Global Mental Health in the Wake of a Pandemic

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hello everyone thank you so much for joining us for another edition of roads ahead which is our series on thought leadership from the rhodes community where today i'm going to be leading a discussion on mental health and its relation to the covet 19 pandemic my name is vidal arroyo california university 2019 and i'm a current rhodes scholar at oxford where i'm completing a master's degree in statistics i am also currently serving as the managing director for it gets brighter which is a global nonprofit organization focused on decreasing the stigma surrounding mental health issues in young adults today i'm thrilled to be joined by both doctors joshua chavin and victor bertel who i wanted to introduce briefly before we dive into our discussion dr joshua chavin ontario new college 2011 is an entrepreneur and psychologist passionate about building innovative technologies businesses and non-profit initiatives globally to meet the challenges in mental health care as a senior strategy manager for koa health he is currently helping to lead a collaborative effort with harvard medical school to build in power an open access digital platform designed to train up the world's mental health workforce he has previously worked as partnerships manager for mind strong health and as a research consultant for the canadian mental health association he has also been involved in a number of anti-stigmatization campaigns in canada has chaired the minder health campaign in oxford and his co-founder of the it gets brighter campaign which shares and collects video messages for young people struggling with mental health issues joshua completed a d fill in experimental experimental psychology at the university of oxford as about the rhodes scholar and a canadian centennial scholar and is an associate fellow at the evidence-based practice institute advisor to jack.org and an honorary senior research fellow uh research associate at ucl and then in addition to josh joining us we're also joined by dr vikram bertel who i also wanted to briefly introduce dr vikram patel indian and worchester 1987 is the pershing square professor of global health in the blavatnik institute's department of global health and social medicine at harvard medical school he is an adjunct professor at the public health foundation of india honorary professor at the london school of hygiene and tropical medicine where he co-founded the center for global mental health in 2008 and is a co-founder of sangath an indian ngo which won the macarthur foundation's international prize for creative and effective institutions in 2008 and the who public health champion of india award in 2016. he is a fellow of the uk's academy of medical sciences and has served on several who expert and government of india committees his work on the burden of mental health disorders their association with poverty and social disadvantage and the use of community community resources for the delivery of interventions for the prevention and treatment has been recognized by the chalmers medal royal society of tropical medicine and hygiene in the united kingdom the sarnot medal from the u.s national

academy of medicine an honorary doctor from georgetown university the partis humanitarian award from the brain and behavior research foundation an ordinary obe from the uk government and the posey behavior leadership award from austin college he also works in the areas of child development and adolescent health he was listed in times when magazine's 100 most influential persons of the year in 2015. welcome with josh and vikram i'm super excited to chat with you guys was there anything you guys wanted to add on that are you guys ready to dive straight into our conversation ready to dive right in thank you let's go let's go so i actually wanted to kick up the conversation talking about empower um which is an initiative that both you're involved in i i really wanted to get a large-scale picture of how and why did it get started and in particular i'm keen to hear how both of your paths have crossed um and how your prior work has influenced this initiative i'm particularly curious of this because both you come from different backgrounds and you know with vikram being more in academia and and josh you know your um background more and um in business and i'm just super curious to see you know what your guys's thoughts are on that um and to make it easy for all the questions moving forward josh if you want to answer first then victim you could follow up just so it's a bit more systematic sure i'm happy to go first and i want to say though that i'm still an academic at heart so i did my d fill in in experimental psychology and i still um it stayed true to my roots in most of what i do so everything like that that's fair thank you for that evidence-based and everything um and and so to your question vidal i i just i want to say that i was introduced to vikram back in 2018 by tom insole who's the former director of the national institute of mental health and also my former boss at mindstrong and tom told me that a hero of his was working on this really cool global mental health initiative and when a hero of yours as tom is for me wants to introduce you to a hero of his naturally i perked up a bit so tom sent me an early draft of vikram's concept note from power which at the time lacked a name but was focused on bringing together a range of technologies as part of a single digital solution to reduce the global suffering due to mental health conditions it was hugely ambitious but central to the proposal was the intention to use technology to train frontline carers to deliver effective psychological treatments and what i learned looking at victor vikram's work is that the proposal is built on decades worth of research that's shown you can train just about anyone to deliver mental health care and achieve achieve impressive