Note: Guests of The Psychedelic Blog do not endorse, support, or otherwise advocate on behalf of any particular treatment approach for mental illnesses unless stated otherwise. The views expressed during this interview do not necessarily reflect the opinions or endorsement of The Psychedelic Blog. Readers should always consult with qualified healthcare professionals and conduct their own research before considering any treatment options. The blog and its authors are not responsible for any decisions made based on the information provided by the guests.
Interdependence - It was a few minutes before my call with Sarah Kline when I quickly jotted down the word, interdependence. Having just seen a quote online, I wanted to be sure to touch upon the idea of interdependence during our conversation. This is how Chief Seattle saw things:
"Humankind has not woven the web of life.
We are but one thread within it.
Whatever we do to the web,
we do to ourselves.
All things are bound together.
All things connect."
-Chief Seattle
Chief Seattle was a famous 19th century warrior and leader of the Suquamish and Duwamish tribes in North America. Clearly, he was a wise and important figure; I believed him. Even if there hadn’t been a large city named after him, I would still believe, in my heart, that he was absolutely right about all things being bound together.
The problem is that most of us have been conditioned and rewarded for our independence. Education about how things connect has been overshadowed. So, despite knowing that Chief Seattle spoke the truth, I’m likely to behave as if I’m the weaver of the web. Besides, how can anyone really wrap their head around the concept of everything being connected?
This tension between what I believe to be true and how I live my life in contrast to those beliefs—as well as the ways in which I justify the inconsistencies—is something Leon Festinger may have called, Cognitive Dissonance. One area of interest at The Psychedelic Blog is in spotlighting and explaining exactly how we are interdependent with all things. And, of course, we want to discuss ways to eliminate the need for cognitive dissonance by reinforcing, rather than ignoring, the connections that give us life. I'm Robert Benz. Let’s meet Sarah Kline.
Sarah Kline is the CEO of United for Global Mental Health, a UK-based global mental health charity that exists to advocate, campaign and fundraise for greater political and financial support for mental health around the world. Over the course of her career, she has developed and delivered successful national and international campaigns and initiatives aimed at governments, international institutions and political parties at the highest levels.
“Never has it been so urgent for the world to prioritize mental health.”
- Dr. Dévora Kestel, WHO
Robert: Sarah, above is a quote from Dr. Dévora Kestel, Director of the Department of Mental Health and Substance Abuse at the World Health Organization (WHO). In their June 2022 World Mental Health Report, the WHO said that:
· 1 in 8, or nearly one billion people worldwide, live with a mental health condition,
· 71% of people living with psychosis do not receive mental health services and,
· Only 2% of health budgets, on average, go toward mental health.
When reading this report and looking at statistics like these, one could objectively call what we´re experiencing at present a global mental health crisis. From the standpoint of mental health advocacy, does such a dire diagnosis of the field begin to create enough of a sense of urgency to help drive meaningful conversations and progress?
Sarah: That's a good question. I think the report reflects the scale of the challenge. If you characterize it as a crisis, it’s been a crisis for a long time. The number of people living with mental health conditions arguably has risen due to conflict and displacement as well as the impact of the Covid-19 pandemic. The fact is that many people have lived with mental health conditions that have not been reported and, generally, the issue has not been adequately financed for many years.
In terms of whether or not it creates a sense of urgency, I think the numbers do, in part, but what changed over the last few years, is COVID-19. This has generated a lot more awareness of people's mental ill health and more willingness by health ministers, in particular, to talk about it and to recognize the concerns that it caused amongst families and amongst communities. The conversations about mental ill health have grown, including at the WHO annual meeting, the World Health Assembly, but also domestically.
If you look at what's happened now, you’ll see there is change happening. We’ll come to the kinds of things that you've asked about, but the spending on mental health has not dramati-cally increased in many countries and the majority of funding, in fact, the overwhelming majority of funding, in a number of countries, is spent on one or two institutions to lock people up. This is not really an efficient or effective treatment and it's not always a humane one either. So, there are still quite a lot of factors that mean, yes, we're in a mental health crisis, but we've been there for a while.
