The Global Health Research Center (GHRC) successfully convened the first “This is Global Health” symposium in Spring Semester 2025. Focusing on “Global Mental Health: Where We Are and Where We Are Going”, the event brought together global health experts, DKU faculty, students, and healthcare professionals from Kunshan to address critical mental health challenges. The conference invites three guests to share their insights and engage in discussions: Dr. Eve Puffer, Associate Professor and Founding Director of the Duke Center for Global Mental Health; Professor Xiaoshuiyuan, former head of the Public Mental Health Research Department at the Institute of Mental Health of the Second Xiangya Hospital at Central South University; and Dr. Rebecca Hock, Assistant Professor of Global Health, Duke Kunshan University.
The State of Global Mental Health: An Urgent Supply and Demand Crisis
In recent years, the issue of mental health has rapidly become an undeniable major challenge across the globe. Depression, anxiety, stress from trauma, and the negative impacts of social media are silently undermining the mental well-being of individuals worldwide.
Dr. Eve Puffer highlighted that one in eight people worldwide have a mental health disorder. She further emphasized that the shortage of mental health professionals has become a widespread issue, raising significant concerns. Even in high-income countries, the demand for mental health services far exceeds the available human resources, and this challenge is particularly acute in low-and middle-income countries.
In her discussion on addressing the treatment gap, Dr. Puffer highlighted various strategies such as task sharing and stepped care, alongside introducing the World Health Organization’s Mental Health Gap Action Program（mh GAP）, a global initiative aimed at bridging these gaps. Dr. Puffer introduced WHO interventions, such as Problem Management Plus （PM+） and Self-Help Plus （SH+）, and also stressed the importance of prevention and promotion over merely treating mental health issues. In addressing mental health challenges among adolescents and adults, interventions such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and problem-solving therapy are playing a pivotal role in delivering effective and accessible care. Dr. Puffer and her team are currently evaluating peer-delivered problem-solving therapy in Kenya with promising results.
Dr. Puffer is currently dedicated to exploring solutions for the prevention and treatment of mental health issues in resource-limited environments. Drawing on her project experiences in two lower-middle-income country settings—Kenya and the Myanmar-Thailand border—she notes the critical role that families play in mental health interventions, particularly in preventing and treating mental health problems among children and adolescents. Her team has developed the “Tuko Pamoja” intervention, aimed at strengthening family relationships to prevent mental health problems. On the Thailand-Myanmar border, she has worked with the Global Parenting Initiative to develop an entertainment education film that has reduced physical maltreatment. This approach has potential for scale-up throughout many communities. Overall, Dr. Puffer and colleagues are developing scalable mental health programs that integrate family systems, cognitive and behavioral approaches, and that are solution focused.
Rapid Social Development: China’s Mental Health Challenges Highlighted
Professor Shuiyuan Xiao reviewed the evolution of mental health services in China.This includes the enactment of mental health legislation, the implementation of mental health policies, and the establishment of a mental health service system. He pointed out that China has formed a grid-like mental health system supported by schools, enterprises, government agencies, and other institutions.
However, Prof. Xiao points out that despite advancements, China continues to face numerous challenges in the field of mental health. Issues such as uneven distribution of resources between urban and rural areas, as well as between eastern and western regions, a shortage of mental health professionals, and insufficient evaluation of mental health policy implementation, are all in urgent need of attention. While government agencies do provide economic support and care for individuals with mental disorders, the government’s focus remains on those with severe mental illness often overlooking common mental health issues such as depression, anxiety, and dementia. Moreover, initiatives for the prevention of mental disorders and the promotion of public mental health are still in their infancy.
Over the past 40 years, China has undergone profound transformations never seen before—an extremely rapid evolution in socio-economic, cultural, demographic structure, and epidemiological characteristics. Dr. Xiao observes, “Industrialization and urbanization have been double-edged swords. While driving economic prosperity and social progress, they have also brought about a range of social problems that cannot be ignored. The fabric of interpersonal relationships is tearing, the fast-paced lifestyle and the intense competitive pressures have weakened the emotional bonds between people. Furthermore, there is a pervasive anxiety over social status. Young people face enormous academic pressures, making their mental health a pressing concern.” Against this backdrop, the importance of public mental health is becoming increasingly evident.
Views on the future
During the panel discussion, speakers shared their insights and perspectives on global mental health, offering thoughtful reflections and future outlooks on the topic.
Rebecca S. Hock highlighted that the rich experience gained from the global public health movement against HIV/AIDS provides invaluable lessons and insights for effectively tackling current and potential future global health challenges, such as mental health. For example, the power of having people with lived experience be at the forefront of the movement. Significant progress has been made in encouraging young people to take a more active and leading role in various health issues.
The sustainability and scalability of mental health therapies remain two core enduring challenges in the field of mental health. Dr. Eve Puffer stated that her next goal is to explore and achieve the sustainability and scalability of mental health projects in resource-limited areas by integrating multi-dimensional strategies. These strategies involve integrating social resources, poverty alleviation interventions, and sustained family-centered mental health services, thereby aiming to improve the mental health status of residents in middle to lower-income countries and regions.
Professor Xiao Shuiyuan believes that mental health is a core element of people’s lives and is crucial for coping with changes, challenges, and uncertainties. Therefore, education about mental health during adolescence is more important than medical treatment after psychological health issues have arisen. He emphasized in his talk that mental health concerns not only the healthcare system but should also be the responsibility of the entire society. Moving forward, efforts should be made at the socio-structural level to actively address public mental health concerns.
By Zhangyang Pan & Wuyue Qian