clinical outcomes basically just as good as the outcomes as you might expect to achieve with specialist providers and as you know vidal through our work with it gets brighter i've spent an awful lot of time thinking about increasing awareness of mental health challenges and destigmatizing mental health issues but one of the consequences of raising awareness is you have to tackle with this take on this challenge which is once you create the demand once you've raised awareness what are you going to do about it where are you going to direct people and what i saw with vikram's proposal was a a partial solution to this demand issue so by helping to address the issue of limited providers we might be able to expand access to cara and the best i could tell at that stage no one else was doing anything like it so i was immediately sold on the vision and when vickerman and i finally met to discuss the concept i just wanted to know how i could help things move along and and i got sucked in immediately then we probably spent six months or so really refining the idea and putting together a more concise pitch which then was used to attract funding throughout 2019 and 2020. um phenomenal vikram what would you like to add on top of that well you know basically what i'd like to add is that i'm so glad that i've had the opportunity to work with people like josh um because as an academic it has always been one of my greatest frustrations to generate knowledge that is intended to have impact uh at a population level at scale but never actually does um you know the kinds of science that uh josh is alluding to is actually not just my work but the work of literally dozens of scientists around the world demonstrating exactly what josh described that brief psychological treatments when delivered by frontline providers who don't have any prior mental health professional training can i achieve clinical and social outcomes comparable to the best care you can receive from mental health professionals this evidence base is huge and actually even today almost nobody in most parts of the world actually benefits from this knowledge and it was very frustrating and i realized to be honest that a purely scientific approach to transform mental health care wasn't sufficient i needed to work with people who understood entrepreneurship or understood technology who understood business who understood the whole process of scale up which scientists don't have any clue about um and so i think this is empower is a good example in my for me anyway i'm learning all the time from people like josh uh how do scientists collaborate with private with business with technology sectors uh to learn how they've scaled up and apply this incredibly powerful knowledge uh so that far more people can benefit from it than typically what scientists actually traditionally have targeted you know i i you know my being i want to be an academic in the future i really resonate with that frustration with the just large amounts of knowledge we have that haven't been acted upon yet um and it sounds like empower is a really beautiful example of that happening in in the mental health space and you guys both hit on this a little bit but i wanted to flesh this out a bit more what do you think the unique contribution of empower of empowers and you know in the mental health space beyond acting upon this knowledge what ways has empowered been designed in order to really act upon that knowledge in a really unique way that's going to make a really direct impact in the lives of people so vikram touched on this a little bit for now but one of the biggest challenges in mental health care is limited access to quality affordable evidence-based treatments so in high-income countries that translates to around 40 to 50 percent of people with a diagnosable mental health condition going untreated and in lower middle income countries that number shoots up to nearly 90 in other words there's this colossal mental health treatment gap and this gap the gap between what people need and what current systems can deliver is so great that i believe and vikram believes and many in the space believe that only a revolution in access um a digital revolution can meaningfully address it so we believe that part of what's required to close this gap is the development and update of new technologies but in particular solutions that can help meet the excess in demand so this is where empower enters empower is seeking to close this gap by deploying a digital learning platform to rapidly train up a workforce of frontline providers to deliver evidence-based treatments in psychological or rather psychological treatments that are evidence-based in areas around the world especially those that are under-resourced and lack access to treatments currently just after that you know um i think you might wonder what's what's the what's the big deal here you know i mean online learning is as well especially in the last year has become routine here's here's the difference the difference is simply this every single project scientific project that is evaluated brief psychological treatments has done so in the old fashioned format of the expert in a classroom in a workshop with a very select number of providers who are then trained to deliver the intervention in the context of a for example a randomized control trial or a small scale pilot project and then the quality assurance is also done in exactly the same way the expert often a mental health professional often from a university background therefore completely non-scalable um is then does the quality assurance this is not the way the real world's ever going to work this is not the way you're ever going to scale up what is intended to be actually a low-cost intervention yet you've got this incredible high cost of the expert and the in person so what we're simply doing in empowerment it is a very simple idea and that's what makes it so beautiful the simplicity is the fact that we're using a well