Robert: Do better diagnoses give us a sense that there are more people living with mental health illnesses?
Sarah: Yes, I think that inevitably better diagnoses help and it gives greater insight. It also has to be coupled with changes in stigma and discrimination around mental health. So, even if you have a diagnosis or a suspicion that there is a diagnosis, people don’t necessarily want to acknowledge that diagnosis because of the stigma that surrounds mental health. So, it’s probably a combination of better diagnoses and more willingness to come forward and identify as someone with a mental health condition. And, on the part of mental health professionals, more willingness to see and identify people with a mental health condition.
Robert: Can you talk about some of the work your organization, United for Global Mental Health, has done to push for prioritizing mental health with legislators? Have you worked with legislators outside the United Kingdom?
Sarah: United for Global Mental Health was set up to increase political and financial support for mental health around the world and to uphold the rights of everyone to good mental health.
In terms of our work, we don't actually do much work at all in the UK. There are already lots of well set-up or well-resourced, relatively speaking, mental health organizations. Most of what we do is work with partners, particularly in the Global South—low-to-medium income countries (LMICs)—and helping them with their activities. In terms of legislation, yes, there have been significant changes in legislation in the last two to three years in a number of countries and we've helped support partners working there.
For example, suicide has been decriminalized in Pakistan, India, Guyana, Malaysia, and recently in Ghana. So, there is progress being made around legislation. We consider legislation and laws to be important. If it's not enshrined in law, that someone has the right to seek access to mental health care, or, conversely, if the law punishes someone for taking their own life or even considering taking their own life, then that means that there just aren't the services and the support that are needed and people will be dissuaded from coming forward to seek support.
Robert: Do the larger changes in the public sphere have more to do with legislation and legislators or are they also dependent upon public campaigns and organized advocacy?
Sarah: It’s a combination, a combination of public campaigns and then the political will, if you like, or the leadership of policymakers. Making a change such as decriminalizing suicide is quite a bold step forward for a country where it’s been illegal for the best part of a century or longer. It takes a combination of public campaigning with a dedicated supporter base, and other groups who have influence in that society. And, it does mean that you need legislators willing to challenge the status quo. That's been very important and sometimes that’s been the result of the legislator's own lived experience of maybe having lost a loved one to suicide and understanding that, by decriminalizing suicide, you can start to break down the stigma and discrimination and begin to encourage people to come forward before it’s too late.
Robert: And, I assume that changing a law related to suicide, for instance, requires some kind of negotiation or accommodation with churches and/or mosques to remain sensitive to religious beliefs?
Sarah: Yes, although historically, a lot of the countries where suicide is illegal are former British colonies. The laws are based on what are called the Lunacy Acts of the last century which were based on Christian beliefs that it was a sin to take one's life. The laws persisted in many countries as well as the UK for many years. Today, there is a lot less backing for such an approach and much more willingness and openness on the part of faith groups to acknowledge that mental ill health is something that requires support, understanding and compassion rather than punishment. And, that, frankly, threatening someone with punishment or jail for taking or attempting to take their own life is not an effective way to dissuade them from doing so. It only punishes them further and their family. So, yes, it partially has to do with religion and partly with history. Certainly, something that was long due for change.
Robert: You mentioned funding as a major challenge. Of course, funding is the fuel that mobilizes initiatives. When United for Global Mental Health helps a civil society organization or a nation to develop a campaign or raise funds for a specific initiative, how do you ensure that the funds will be appropriated in a way that is in line with the vision of your organization? And, are there mechanisms in place for accountability?
Sarah: Yes. United for Global Mental Health is a small charity. The money that we provide to partners is very specifically for particular activities. For instance, there were some funds given to a partner who was working with religious groups across Indonesia to get them to come together to take action on mental health. Or, funding for partners in Pakistan working to try and better integrate mental health into health systems. So, they’re relatively small but catalytic sums of funding.
