Global Mental Health
Mental Health is finally being recognized as a global health priority. In 2013, the World Health Assembly created a Mental Health Action Plan, and in 2015, mental health was added to the UN’s Sustainable Development Goals. These initiatives were borne out of the urgent need for improved strategies regarding mental health promotion and prevention of mental illness.
In many parts of the world, especially in low- and middle- income countries, people suffering from mental disorders are severely underserved and are more vulnerable to physical and psychological abuse. The Global Mental Health focus area of the CIHLMU was established to improve global mental health by fostering education and dialogue between the Global South and North, as well as between low-, middle-, and high-income countries. It firmly supports the belief that “there is no health without mental health.”
To tackle this paradigm, the CIHLMU organizes annual International Symposia on Global Mental Health and an annual Advanced Module in Global Mental Health. The CIHLMU also supports research in the field and will continue to strengthen ties between countries of all incomes levels and highlight the importance of thoughtful, sustainable, and effective strategies in global mental health.
Focus Area: Ethiopia
The Department of Psychiatry and Psychotherapy, LMU University Hospital, is involved in a range of activities in Ethiopia, particularly through a close partnership with Jimma University (JU) and the St. Paul´s Hospital Millenium Medical College Addis Ababa.
In 2019, Ethiopia, with a population of about 86 million, had only around 111 psychiatrists. Ethiopia is responding to this dire shortage by increasing funding and resources for mental health initiatives, although much work remains to be done. To support this mission, in 2009, JU with the support of CIHLMU, established a two-year Master’s program (MSc) in Integrated Clinical and Community Mental Health. In addition, the CIHLMU Global Mental Health Research Group of the LMU University Hospital has developed annual network gatherings across Ethiopia, bringing together alumni, local, and international health care workers to discuss challenges and exchange ideas.
Activities
Projects
In Ethiopian society, mental illness remains a highly stigmatized topic. Public awareness of mental health and knowledge about mental disorders is low, which contributes to persistent barriers for those seeking help. Research shows that educational anti-stigma interventions can effectively change attitudes, beliefs, and behaviors related to mental health—especially when targeted at young people. To address this, this project implemented stigma-reduction interventions in high schools across Addis Ababa, aiming to:
- raise awareness of mental health problems,
- reduce stigma,
- increase knowledge on mental health
- reduce barriers to seek help for youth.
In this project, we trained Ethiopian staff nurses and health extension workers to enhance their mental health literacy and reduce their stigma-related biases. These trained professionals then led school-based anti-stigma sessions by sharing support contacts, using informative presentations, discussions on mental health stigma, and facilitating direct exchanges with people who have lived experience of mental illness. An evaluation of the intervention’s impact among students in Addis Ababa showed positive outcomes, demonstrating the effectiveness of early, community-based stigma reduction efforts.
- Funding by CIHLMU network funds (grant to Prof. Eshetu Girma) (2021-2022)
- Project completed
Mental health problems are caused by an interplay among biological, psychological, social and environmental factors. Even-though most mental disorders typically occur during adolescence, treatment often begins several years later due to a lack of mental health policy and strategies, a limited number of professionals, financial limitations, research gaps, cultural beliefs towards mental health problems, stigma and discrimination.
Most seen conditions in child and adolescent psychiatry units in Ethiopia are developmental disorders (DDs) (e.g., intellectual disability, autism spectrum disorder, ADHD, cerebral palsy or developmental delay). Successful treatment of children with DD is hugely dependent on the engagement and well-being of their caregivers. Based on evidence that caregivers can learn skills to help their children develop, the World Health Organization (WHO) developed a caregivers skill training (CST).
This project is currently assessing the impact of WHO´s CST on caregivers’ burden and parent-child interaction among caregivers receiving CST at Saint Paul's Hospital Millennium Medical College SPHMMC in Addis Ababa.
- PhD project within the CIHLMU PhD program in Medical Research – International Health (Surafel Worku)
- Supported by a CIHLMU scholarship
In Ethiopia, many reports highlight the abandonment of patients with severe mental disorders, such as treatment-resistant depression, by their families and communities, forcing them to live on the streets where they are vulnerable to assault, alcohol, and drug abuse. Yet, there are significant gaps in the specialized treatment opportunities for such patients.
Repetitive transcranial magnetic stimulation (rTMS) has shown to be highly effective for treatment-resistant depression, as well as other mental health conditions (e.g., schizophrenia, obsessive compulsive disorder, substance use disorders, neurodevelopmental disorders). Moreover, it is a comparatively cost-effective treatment option that is independent from pharmaceutic trade issues.