established platform of learning and supervision but applying it specifically to the mental health sector and then creating new methods on how you can take curricula and digitize them with a focus on competencies and then following this with well i think one of the other innovations that the global mental health sector has uh uh has developed is the idea of peer supervision which you say you don't need the expert if you have sufficient numbers of front-line workers who are competent they can supervise each other for quality assurance with the same degree of accuracy as an expert and so applying the twin ideas of digital learning and supervision with peer supervision as the modality for quality assurance and and bringing that together all together on a digital platform that's really beautiful you know um one of my favorite books reading in college was um called pedagogy of the oppressed by paulo freda and he talks about this idea of a student teacher where you know all of us are able to teach each other but also able to learn from one another and it sounds like you guys are really bringing that paradigm directly into the structure of how you guys have been designing power which is really really cool moving forward i'm curious of what are your guys's next steps within power so i think immediately we're finalizing the website hoping to get that over the next couple months and then aiming to launch our first training program by the summer um in parts of northern texas and also in madhya pradesh and india but in addition we're working to and this is a longer term vision of ours we're beginning to work with the well-being trust to think about how we can effectively scale up our work across the u.s so that means thinking about systems and what needs to change at all levels so policy healthcare regulation the level of the community and so on in order to enable empower to take group and maximize our impact and then in parallel to that work i've recently received funding from the from schmidt futures to think about how we can bring together some of the digital apps we're creating at a company i'm working for now koa health to support both empower trained providers and help manage burnout and also the individuals receiving care to provide a continuity of care and this is just a set one type of digital apps that could be used called foundations which supports general well-being and help helping individuals manage stress but vikram's initial vision actually involved bringing on board a whole variety of tools to provide that content continuity of care to the patient but also to uh to support the people who are effectively giving out that care um yeah maybe you know just just to amplify some of those points um first of all you know after the foundation skills which of course is a very important aspect of delivering psychological treatments these are these are not specific to any mental health issue there are actually foundational skills that are provided based skills to make sure that you can engage the individual who needs help uh and is then a foundation for the treatments the specific treatments for specific mental health conditions so soon after the foundational skills we're also hope we will be launching our brief treatment for depression which is of course the program of uh the psychological treatment that we developed that um uh that josh referred to earlier in parallel we're working with colleagues uh in university college london led by peter fonergy to develop the curriculum for a completely different kind of mental health intervention which is parenting interventions uh to promote the development of very young children which we now know is one of the most powerful preventative interventions that as well strengthens the cognitive capabilities of children and then young adults to actually withstand some of the stressors they will face as they grow older and therefore protect them from mental ill health we're also as josh mentioned the well-being trust exploring broader self-help mental health promotion curriculum so that's the first thing to say in our intervention selections we have three different kinds of interventions that we intend to develop and hopefully roll out by next year but the other thing that i'm sure some of your listeners must have caught and wondered about is he mentioned the us and india simultaneously and to me this is another really exciting thing about empower which is that we're not just doing work in one particular resource context we think every country has underperformed when it comes to mental health care all countries are developing actually when it comes to mental health and therefore the same solutions should be applied in every resource context obviously there'll be contextual adaptation but there's no reason for us to think that this is only a solution for for example an asian or an african country and finally i want to say one more thing that you know when the word digital mental health is used um a long time ago when you know the digital revolution began in mental health this is maybe even two decades ago the same barrier that empower is seeking to address was the barrier that that revolution sought to address and what was the barrier the lack of skill providers and in order to overcome that barrier what the first wave of digital mental health innovators focused on was taking psychological science-based interventions and transforming them into apps that people could use directly you didn't need a provider at all but we now know 20 years later that unfortunately that idea has not achieved great traction in most populations because it turns out that when most people are struggling with their mental health the last thing they want to do is to sit with their phone and figure out how to fix their minds if you give them an option of a provider who is trained to deliver psychological treatment then the apps become additional tools much like what i think josh spoke about it doesn't replace the provider it becomes an additional tool to strengthen the provider and that is what empowers seeking to do to build a provider base who can then use apps uh to actually support patient care um that's phenomenal i mean i think the idea of using technology to increase human interaction you know or surrounding these issues instead of decreasing it is hugely powerful and um you know your remark about you know india and u.s

