Mental health for all by involving all - Vikram Patel
I<00:00:15.209> want<00:00:16.209> you<00:00:16.360> to<00:00:16.720> imagine<00:00:16.869> this<00:00:17.200> for<00:00:17.380> a<00:00:17.440> moment
I want you to imagine this for a moment
I want you to imagine this for a moment
two<00:00:19.510> men<00:00:19.720> Rahul<00:00:20.470> and<00:00:20.560> Rajiv<00:00:20.950> living<00:00:21.760> in<00:00:21.820> the
two men Rahul and Rajiv living in the
two men Rahul and Rajiv living in the
same<00:00:22.060> neighborhood<00:00:22.380> from<00:00:23.380> the<00:00:23.470> same
same neighborhood from the same
same neighborhood from the same
educational<00:00:24.730> background<00:00:25.180> similar
educational background similar
educational background similar
occupation<00:00:26.470> and<00:00:26.770> they<00:00:26.920> both<00:00:27.100> turn<00:00:27.340> up<00:00:27.490> at
occupation and they both turn up at
occupation and they both turn up at
their<00:00:27.850> local<00:00:28.060> accident<00:00:28.720> emergency
their local accident emergency
their local accident emergency
complaining<00:00:30.250> of<00:00:30.340> acute<00:00:30.940> chest<00:00:31.119> pain<00:00:31.920> Rahul<00:00:32.920> is
complaining of acute chest pain Rahul is
complaining of acute chest pain Rahul is
offered<00:00:33.489> a<00:00:33.610> cardiac<00:00:33.970> procedure<00:00:34.470> but<00:00:35.470> Rajiv<00:00:35.860> is
offered a cardiac procedure but Rajiv is
offered a cardiac procedure but Rajiv is
sent<00:00:36.640> home<00:00:37.800> what<00:00:38.800> might<00:00:39.010> explain<00:00:39.160> the
sent home what might explain the
sent home what might explain the
difference<00:00:40.030> in<00:00:40.210> the<00:00:40.300> experience<00:00:40.750> of<00:00:40.930> these
difference in the experience of these
difference in the experience of these
two<00:00:41.379> nearly<00:00:41.710> identical<00:00:41.830> men<00:00:43.680> Rajiv
two nearly identical men Rajiv
two nearly identical men Rajiv
suffers<00:00:45.309> from<00:00:45.610> a<00:00:45.730> mental<00:00:46.000> illness<00:00:47.010> the
suffers from a mental illness the
suffers from a mental illness the
difference<00:00:48.370> in<00:00:48.640> the<00:00:48.790> quality<00:00:49.239> of<00:00:49.450> medical
difference in the quality of medical
difference in the quality of medical
care<00:00:50.200> received<00:00:51.070> by<00:00:51.219> people<00:00:51.280> with<00:00:51.670> mental
care received by people with mental
care received by people with mental
illness<00:00:52.329> is<00:00:52.600> one<00:00:53.020> of<00:00:53.110> the<00:00:53.170> reasons<00:00:53.530> why<00:00:53.710> they
illness is one of the reasons why they
illness is one of the reasons why they
live<00:00:54.130> shorter<00:00:54.700> lives<00:00:54.730> than<00:00:55.120> people<00:00:55.719> without
live shorter lives than people without
live shorter lives than people without
mental<00:00:56.230> illness<00:00:56.620> even<00:00:57.370> in<00:00:57.489> the<00:00:57.610> best<00:00:58.120> resource
mental illness even in the best resource
mental illness even in the best resource
countries<00:00:58.809> in<00:00:59.110> the<00:00:59.200> world<00:00:59.320> this<00:00:59.860> life
countries in the world this life
countries in the world this life
expectancy<00:01:01.540> gap<00:01:01.690> is<00:01:02.020> as<00:01:02.260> much<00:01:02.440> as<00:01:02.620> twenty
expectancy gap is as much as twenty
expectancy gap is as much as twenty
years<00:01:03.370> in<00:01:04.270> the<00:01:04.390> developing<00:01:05.050> countries<00:01:05.470> the
years in the developing countries the
years in the developing countries the
world<00:01:05.740> this<00:01:06.220> gap<00:01:06.460> is<00:01:06.700> even<00:01:07.090> larger
world this gap is even larger
world this gap is even larger
but<00:01:08.800> of<00:01:08.890> course<00:01:08.920> mental<00:01:09.759> illnesses<00:01:10.180> can<00:01:10.360> kill