The largest sources of funding are not from us, it’s us persuading big funders to change what they fund. So, for example, we’ve done a lot of work with The Global Fund to Fight AIDS, Tuberculosis and Malaria to persuade them to change their policy so that they actually fund work to support people at risk or living with HIV or TB. If you do that, you can reduce the numbers of deaths from those illnesses. For TB, you can reduce by as much as about 14 million the numbers of cases by 2030. So, we look to persuade global funders that are already working to support people's physical health to now include people's mental health too. And, they have a whole series of accountability mechanisms to make sure those funds are well spent.
Robert: I want to ask about two of your organization’s vision statements, one at a time:
First, ¨A world where everyone has access to the high-quality, rights-based services and support they need.¨
In practical terms is “high-quality” relative to where we are in the world? In other words, are expectations higher for a mental health facility in London, England versus Port au Prince, Haiti or is it part of the vision to one day standardize the level of mental health services everywhere?
Sarah: I think it would be wrong to assume that people from a low-to-middle income country should settle for services that are anything less than what we would expect in a high income country.
In most cases, we are looking at ways that people don’t have to be in an institutional facility; full stop. Because they don’t need to be. There's a misconception that people need to be hospitalized. That's sometimes the case but rarely. What's more effective is to provide people support in their community and to surround them with others that care about them and can support them, rather than taking them away from the ones that love them. I think that, when we say quality, we mean qualified doctors, nurses, and mental health professionals. Quality means caring and compassionate people. It also means a relatively predictable nature of access to medication because you can't quickly come on and off a psychotropic drug when there are very often stockouts in-country. So, quality refers not simply to in-patient care. It's the whole approach to mental health which is too often being seen as a low priority, low status, stigmatized profession. You actually need the very most caring and most empathetic people to be a part of it.
"… it’s not as simple as restraining someone
or giving them a pill."
- Sarah Kline
Robert: You’re speaking about a holistic approach to mental health care.
Sarah: Yes, absolutely. When you look at what is effective in helping to support people’s mental health, it’s not as simple as restraining someone or giving them a pill. It’s a combination of lifestyle and the factors that surround them. It’s what we would call the Social Determinants of Mental Health. If you're living in poverty, if you are struggling with access to a job, to education; there are lots of reasons that people might experience a period of mental ill health throughout their lives, all of us do. Our mental health is on a spectrum between good and bad, all of us, just as it is for our physical health. The point being, some people may live with a health condition that requires ongoing treatment and support. It may be serious enough that it requires institutional care, but, in most cases, people should be able to live within their own communities and manage their mental health.
Robert: I imagine this next question partly has to do with that answer: When the vision statement mentions “rights-based services”, what do you mean by rights-based?
Sarah: In that case, we’re referring to human rights. It’s the idea of forcibly restraining people, forced treatment. There are cases of people being locked-up for many years and, frankly, don't need to be locked up. There are worse cases of people being chained, left naked or semi-clothed. There are various traditional beliefs which involve using harmful and hurtful practices that are completely unnecessary and have no merit in terms of therapeutic care. Some of it has to do with the most basic of human rights for dignity during treatment and some of it has to do with thinking about the right to parity between physical and mental health care. You should just as easily be able to have support for your mental health as you do your physical health. If you have a broken leg, you go somewhere and someone will treat it. If you are suffering depression, you should have somewhere to go and someone to help you.
Robert: Is diagnosis the biggest challenge in seeking parity between one’s physical and mental health care - whereas a broken leg could be more easily diagnosed than say depression or another similar mental illness?
Sarah: It depends. I think you´ll find that in most societies there is an acknowledgement of the difference between a usual period of highs and lows and something more serious. Actually, many cultures and societies have ways to acknowledge that. They don't always have ways to effectively treat it and there can be confusion sometimes around neurological conditions. For example, with epilepsy people can be concerned about if it may be spirits or related to other traditional beliefs. But it's not beyond the realm of possibility for doctors, nurses, and even community health workers to have the basic tools to be able to accurately diagnose at least basic mental health conditions and, obviously, to refer the most several serious cases. It should be perfectly possible for people to be correctly diagnosed and supported wherever they are.
