It’s 1998. A 34-year-old, soft-spoken but intense Indian psychiatrist named Vikram Patel sits at a table in a conference room at the World Bank in Washington, D.C. Flanking him are several other mental health experts, looking out at a group of economists. Over the course of several hours, Patel and his colleagues carefully build a case supporting World Bank investment in mental health programs in developing countries, where little to no care for the mentally ill is available. People with untreated illnesses are unable to work. They are often rejected by their communities. Sometimes they’re chained up. Treatment programs could return these people to society.
The economists aren’t impressed. Where are the numbers showing the problems are widespread, and that illnesses can be treated? Patel is stunned by the lack of compassion. “It just seemed that all that mattered was the science, the numbers,” he says now. In 1998, there would be no help from World Bank.
But the meeting did accomplish one key thing. It energized Patel and others who were fighting to get mental illnesses recognized as a major global health challenge. The time had come to build an unassailable knowledge base to prove what they believed in their bones — that mental illnesses, like bipolar disease, schizophrenia and depression, are medical issues, not character weaknesses. They take a major toll on the world’s health, and addressing them is a necessity, not a luxury.
Building that base was not going to be an easy task.