you know implementing and power in parallel is actually a great segue to the next part of the conversation i want to take us because um you know we know that you know empowers doing really really exciting things in the mental health space we know that you know just as in large you know the last year um has been really tough for a lot of people in terms of mental health surrounding the pandemic and so i wanted to start off this conversation by just asking you both you know how has cove 19 impacted her mental health and why you know what is it about lockdowns and everything surrounding it that is that has really made it tough for us um you know with mental health yeah so vidal i think there's no one answer to that question since everyone is different and the pandemic has impacted us all in different ways so for some it says social upheaval it's the isolation that comes with lockdowns and physical distancing and if you're alone or living alone the impact of limited socialization it can be particularly severe for others it's the economic stress it's the impact of losing their job or being on furlough for an indefinite period of time and for yet others it may be the impact of having had the virus itself so what we're starting to see is that increased mental health issues may be linked to having had the virus with something like one in five who've contracted covet going on to develop a mental illness within 90 days and for many many it's just the ongoing uncertainty of everything that's taking a toll so the ways in which co-fed is impacting on our mental health is multifaceted but what it's meant is that many countries we're starting to see alarming rises in symptoms and presentation i'll just take the uk and u.s and maybe vikram can comment more globally but in the uk and us symptoms of anxiety and depressive disorders have gone up nearly threefold so we're talking about before the pandemic 11 of the population at any one time presenting with symptoms of anxiety or depressive disorders now it's over 30 and perhaps as high as 37 by some reports and things are particularly worrying among young adults where this number rises to an unbelievable level of something like 57 according to some um results that come out come out of the kaiser foundation reporting and there was even a new york times article recently that suggested nearly a quarter a quarter of young adults have seriously thought about suicide in the u.s but of course you might say well that's just symptoms it's not the same as meeting diagnostic criteria for a disorder but we're starting to see early indications that it's not just symptoms in the uk before covid we saw that 27 of young females young adult females met criteria and now we're seeing that this number has increased to something like 40 so all to say the situation is so dire and something needs to be done um to address this growing concern yeah well i want to just amplify the point about disparities you know i think um the picture of uh you know there's obviously variations across different countries on the impact that the pandemics had on people's mental health in large part because of course the pandemic itself has had hugely variable trajectories in different countries um so a single you know a you know time will tell us the extent to which the nature of the pandemic itself uh is correlated with the mental health uh a burden that you see in populations but what is for certain in all populations is that this impact has not been evenly distributed across the population and you know josh alluded to some of those disparities but i want to emphasize the most important one which is young people young people in almost every single context and population which has been studied have suffered disproportionately worse than any other age group in the u.s for example you can actually see a absolute correlation from each age segment to the next such that the youngest age segments have the highest rates of mental health difficulties and the oldest of the lowest which is completely contrary to to what you might have expected to some extent because you know we were told it's the elderly who are going to be suffering the most because of loneliness because of you know the need to be physically distanced and isolated and because they are the most risk group of the infection you see you know a complete inversion and i think that requires interrogation and maybe we can talk about that later but essentially young people the second big group particularly in developing countries is women because women of course have found themselves at home having now now to deal only with their remote work uh responsibilities but with their kids at home because schools are shot you know in very many patriarchal societies it isn't the case that them uh that that male partner will suddenly sort of jump up and say oh i'll share the domestic chores with you know so women have suddenly found themselves trapped at home doing multiple jobs and often also for unfortunately a very significant proportion of women facing uh you know violent husbands so the astonishing increase of gender-based violence in the pandemic which we know is a very significant risk factor for depression and substance abuse has and suicide um has grown and the final group is frontline workers and by frontline workers i don't only mean health workers i also mean those essential workers who have had to you know drive buses public buses public transportation we clean our streets they haven't had the luxury to go remote working and not only have that has that