but of course mental illnesses can kill
but of course mental illnesses can kill
in<00:01:10.960> more<00:01:11.229> direct<00:01:11.619> ways<00:01:11.800> as<00:01:11.979> well<00:01:12.160> the<00:01:12.970> most
in more direct ways as well the most
in more direct ways as well the most
obvious<00:01:13.270> example<00:01:13.960> is<00:01:14.050> suicide<00:01:14.530> it<00:01:15.369> might
obvious example is suicide it might
obvious example is suicide it might
surprise<00:01:15.759> some<00:01:15.970> of<00:01:16.240> you<00:01:16.450> here<00:01:16.720> as<00:01:16.959> it<00:01:17.289> did<00:01:17.440> me
surprise some of you here as it did me
surprise some of you here as it did me
when<00:01:17.830> I<00:01:17.860> discovered<00:01:18.520> that<00:01:18.700> suicide<00:01:19.569> is<00:01:19.810> at<00:01:20.170> the
when I discovered that suicide is at the
when I discovered that suicide is at the
top<00:01:20.470> of<00:01:20.619> the<00:01:20.679> list<00:01:20.860> of<00:01:21.069> the<00:01:21.130> leading<00:01:21.550> cause<00:01:21.789> of
top of the list of the leading cause of
top of the list of the leading cause of
death<00:01:22.240> in<00:01:22.539> young<00:01:22.990> people<00:01:23.440> in<00:01:23.649> all<00:01:24.069> countries
death in young people in all countries
death in young people in all countries
of<00:01:24.670> the<00:01:24.819> world<00:01:24.880> including<00:01:25.300> the<00:01:25.630> poorest
of the world including the poorest
of the world including the poorest
countries<00:01:26.440> of<00:01:26.590> the<00:01:26.679> world<00:01:27.750> but<00:01:28.750> beyond<00:01:29.140> the
countries of the world but beyond the
countries of the world but beyond the
impact<00:01:29.440> of<00:01:29.830> a<00:01:30.069> health<00:01:30.369> condition<00:01:30.819> on<00:01:31.030> life
impact of a health condition on life
impact of a health condition on life
expectancy<00:01:32.009> we're<00:01:33.009> also<00:01:33.190> concerned<00:01:33.640> about
expectancy we're also concerned about
expectancy we're also concerned about
the<00:01:34.300> quality<00:01:34.539> of<00:01:34.840> life<00:01:35.140> lived<00:01:35.470> now<00:01:36.399> in<00:01:36.520> order
the quality of life lived now in order
the quality of life lived now in order
for<00:01:36.759> us<00:01:36.910> to<00:01:37.030> examine<00:01:37.420> the<00:01:37.929> overall<00:01:38.349> impact<00:01:38.709> of
for us to examine the overall impact of
for us to examine the overall impact of
a<00:01:38.920> health<00:01:39.069> condition<00:01:39.280> both<00:01:39.700> our<00:01:40.030> life
a health condition both our life
a health condition both our life
expectancy<00:01:40.569> as<00:01:41.080> well<00:01:41.410> as<00:01:41.709> on<00:01:42.190> the<00:01:42.280> quality<00:01:42.700> of
expectancy as well as on the quality of
expectancy as well as on the quality of
life<00:01:42.970> lived<00:01:43.270> we<00:01:43.690> need<00:01:43.840> to<00:01:43.929> use<00:01:44.050> a<00:01:44.080> metric
life lived we need to use a metric
life lived we need to use a metric
called<00:01:44.770> a<00:01:44.860> dolly<00:01:45.160> which<00:01:45.670> stands<00:01:45.940> for<00:01:46.060> a
called a dolly which stands for a
called a dolly which stands for a
disability<00:01:47.259> adjusted<00:01:47.619> life<00:01:47.890> here<00:01:48.990> now<00:01:49.990> when
disability adjusted life here now when
disability adjusted life here now when
we<00:01:50.259> do<00:01:50.410> that<00:01:50.590> we<00:01:51.009> discover<00:01:51.429> some<00:01:51.700> startling
we do that we discover some startling
we do that we discover some startling
things<00:01:52.420> about<00:01:52.660> mental<00:01:53.020> illness<00:01:53.349> from<00:01:53.440> a
things about mental illness from a
things about mental illness from a
global<00:01:53.890> perspective<00:01:54.360> we<00:01:55.360> discover<00:01:55.780> that<00:01:56.229> for
