivered community health support to more than 250,000 people in the last two years, helping to narrow the care gap in Zimbabwe.

While Dixon’s local experiences have framed his views and ambitions, he is clear that more affluent countries are not immune to the global mental health challenge: “When it comes to mental health care, all countries seem to be resource-constrained. It is not unusual to wait for months to see a psychiatrist in many developed countries.”

Informing a generation

On his new role at Cambridge Prisms GMH, Dixon said: “It’s a great opportunity to promote research that seeks to narrow that care gap, and for me it’s an opportunity to learn about all the great innovations happening – particularly from low-resourced settings. I hope that I will be able to facilitate the publication of quality research carried out across the globe. A cross-disciplinary approach is needed but, also, we need to hear the voices of researchers from low-resourced settings, who have previously not had the opportunity to publish their work.”

Judy, who by her own admission entered the field of global mental health “before it existed”, also recognises that improving access to mental health services is a “crucial avenue to improving the lives of people”, and that a long-term plan for the needs of the population is essential. She is rightly proud of her track record in training the next generation of global mental health researchers and, like Dixon, believes that Cambridge Prisms GMH can help create a paradigm shift for the good. She concludes: “The journal articles will help inform policy makers and will help inform researchers on what really needs to still be answered. We are at a time in the field to really expand the umbrella in a journal of global mental health and it’s an exciting opportunity to help guide that expansion.” 

Cambridge Prisms Global Mental Health invites contributions from a range of disciplines, perspectives and voices in order to achieve its aim. Article processing charges will be waived for content submitted prior to September 30th 2023.