Addressing mental illness in Africa: Global health challenges and local opportunities

Mental illness is considered a silent epidemic throughout Africa due to substantial financial and systemic challenges. In this article, I discuss the infrastructure, psychosocial and socioeconomic contributors to the global mental health disparities in Africa, which include: low priority/lack of clear mental health policy; poor health infrastructure and lack of funding; insufficient number of trained specialists; poor legal protection and lack of equity; lack of evidence-based and culturally aligned assessment and treatment; stigma, discrimination and human rights abuses; and social, environmental and economic vulnerability.  I propose extending the biopsychosocial model of clinical and research practice in psychiatry to focus on the socio-cultural-spiritual factors that are the basis of many traditional explanatory models of mental illness in Africa and are also important determinants of illness, health, and wellbeing. Strategies for contextualizing mental health care approaches in Africa include: understanding explanatory and treatment models in Africa; recognizing multidimensional protective factors; strengthening community mental health and exploring parallel health systems; and incorporating global health best practices Implications for making current treatment more culturally responsive and improving mental health systems are discussed.