Robert: Still on the subject of human rights related to mental health, how big of a debate is involuntary commitment?
Sarah: It is a fairly central debate, but it depends on the context. More typically, in high income countries, there’s been a move away from forced restraint and involuntary in-patient care. It’s changing and there’s more acknowledgement that it really is for extreme circumstances only and, most of the time, it should not be necessary. Really, all of the time, it should not be necessary.
In low-to-middle income countries there are still more practices along the lines of involuntary commitment and then there is also the outright abuse of human rights. For example, people are sent to so-called prayer camps that are supposedly using traditional beliefs in order to cure people with a mental illness. They are actually just locking people up without care and without basic human rights. That may mean little access to food, shelter or water. So, it is a very live issue and it's changing people's perceptions. I do think that some of it has to do with stigma. The idea that someone with a mental health condition is sub-human and shouldn't be treated as any other human being in terms of their human rights is just appalling. But it's taking time to change that opinion.
Robert Going back to the vision statements: “A world where mental health services are funded sustainably and where the financial burden does not fall disproportionately on the people who need those services.”
Can you talk briefly about how we can create a sustainably-funded system of mental health services?
Sarah: Yes, of course. What that statement refers to is the fact that, in most countries, high, middle, low income, all countries, people pay most of the cost of their mental health treatment themselves because there isn’t sufficient access to support them. Now, there are some rare exceptions, but, in many countries, that’s the case. To change that, there are a few things.
One is that mental health is not always included in the public health system or it’s not funded. As you referenced earlier, mental health spending is on average 2% of health budgets despite the enormous burden that the disease or, if you like, the morbidity and mortality, that it accounts for. Often, it's less than 1% of a health budget in a low-to-middle income country. And, most of that money will, perhaps, be spent on a mental health institution to, again, lock people up.
One of the ways to make it more sustainable is simply by redressing the imbalance within the health budget and acknowledging that, if you invest in mental health services and support, you can actually improve physical health outcomes. As I mentioned before, if you invest in people who are at risk of or are living with HIV or TB, you will reduce cases and deaths of both and you will help people live and thrive, particularly those in long care treatment.
The treatment for TB, for instance, is quite punishing on the body and the mind. Having mental health support really helps. It's the same if you were diagnosed with cancer. You would expect someone might need mental health support for coming to terms with the diagnosis of a severe illness and, by having that support, it will help them through the treatment and their post treatment survival. Those are very logical things to invest in. The first part of it is changing the proportion within the health budgets. The second is to look at health insurance and make sure that it covers, not just physical, but mental health conditions too.
Robert: Have insurance companies traditionally shied away from funding mental health coverage?
Sarah: Yes, and they’ve charged high premiums or they’ve excluded mental health conditions all together.
Robert If the financial burden falls disproportionately on the people who require services, does that generally mean that they will not seek help?
Sarah: Yes, it means they won’t seek help and/or they can become a burden on families when needing their help financially. But, yes, overwhelmingly it’s a disincentive for people seeking help.
Robert: Studies reveal a disturbing truth: worldwide, over 70% of young people and adults living with mental illness are left without access to crucial mental health care. The cause of this crisis lies not only in the insufficient funding of mental health budgets, resulting in a shortage of professionals and services, but also in the insidious grip of societal stigmas surrounding mental illness which we'll talk about.
Sarah, we’ve talked about some of the work your organization has done, but how do you make your cause stand out from others as the world faces potentially devastating climate change, real threats of more infectious diseases, and growing income inequality?
