1. The chair of the APA Caucus on Global Mental Health & Psychiatry discusses how mental health must now be understood globally due to increased globalization and the flow of information, goods, services, and people worldwide. 2. He argues that mental health issues are still often viewed in local and static terms rather than as global processes influenced by communities and cultures. The caucus aims to build bridges across medical specialties and perspectives to advance global mental health. 3. The caucus is entering its third year with over 300 members. It addresses the global aspects of psychiatry and aims to encourage cross-fertilization of ideas between stakeholders in global health.

1. 1
APA CAUCUS ON GLOBAL MENTAL HEALTH & PSYCHIATRY
MESSAGE FROM THE CHAIR – SEPTEMBER 2016
“Mental Health Goes Global:
The APA Caucus for Global Mental Health & Psychiatry”
By VINCENZO DI NICOLA, M.D., Ph.D.1
The “global village” was coined by Canadian media guru Marshall McLuhan in
the early 1960s to describe a new world where the entire globe interacts like a
village due to the instantaneous flow of information. “Global flows” was a concept
coined by the Rand Corporation soon after to describe the movement of goods and
services, finance, and people around the world. Since WWII, much of the world
created common markets and trading pacts, easing national borders and other
barriers. On top of the information revolution that produces the global village, we
are living with the economic revolution that produces globalization of trade.
Understanding epidemiologist Michael Marmot’s groundbreaking research on the
social determinants of health means that mental health must now be understood
globally.
Flows, speed, social vectors, globalization. And yet, we are still talking about
mental health in local and static terms, confining mental health to the margins.
Complex health problems are seen as entities rather processes, solutions are aimed
at individuals instead ofcommunities, andwe overvalue biological explanationsabout
1 Vincenzo Di Nicola, M.Phil., M.D., Ph.D., F.R.C.P.C, F.A.P.A., is a co-founder and chair
of the APA Caucus for Global Mental Health and Psychiatry, Past President of the APA
Quebec & Eastern Canada District Branch, Area 1 Representative to the APA
Assembly, and a Professor of Psychiatry at the University of Montreal Faculty of
Medicine.

2. 2
genes and brains and undervalue family, social, and cultural contexts for mental and
relational problems. It’s time, as the April 2016 conference sponsored by the World
Bank and the WHO, “Out of the Shadows: Making Mental Health a Global Priority,”
declared, “to move mental health from the margins to the mainstream of the global
development agenda.”
The APA caucus on Global Mental Health and Psychiatry (GMH&P), now
entering its third year, with over 300 APA members from around the world,
addresses the global aspects of our field, under the wing of the APA Council on
International Psychiatry. Proposed by a group of residents and early-career
psychiatrists under the mentorship of Eliot Sorel, MD, the caucus has organized two
meetings and symposia at the APA annual meetings, first in Toronto in 2015 and this
year in Atlanta. The first chair, Milton Wainberg, MD, was named by APA President
Jeffrey Lieberman in 2014, and the second chair, Eliot Sorel, MD, was elected by
caucus members. A symposium sponsored by the GMH&P Caucus was organized at
the Annual Meeting in Atlanta by Dr. Sorel on “The Surgeon General's Report on
Mental Health, Parity and Integrated Care,” featuring former Surgeon General David
Satcher, MD, PhD and Congressman Patrick Kennedy.
As a founding member and current caucus chair, I am pleased to share with
ourcaucusmembers my chosenthemeof “Bridges, Syntheses, and Cross-fertilizations”
for the year. GMH&P is necessarily interdisciplinary, needing to reach across many
other domains within health care and beyond. Bridges need to be built and reinforced
among medical specialties and research domains—epidemiology and public health,
administrative and international health, primary care and medical specialties, social
and cultural psychiatry, as well as family and community approaches for research,
training, and interventions. Syntheses of approaches are waiting to be made—just to
mention two in which I am involved: child psychiatry and GMH and family therapy
and GMH. In fact, at this early stage of the conceptualization and definition of this
emerging field, Dr. James Griffith’s question, “Where is the family in GMH?” may be
expanded and generalized to any specific concern, group, or approach. When I took

3. 3
the GMH course in refugee mental health at the Harvard Program in Refugee Trauma
(HPRT), one of the most important tools I acquired is the HPRT comprehensive
“octagon” of approaches, perspectives, and stakeholders. This encourages cross-
fertilizations and working groups with other stakeholders in global health, from
international and human rights law to policy makers to major funding sources for
health care and social services.
Forthcoming messages will address the origins of GMH, a review of the key
foundational textbooks edited by Eliot Sorel, 21st Century Global Mental Health
(2012), Samuel O. Okpaku, Essentials of Global Mental Health (2014), and Global
Mental Health: Principles and Practice by Vikram Patel, et al. (2014),as well as reports
on major conferences and members’ activities. We won’t neglect dissenting voices
and critiques of globalization, including American journalist Ethan Watters in his
Crazy Like Us (2010) and Briton China Mills in her scholarly volume, Decolonizing
Global Mental Health (2013). I warmly invite responses and contributions by GMH&P
caucus members.
Theodore Zeldin’s grand survey of human history closes with this delightful
aphorism: “I think of humanity as a family that has hardly met.” GMH&P invites us to
think of the many varieties of psychiatric disorders around the world as part of a
family of human suffering that we have only begun to address on a global scale.