put them um at much higher risk of exposure to cobit and we can see the results of that in the britain for example in the us for example but of course the anxiety levels of going to work when everyone else is sitting at home uh obviously also will have an impact on their mental health so i think we must acknowledge that it isn't the wealthy the elite those of us who can complain about oh i'm missing my friends and you know doing remote learning who are the highest risk it's the young people it's women particularly low-income women and more generally low-income front-line workers who we should be most concerned about in terms of their mental health um yeah i actually i didn't know the scale of the disparities you know surrounding those three groups and um that's you know obviously incredibly concerning to hear about and you know i think it's hard you know when hearing those statistics you know at least for me personally because it's like you know you hear that on an abstract level but you wonder you know what can i do on the day to day to help those around me who may be showing with these issues it may fall into one or more of these groups and i actually want to ask you both you know that exact question you know what can we do in these times to help create you know some sort of ecosystems of support you know with those that are close to us even though you know we can't get together like normal and and etc so i think that what we can probably do is we can take time to check in with our friends and carve out some time to invest in more in those relationships so what what i've started to do in looking after my own mental health is reaching out to to folks that i i often don't reach out to because my life is so busy and making sure that i i carve some time over the weekend and outside of work hours to really wind down a bit and to take time out to invest in those relationships um i've also on a personal level started to go on more frequent and longer walks um with my partner um and that's been a tremendous help for my own mental health yeah well you know i think i think josh's uh you know describe actually very important techniques of helping yourself and i think uh in and i think the one that i want to really uh uh you know emphasize is helping others um you know there is a very powerful science and this might sound like platitudes but it isn't it is actually grounded in science which is the science of compassion uh the science of caring for others of being engaged in purposeful meaningful activities we often think of that as charity we often think that you're doing good to others but vidal here's the thing you're the biggest beneficiary is yourself um you know the the wonderful long-term life expectancy cohort studies which actually have collected information on individuals about the level of engagement they have with the communities around them have shown without any doubt that the more engaged you are in purposeful and meaningful activities the longer you live not only the longer you live but the longer you live happy lives healthy lives so let's be very clear reaching out to other is not charity it's actually doing good for yourself oh and by the way you're also helping others um there's a bunch of other things you can also do i mean certainly in addition to exercise and and so on i think there's a lot of uh evidence on the back backing meditative practices and by meditation i'm not um promoting one kind of meditation versus other because they all really do the same thing what they really do is essentially turn your your mind to your inner stimuli whether it's your breathing uh or some other bodily sensation and therefore really concentrate your sensory experiences to the inner world rather than the ones that come from outside that's why you know almost all meditation techniques ask you to close your eyes uh find a quiet space you know sit comfortably et cetera just to minimize the distractions and it's it's it's got a very strong physiological basis and one of the things that we want to do in empower is also to help uh uh both the health workers learn these meditative techniques in a a secular way um and in fact the app that josh spoke to actually does have those sorts of techniques which are really based on mindfulness which is a form of meditative technique but also to teach people in the community who are distressed how to learn those techniques and apply them in their daily lives that's really interesting and actually i picking up on this because i know that you know josh we talked about some specific things that he's doing vikram i'm curious are those you know the meditation or the reaching out are those some specific things that you're doing are there other things that you found helpful for yourself yeah well i certainly do the exercise but i swim which of course has been problematic with the pandemic because swimming pools were closed um uh thankfully at least where i am right now in india they've reopened um so i started walking uh but i'll tell you what i've really enjoyed doing in this in this period obviously being with my family has been a bonus um you know we're all locked down we're not traveling i've suddenly found myself having heaps more time because i'm not on a plane or uh you know or a train going to work and that's been a it's been a very positive development but the thing i've really loved is that um i i i have a dog and the house who she she came to our household about a year before the pandemic and we've just got on really well together and you know i've discovered the joys of the dog uh and walking her spending time with her taking her to the beach luckily i live in a place which has got a very nice seafront um so you know those have been the small pleasures but again i want to stress uh you know vidal i i people like us are incredibly lucky that we are actually able to pivot with a little bit of initial turmoil with a little bit of initial distress there's no question i also remember