St. Paul’s Hospital Millennium Medical College (SPHMMC) and the Department of Psychiatry and Psychotherapy at LMU University Hospital in cooperation with CIHLMU are establishing Ethiopia’s first nationwide unit for non-invasive brain stimulation in Addis Ababa. This will lay a strong foundation for the expansion and scaling up of workforce capacity with this promising treatment modality.
A core team of psychiatrists and nurses from SPHMMC will undergo specialized training in the application of rTMS for treatment-resistant depression at the Center for Non-invasive Brain Stimulation (CNBS) at LMU University Hospital. In addition, SPHMMC will be equipped with the necessary technical infrastracture.
- Cooperation Partners: St. Paul’s Hospital Millennium Medical College (Surafel Worku), Department of Psychiatry and Psychotherapy at LMU University Hospital (PD Dr. Andrea Jobst-Heel), Center for Non-invasive Brain Stimulation (CNBS) at LMU University Hospital (Prof. Frank Padberg, Dr. Gerrit Burkhardt)
- Funded by the Federal Ministry for Economic Cooperation and Development and the Else Kröner-Fresenius-Stiftung over GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit) – Funding line Klinikpartnerschaften Global (2025-2027)
This initiative, founded in respond to the current conflict situation in Ethiopia and supported by the Clinton Global Initiative, is a holistic approach for post-conflict recovery rooted in the One Health principle, which acknowledges the interconnectedness of people, animals, and the environment. The alliance consists of a experts from multiple organizations, including WeForest, Mekelle University, Permachive, Vivo International, and CIHLMU focus area Global Mental Health, to address these multifaceted challenges. The approach involves providing substantial support and training, focusing on agricultural inputs, mental health services (esp. Narrative Exposure Therapy), and sustainable practices.
Situated at the intersection of anthropology and medicine, this project aims to examine the impact of Indigenous healing practices on human–environment relationships in Northwest Amazonia. It follows the interdisciplinary One Health framework, describing the interconnections between humans, animals, and the environment, making it ideally suited to link with both anthropology and the sustainability discourse. The central focus of this project is on how Indigenous healing knowledge establishes "rules for living" that, in a "Western" sense, foster sustainability. This interdisciplinary and cross-faculty project between the Institute of Social and Cultural Anthropology at LMU (Prof. Eveline Dürr, Dr. Wolfgang Kapfhammer), Indigenous members of the Institute of Social Anthropology at the University of Manaus (UFAM), and the Global Mental Health Research Group of the LMU University Hospital innovatively merges the ethnological study of Indigenous cosmology with the case-based approach of medicine.
- Global Mental Health Research Group of the LMU University Hospital, Department of Psychiatry and Psychotherapy, as Advisory Cooperation Partner
- DFG grant to the Institute of Social and Cultural Anthropology, PI: Prof. Eveline Dürr (2024-2029)
- Cooperation partner/affiliated researcher: PD Dr. Andrea Jobst-Heel
As a result of decades of occupation, systemic violence, and recurring military escalations, children and adolescents in Gaza are experiencing an acute mental health crisis. The complete destruction of healthcare infrastructure and the lack of evidence-based, trauma-specific therapies in Gaza hinder the implementation of effective care services that are urgently needed to prevent ongoing cycles of violence and the intergenerational transmission of trauma which have severe public health consequences.
In a joint mission between the Institute for Interdisciplinary Conflict and Violence Research (Institut für interdisziplinäre Konflikt- und Gewaltforschung) - University of Bielefeld, Vivo International, HEAL Palestine, NET Institute and the Global Mental Health Research Group of the LMU University Hospital, Department of Psychiatry and Psychotherapy, in cooperation with CIHLMU, this project introduces a community-based Training of Trainers (ToT) model for the provision of improved and specialized outpatient care for traumatized children and adolescents in Gaza.
The project will implement and deliver a systematic population screening and evidence-based trauma-focused treatment with Narrative Exposure Therapy (NET) for minors in regional outpatient service settings. Herewith, this project aims to build an evidence-based hub for holistic trauma treatment and research for Palestinian communities and crisis response in settings of ongoing conflict.
- Cooperation project with the Institute for Interdisciplinary Conflict and Violence Research (Institut für interdisziplinäre Konflikt- und Gewaltforschung) - University of Bielefeld, Prof. Tobias Hecker (Leading Institution)
- Funding by HEAL Palestine
- Grant and PI Munich: Dr. Tarek Jebrini
Team
