As a medical student, Allan Tasman ’69 focused on psychiatry, but he didn’t really know where it would lead— until he was asked to help create a free clinic. It was not fair, he thought, that poor people often received poor health care, diminishing their life prospects.
“I know it sounds corny, but that’s really what it’s about and what has motivated me through my whole career,” said Tasman, who earned his M.D. from the University of Kentucky. It is a career that lately is taking Tasman around the world as part of an effort to address the severe shortage of psychiatric resources in many of the world’s poorest counties. He expects the work to produce benefits in the U.S. Despite this country’s resources, many Americans still struggle to find adequate care, he said.
Some people might dismiss mental health as a concern for better-off Western countries, but the issue is global, Tasman said. In fact, mental illness was ranked among the planet’s top five costliest diseases in a 2011 report by the Harvard School of Public Health and the World Economic Forum. “It costs so much because it’s so disabling,” Tasman said.
Studies show that diagnosable depression afflicts up to 20 percent of the population at one time or another, Tasman said. Even mild episodes can impair a person’s ability to function. “We have a terrible human toll when we have illnesses that we know are readily diagnosable and readily treatable but we don’t have the resources to ensure treatment,” Tasman said.
Tasman first realized the international scope of the problem in 1999 when, as president of the American Psychiatric Association, he attended a conference in South Korea. Psychiatrists from around the Pacific Rim discussed the challenges of delivering mental health in their countries. “It was like the light bulb went on in my head,” he said.
More than a decade later, Tasman can reel off statistics illustrating the scarcity of psychiatrists in other countries. Bangladesh, for example, has 250 psychiatrists for 150 million citizens. Cambodia has 40 psychiatrists serving a population of 12 million. The United States, by comparison, is home to about 50,000 psychiatrists. The U.S. also has more training programs, he noted. And while medical specialists, including psychiatrists, are hard to find in rural areas here, the geographical distribution is more lopsided in other nations.
“To solve the mental health treatment needs in countries like these, you cannot rely on a Western model of psychiatric care,” said Tasman, who was elected in 2005 to a six-year term as secretary for education of the World Psychiatric Association. “You have to find alternative methodologies.”
And that is what Tasman has been doing. A clinician in southern India, for example, is training non-clinicians to screen patients for psychiatric illness, so the burden does not fall to already overworked primary care doctors. What succeeds in other countries could be modified to improve access to mental health care in the U.S., he said. “Everybody should be able to get the best care that they can so they can live the best life they can.”