being very distressed when the lockdown happened but god knows actually i've turned this around thanks to all the scaffolding that is around me uh uh interes into something that's become a positive life experience and i just want to end by by saying you know we often talk of resilience as a very powerful concept in mental health and we often think that resilience is something about just you uh you know somehow it's all up to you to bounce back you know uh look at look look at vikram he bounced back look at him he's he's doing so much why aren't you actually doing something like him i think that's a very false narrative i think we have to recognize that resilience is more in the social environment in your opportunities your life chances and i've had the best and therefore i was able to bounce back very quickly that's really wonderful to hear and i think you know a common theme i'm seeing or two common themes is one um you know again that ecosystem of support and you know of how you know none of us can really get through this period together it's all of us working together supporting one another um to help us get through this period and form not only you know necessarily only an ecosystem of support but you know maybe as this term using resilience an ecosystem of resilience how we can continue you know even on those darkest days reach out and and nurture each other and i think you know hitting on josh's first remark about this the idea that you know each of us are dealing with epidemic in different ways and so each of us are going to have different solutions you know with how to process what's going on and and get through it but i think definitely that common theme of connecting with those you love and those that are close around you is is um is is a really really good nugget to take from this conversation so i actually want to go a bit broader now and just ask you know looking forward you know outside of covet outside of empower what are the biggest barriers to realizing mental health for all and how can we overcome them so vanilla i think to this one in addition to having too few providers and limited access what's probably some of the biggest challenges in mental health care are what we talk about at co health as uh the four big challenges to mental health for all so that's there's a fragmentation of services there's a lack of evidence-based quality care um thirdly there's issues related to privacy and trust amongst those receiving care especially for those who feel stigmatized and finally a lack of personalization so we need to think about how we're we're able to overcome these challenges and i i think um we need solutions that are one in response to those four challenges they need to be integrated so we need to move from isolated tools to a comprehensive care platform or platforms that work across the entire mental health healthcare pathway from prevention to assessment and treatment to monitoring to prediction and preemption and then we need to make sure that the treatments that we're providing are effective and by that i mean they need to be evidence-based but they also need to be engaging drawing on the best of science and the best of academia but also industry and design um and thirdly we need solutions to be safe and if and if they're digital they need to protect the user's privacy and finally and we need to create treatments or solutions designed with the user so not just with the user in mind but they need to be actively involved and consulted during the process um and we need to be able to find them where they are when they need care and connect them with the right type of care at that time and so what we're doing with empower and and co health is really trying to develop solutions to address these challenges and solutions that are integrated and comprehensive and hopefully by bringing them together we can start to create and that ecosystem of care that you refer to vidal to help bend the curve of morbidity and mortality which we know is on the rise yeah well you know again i won't repeat what josh has said just agree with everything he he just said but i i wanted to maybe give a you know conceptual uh picture of where i think we need to go let's be honest with even before the pandemic the mental health care systems in most countries were overstretched were broken were underperforming let's not for a moment think that the pandemic has actually created the crisis we're in no the crisis already existed what the pandemic has done it's a it's a portal really for us to view the dysfunctional nature of the mental health care system in almost every country of the world and so i would start by saying that the fixing of this mental health care system isn't just a matter of putting more money into business as usual it's actually about totally reimagining and transforming what mental health care looks like and i can think of a few very critical ways in which uh a mental care needs to be reimagined the first and most important one is we need to move away from narrow biomedical diagnosis and drug driven models of mental health care simply because psychological treatments have historically been very hard to access de facto for most people mental health care has mean has meant getting a prescription even though actually psychological treatments are often not only better than but actually have better long-term outcomes than medication even though people don't even necessarily want the medication they don't have a choice i think this whole dominance of a very narrow brain chemical kind of model of mental illness requiring an md a diagnosis to get reimbursed the whole thing is an edifice that actually has become in itself one of the most important barriers to mental health care and what empower is doing is building the foundation of a community facing mental health care system that is choose the need for a diagnostic evaluation that is choose the need for medication as your first port of call but instead offers to