Lifting the burden of mental health
TW Kambule-NSTF Award: Research and its outputs over the last 5-10 years
In South Africa, along with many other low and middle-income countries (LMI) around the world, there is a growing burden of mental illness. There is a need to find ways of addressing this burden and building solutions that create positive changes for the future. Professor Crick Lund has taken this need to heart, pioneering the development of policies and services designed to address mental health.
Developing policies
His scientific work has had a sig- nificant impact on the creation of norms for mental health services address the cycle of poverty. He has also played a part in the development of World Health Organisation (WHO) guidelines for mental health policy and services, as well as in identifying major social causes of mental illness in LMI countries.
New community-based care
“While I was doing my training as a clinical psychologist, I was struck by the way in which mental health services were organised,” says Professor Crick Lund, director of the Alan J Fisher Centre for Public Mental Health, department of psychiatry and mental health, University of Cape Town. “Communities with the most pressing mental health needs — those living in poverty with minimal resources — had the least access to mental healthcare.”
One of Lund’s first roles after qualifying was to become involved in a study to develop the first postapartheid norms for mental health services for the department of health. It was also when he became fascinated with developing new community-based models of care and the health systems and policies which could make them possible.
He then became i nvolved i n international work and has been inspired by innovations in primary mental healthcare in countries like Chile, India, Brazil, Pakistan and, more recently, Zimbabwe.
A vicious cycle
“Poverty, violence and inequality are major social determinants of mental health,” explains Lund. “Poverty and mental illness interact in a vicious cycle. People living in poverty have increased risk for a range of mental illnesses through