Developing Countries Offer Lessons in Treating Depression, Says Teachers College’s Lena Verdeli

The Santiago Center teamed up with the Millennial Institute for Depression and Personality Research (MIDAP) and Universidad Católica’s  office of the Vice-Provost for Research to organize four major conferences featuring Columbia University experts focusing on Global Mental Health Topics. The series was inaugurated in early July by Lena Verdeli, Founder and Director of the Global Mental Health Lab and Associate Professor of Clinical Psychology at Teachers College.

In her presentation, Verdeli spoke about how the focus on community and building support in group psychotherapy may explain the much higher rates of response in treating depressed patients in developing countries when compared to more developed countries.

“These are often collective societies where it is difficult for people to think of self, so we needed to change the focus to inter-personal relationships when considering treatment,” she said during the “New Trends and Challenges in Global Mental Health” master class.

The psychologist came to this conclusion after adapting and testing Interpersonal Psychotherapy (IPT) to treat depressed adults in war-torn Uganda at the turn of the century, when it also faced an AIDS epidemic. Similar treatment was further developed in countries such as India, Haiti and Lebanon.

Other take-aways from her experience include:

• The importance of IPT treatment delivered in community - not in a clinic, where treatment could be stigmatized – and sanctioned by village leaders and traditional healers.
• The need to involve group facilitators including local mental health providers and lay community members such as primary care staff and community health workers.
• The value in defining locally what “depression” means and emphasizing that it is common and very impairing.
• The requisite to provide specific structure and duration of the therapy.

Mental health treatment can also be linked to the UN Sustainable Development Goals, such as in the case of IPT treatment for maternal depression in lowering child malnutrition and stunting by as much as 27%, Verdeli noted, adding that mental health also provides a return on investment: every US$1 in treating depression and anxiety leads to a US$4 return in better health and ability to work.

To open the event, Pedro Bouchon, Vice-provost of research at Universidad Católica, highlighted the urge for global mental health as there are 300 million people diagnosed with depression throughout the world. In Chile, 6.2% of the population is diagnosed with an advanced state of depression but of that, only 20% can access medical treatment; while suicide is the second cause of death in Chilean youth aged 15-29 years, he pointed out.

In turn, MIDAP Director Juan Pablo Jiménez, calling depression “a complex phenomenon and a non-homogenous illness,” called for further inter-disciplinary studies to address its complexity and for its intervention.