people who are distressed low-intensity psychological treatments that are actually built on scientific evidence um so that's a that's a very important conceptual shift that i think we need to engage with the other point that josh said and i really want to say it again because i want to amplify it is is is the importance of a person-centered approach to care it isn't the case that people with mental health problems simply want their diagnosis treated no actually many most individuals have coexisting social difficulties and to treat the clinical experiences of mental health problems as if this can be separated from the social suffering that so many individuals experience is to treat only half the problem it's like treating tuberculosis by only treating the cough but not the bacterium that caused the cough it's really kind of a unidimensional way of treating mental health problems and again the empire approaching particularly with the well-being trust what we're really hoping to do is to work with community-based organizations that can explore how can the psychological treatments or interventions for the mental health symptoms be married with the social work interventions that actually address the social determinants of mental health that typically coexist yeah i mean i i agree with both you that um you know mental health is this incredibly interdisciplinary possibly even a disciplinary problem that crosses really all facets of the way that we like to categorize you know knowledge and problems and so um equally it sounds like our solution needs to be equally a-disciplinary and and innovative in that regard i just wanted to open up you know are there any final closing words or remarks that either would you uh would like to say yeah so i would just close by saying that while the consequences of covet on our mental health and the mental health of our communities have been severe as we've spoken about um and there's a genuine cause for concern i also want to finish by saying that i've never felt more optimistic about the future of mental health care i haven't been in this space as long as vikram has been but it's certainly over 12 years i've really seen all the lights turn on to pave the way for innovation like never never before so individuals are way more aware of mental health challenges than ever before and this is across countries and mental illness is far less stigmatized private and public sector funding is flowing into the space to fuel innovation at an astonishing rate governments and international organizations are working together and taking action um and digital health companies are creating products that are shown to be effective and engaging and more people are seeking out help in getting access to effective treatments and they're able to get access to effective treatments and then in the case of empower innovation in mental health treatment science means that we finally got a real shot at growing the mental health workforce to meet the growing demand i could go on but the point is with all the activity in the space the future of mental health care um in the words if it gets brighter to me the future of mental health care is brighter than ever before thanks josh you certainly lifted my spirits uh all i want to say is um two things actually the first thing is i think empower is a terrific example of how science uh can be put to good use um the science in this case is not only the science of the effective delivery of these interventions but let's give you credit to the incredible long history of psychological science um you know which to me is the foundational science of mental health um and i think the psychological treatments we're talking about could not have come about without that long history of psychological science itself there's the implementation science that we discussed earlier and there's digital science you know the way that technologies can be used to enable and empower people to perform the tasks that they have historically struggled to actually get done in this case is to learn at their own convenience and then also be supported and supervised in a way that is engaging and also empowering second thing i want to say is you know our journey has just began without you know the the epidemic the pandemic last year really put a spoke in the wheels because you know we were just about to actually hit the ground running and you know in effect uh we've used the year in very productive ways but clearly we're not where we wanted to be at this time and and you know everything's been pushed forward by six to eight months but i wanted to say we're a small team we're a growing team of collaborators and uh you know members uh uh from around different communities different sectors who are working with us but we have an open door policy and we are very very keen to partner with members of the rhodes community and beyond who are passionate about mental health but also passionate about innovation about scale up uh if you think there is something you have to offer something you can contribute in any way uh to empower please just write to josh and i and i'm sure we would love to hear from you wonderful and yeah i think um you know to that i i you know given the reflections of on this pandemic and stuff i um i'm actually thinking of going into this space as well you know at least in an academic setting and next stage my training and you know having both you guys at the helm um you know leading the charge and you know painting that vision for you know um the bright future in this space um is really encouraging for me personally so thank you both for that i honestly don't think we have much more to add to that so i just want to finish up by saying thank you everybody for joining us on another edition of roads ahead um and as vikram and josh alluded to um you know we we'd be happy to connect with you moving forward thank you very much thank you vidal

2021-03-31

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