Sarah: In some ways, we take a different approach. It’s less about standing out than it is about being integrated within. For example, if you look at issues around poverty or inequality, people's mental health really suffers when they're living in poverty and when they don't have access to employment. We would argue that it's important to find simple ways to support people through hard times. Even if it’s peer-to-peer support, counseling, or self-help groups because they will suffer in terms of their mental health.
In the case of climate change, there is already a lot of evidence of climate anxiety amongst young people, in particular, about their futures and what that change will bring. But, also the impact on mental health from the weather related disasters that you see on the news: the fires, the floods, landslides and this need to help support people, all people really. Because we will be adapting our societies to rising temperatures and sea levels, to changes in the way that we farm and to changes in what we do for our work or employment. Mental health is there, in all of those things. It’s more a question of thinking about where we can add value and support people through difficult times across those issues.
"We would rather look at how mental health should be part of the solution
and not just the problem."
- Sarah Kline
Robert: Then all of these issues relate to crisis and crisis relates to increased mental health challenges.
Sarah: Exactly. If you look at something like Covid-19, it was an infectious disease, but it also led to a lot of mental ill health. People have needed support, whether it’s those suffering with long Covid, people who lost loved ones during the pandemic, or all those whose schooling was disrupted. Inevitably, just as everyone has physical health, everyone has mental health. It’s a factor in how we live our lives. We would rather look at how mental health should be part of the solution and not just the problem.
Robert: Can you describe briefly how deeply entrenched stigma and discrimination are around the world with respect to people living with mental disorders? Why is it so important to lessen their effects? And, what are your strategies to do so?
Sarah: Stigma and discrimination are a huge challenge. Last year, there was a study done of people living with mental health conditions from around the world called, The Lancet Commission on Ending Stigma and Discrimination in Mental Health. The study found that most people report that stigma is worse than the mental health condition itself because it makes them feel isolated from their families and from their community. People's perception of mental health can lead to a huge amount of prejudice. There are countries where you cannot vote, where you cannot necessarily get married, you cannot inherit money, and, as we discussed already, suicide is illegal; if you self-harm, or if you even consider self-harm, you could be subject to a fine and/or your loved ones could be bribed or asked to pay a fine. Stigma is a huge problem. Without accepting that we all have physical and mental health and that we all go through periods of good and bad mental health, it's very hard for people to live their full lives in society.
Robert Besides the challenge of the mental illness itself there's a different box that stigmas create around that person and that illness?
Sarah: Yes. And, you can have different kinds of stigma. You can have the stigma, obviously, that one experiences from other people. But there is also something called, self-stigma: feeling ashamed, feeling alone, feeling unable to talk about your mental health condition and not necessarily even understanding what’s happening to you and not willing to seek support because you're frightened. You think that's exactly why they will reject you. Those are often some of the more powerful and difficult areas of stigma to overcome - the experiences that people have within themselves.
Robert Do you have a strategy to reduce the effects of stigma?
Sarah: Yes. It’s more about how to stop stigma in the first place rather than reducing the effects, but I can talk about both. One of the things we´ve been doing is working with journalists in different countries. The media has a really powerful role to play. It can help educate and change people's attitudes. Of course, it can also entrench and reinforce unhelpful or even wrong attitudes and understandings too.
We have been organizing roundtables in Africa, Latin America, and globally, engaging with journalists to discuss their reporting on mental health. We explore the language they use, their understanding of mental health conditions, and how they can bring about positive change. We focus on identifying irresponsible reporting practices that may contribute to adverse outcomes, such as suicide, and promote responsible reporting that can support individuals, encouraging them to seek help rather than resorting to self-harm. It has been encouraging to find that journalists, in general, exhibit openness and receptiveness to these discussions. They express a genuine desire to act ethically, improve their understanding of mental health conditions, and report responsibly. The feedback we have received thus far has been overwhelmingly positive, reflecting a shared commitment to create meaningful impact in mental health reporting.
