Bridging the gap by improving access to psychological services in low resource settings
摘要
The burden of mental disorders is rising globally, but services remain highly unequal. Low- and middle-income countries (LMICs) carry most of this burden yet have far fewer resources and spending on mental health than high-income countries. Social and cultural barriers including stigma, poverty, and lack of trained staff further block timely access to care. This commentary maps the literature on innovative models and strategies to expand equitable psychological services in LMICs. We highlight best practices such as task-sharing with non-specialists and stepped-care models that link community and clinical support. Integrating mental health into primary care and using digital tools can extend services in low-resource settings. Support from trained supervisors and national policies helps improve quality and sustainability. Evidence gaps include limited data on long-term outcomes, scale-up strategies, and how to support and retain frontline mental health workers. Cultural adaptation and stakeholder engagement are essential to make interventions acceptable and sustainable. However, challenges remain such as weak infrastructure, stigma, and governments spending less than two percent of health budgets on mental health. Scaling up must be driven by local contexts and global commitments including Sustainable Development Goal (SDG) 3 to ensure that no one is left behind.