We’re working closely with the World Health Organization (WHO) as they revise their guidelines for reporting on suicide, aiming to provide valuable guidance to journalists. Additionally, the WHO has developed comprehensive resources and guidance for professionals, including documentary makers, to foster meaningful conversations about mental health and effectively engage with audiences on this topic. These efforts are designed to ensure that discussions around mental health are informed, sensitive, and impactful, while equipping professionals with the necessary tools to address the subject responsibly.
Robert: Do you happen to know if there has been a net positive or a net negative effect on Mental Health from social media?
Sarah: It’s a really interesting question. Of course, it’s going to differ a lot around the world, and it changes according to age groups. There have been a lot of different studies, but they would have been a subset of different populations. (Note: here is one example, The Impact of Social Media on Teens´ Mental Health from the University of Utah.) It's fair to say that the data is also changing over time.
I think that the social media companies have been encouraged strongly to change their own policies and practices so that they are much more aware of the information that people can find when searching for particular terms and how to make sure that people are being sign-posted to supportive information rather than the opposite. You've seen some of the bigger companies take a much more proactive role. In sign-posting, for example, to support or to promote helplines for people who are typing in words around suicide or self-harm. You’ve also seen people forming self-help groups or finding others online who may share the same diagnosis as them or some of the same conditions or factors that influence their mental health.
There are a lot of positive things that can happen online in terms of sharing information and being supportive. At the same time, there are cases of cyberbullying, which is a big issue, and of showing inappropriate imagery. And the wider issue of problematic use of the internet such as gambling or excessive social media use. There are lots of ways in which social media can whip up a storm of unpleasant and ill-judged comments and that can really affect people's mental health. So, I would say that it remains something that can be both for good and ill.
Robert: And, just going back to self-stigma for a moment. I imagine part of the process of self-stigmatizing is hearing something publicly, or seeing something especially on social media, then applying that to oneself. It may be seeing unattainable body models in the media and wondering why I can't have a body like that. Is that one way of how self-stigma works?
Sarah: Yes. I think body image is an important issue in the way you describe it. When I was referring to self-stigma it was more like: if you only see the negative commentary about a certain mental health condition, like schizophrenia, you won't want to necessarily acknowledge that you yourself are living with schizophrenia or want to talk to other people about it. There is a form of self-stigma where you don't want to open up about the condition or you don’t want to acknowledge that you even have the condition. Negative imagery on social media and negative commentary can have a variety of different impacts.
Robert: Tell us about the Global Mental Health Action Network.
Sarah: The Global Mental Health Action Network was set up by us and others to provide a way for advocates on mental health around the world to connect and just to work together to achieve change. It has a series of working groups. There are about 3,000 members from over 130 countries now. We just had our annual meeting. We met in Cape Town in South Africa. There were 150 people from 46 countries. We meet in virtual working groups every month and we also have a webinar series every month.
"Our membership network is the world’s leading advocacy network for better
global mental health"
- Global Mental Health Action Network
These are ways that people, from all different countries, can share what they're doing to support mental health. Maybe they're running a nonprofit or they're working in a government department or a big agency, like a United Nations agency. So, in these groups, we discuss what work they're doing; the projects that they're running; the people that they're working with; what they're seeing that works well; what they think is a challenge and whether they want to ask peers effectively for support. It was meant to create a community for the doers in mental health, the people that are actually doing the work. But it's also meant to help change policy and practice. As I mentioned earlier, the people who have managed to get suicide decriminalized in their countries, well, some of those people are now working with other advocates in other countries who are trying to do the same thing. Part of the Network is about providing support to one another and encouragement in the work you’re doing
Robert You´re the CEO of an organization trying to improve mental health outcomes worldwide. How did you get here?
Sarah: I’ve worked in international development, then global mental health for the best part of 25 years. Most recently, prior to this, I worked for the World Health Organization over a number of years. I was approached by someone who was interested in forming an organization looking at mental health around the world because, frankly, at a global level, in UN meetings or big events, mental health wasn't being discussed in a way that many physical health conditions were. Whether it was HIV or cancer or other sectors like clean water or better education, mental health just wasn’t there. It was something I’d worked on for some time, trying to bring issues up in a political agenda, make change happen. I’d worked on a number of those issues whether it was malaria or polio or, in the past, around wider health or education policy.
We formed United for Global Mental Health in 2017 and we launched in 2018. It is registered in the United Kingdom and the United States. It's been a huge pleasure to develop the organization with colleagues. I took over running it 3 years ago.
We've tried to build the capacity of people in different countries to push for and achieve change. That’s really what we do is we work to serve others. As I say, we walk the journey that they want to walk. It's been so inspiring to see, as I said, the progress that has been made in Indonesia, Pakistan, India, or in South Africa. And, to play a small part to support the people who are doing such important work, but also to help improve the enabling environment, whether that’s by changing the policy of the Global Fund or working with the UN Secretary General's office to encourage him to be an advocate for mental health. It's a very rewarding role and an inspiring place to be.
Robert: So, your personal experience within the mental health space was just basically seeing and identifying a need and wanting to do something about it?
Sarah: Yes. And, having worked on other issues in the same way, building a campaign or an initiative or a kind of wave of action. I´ve done that over the years on a variety of different issues for different organizations.
Of course, the other thing that influenced me, as it does many others, is my own lived experience of mental health. I live with bipolar and anxiety and have done so for many years. It’s not something I would have ever talked about in a professional context in the past, but, in this role, you’re given more permission to be your whole self. I think that’s really healthy and we've seen many more people come forward and say the same and share their mental health experiences, whether that’s their own or supporting a loved one or a family member or friend. It's not at all uncommon for people to have some kind of level of lived experience and that, of course, helps inform who we are and what we do as an organization and the people we work with.
Robert: Do you have any suggestions for what individuals can do to begin changing the dynamics of mental health care globally in terms of getting more help for more people who need it?
Sarah: In simple terms, in your own communities, I think it's about doing something like a mental health first aid training so that you’re better equipped to support someone who may be in need of care. That's something that you can quite easily find online. There are lots of organizations that offer it. Born this way foundation is one or the mental health first aid foundation in the UK. The first thing is feeling confident that, if someone approaches you individually, you can say and do the right thing and be supportive. And, not be afraid to talk to someone about their mental health. Nine times out of ten, it's simply being able to sit and talk to someone as a starting point and listen without judgment.
The second thing to be done is to think about the work that you’re doing and how it can link to others. As I said, mental health is not a stand-alone issue. If you’re working in education, there is a mental health component to that in, for example, social, emotional learning and in how children and adults develop. Thinking about your connection to your work, maybe about your workplace mental health policy, is a way in which that can be changed or improved. You can also encourage mental health first aid training at work.
On a global scale, it really depends. If you're already working in an international organization with international links, then encouraging conversations around mental health is always really important. And, being respectful of the fact that it's not always easy for people in other countries to talk about mental health, their own experiences or family members due to stigma. Still, it’s really helpful. The more we talk about mental health, the more we can break down stigma and improve mental health for all.
Finally, the thing that's really lacking is money and financial support. There is a wealth of support and money going into mental health philanthropy in the US. Very, very little, however, is going into funding for mental health around the world from philanthropies or international assistance. Looking at ways to direct more funding, more equitably around the world would be great. That’s a priority for us and we try to encourage that kind of support.
Robert: It has been a pleasure talking to you, Sarah. Thank you for the work you´re doing.
Sure enough, I forgot to even mention the word interdependence during our conversation. And, yet, it still felt as though the spirit of Chief Seattle was with us the whole time. Interdependence seems to be the major theme and emphasis in Sarah’s work. I think her focus on the idea that all things are connected and that we must depend upon each other bodes well for future efforts to improve mental health outcomes around the world.
Check out more resources below.
Learn more about the work of United for Global Mental Health: www.unitedgmh.org
Join the Global Mental Health Action Network: www.gmhan.org
World Health Organization - Comprehensive Mental Health Action Plan
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