global perspective we discover that for
global perspective we discover that for
example<00:01:56.679> mental<00:01:57.459> illnesses<00:01:57.910> are<00:01:58.590> amongst<00:01:59.590> the
example mental illnesses are amongst the
example mental illnesses are amongst the
leading<00:02:00.069> causes<00:02:00.310> of<00:02:00.459> disability<00:02:00.929> around<00:02:01.929> the
leading causes of disability around the
leading causes of disability around the
world<00:02:02.489> depression<00:02:03.489> for<00:02:03.700> example<00:02:03.789> is<00:02:04.360> a<00:02:04.599> third
world depression for example is a third
world depression for example is a third
leading<00:02:05.349> cause<00:02:05.500> of<00:02:05.709> disability<00:02:06.330> alongside
leading cause of disability alongside
leading cause of disability alongside
conditions<00:02:08.080> such<00:02:08.500> as<00:02:08.640> diarrhea<00:02:09.640> and
conditions such as diarrhea and
conditions such as diarrhea and
pneumonia<00:02:10.209> and<00:02:10.690> children<00:02:11.160> when<00:02:12.160> you<00:02:12.280> put<00:02:12.430> all
pneumonia and children when you put all
pneumonia and children when you put all
the<00:02:12.670> mental<00:02:12.940> illnesses<00:02:13.270> together<00:02:13.599> they
the mental illnesses together they
the mental illnesses together they
account<00:02:14.470> for<00:02:14.590> roughly<00:02:14.770> 15%<00:02:15.610> of<00:02:16.330> the<00:02:16.750> total
account for roughly 15% of the total
account for roughly 15% of the total
global<00:02:17.290> burden<00:02:17.709> of<00:02:17.950> disease
did<00:02:20.349> mental<00:02:21.340> illnesses<00:02:21.819> are<00:02:22.030> also<00:02:22.629> very
did mental illnesses are also very
did mental illnesses are also very
damaging<00:02:24.069> to<00:02:24.400> people's<00:02:24.730> lives<00:02:25.290> but<00:02:26.290> beyond
damaging to people's lives but beyond
damaging to people's lives but beyond
just<00:02:27.459> the<00:02:28.420> burden<00:02:28.629> of<00:02:28.780> disease<00:02:28.930> let<00:02:29.560> us
just the burden of disease let us
just the burden of disease let us
consider<00:02:30.099> the<00:02:30.400> absolute<00:02:30.879> numbers<00:02:31.349> the<00:02:32.349> World
consider the absolute numbers the World
consider the absolute numbers the World
Health<00:02:32.709> Organization<00:02:33.519> estimates<00:02:33.970> that<00:02:34.239> there
Health Organization estimates that there
Health Organization estimates that there
are<00:02:34.660> nearly<00:02:34.840> four<00:02:35.260> to<00:02:35.440> five<00:02:35.680> hundred<00:02:36.340> million
are nearly four to five hundred million
are nearly four to five hundred million
people<00:02:37.019> living<00:02:38.019> on<00:02:38.140> our<00:02:38.410> tiny<00:02:38.680> planet<00:02:38.800> who<00:02:39.550> are
people living on our tiny planet who are
people living on our tiny planet who are
affected<00:02:40.060> by<00:02:40.209> mental<00:02:40.480> illness<00:02:40.720> now<00:02:41.440> some<00:02:42.099> of
affected by mental illness now some of
affected by mental illness now some of
you<00:02:42.310> here<00:02:42.580> look<00:02:43.150> a<00:02:43.209> bit<00:02:43.330> astonished<00:02:43.480> by<00:02:43.959> that
you here look a bit astonished by that
you here look a bit astonished by that
number<00:02:44.550> but<00:02:45.550> consider<00:02:45.910> for<00:02:46.120> a<00:02:46.150> moment<00:02:46.209> the
number but consider for a moment the
number but consider for a moment the
incredible<00:02:47.500> diversity<00:02:47.920> of<00:02:48.220> mental<00:02:48.489> illnesses
incredible diversity of mental illnesses
incredible diversity of mental illnesses
from<00:02:49.000> autism<00:02:49.269> and<00:02:49.720> intellectual<00:02:50.410> disability
from autism and intellectual disability
from autism and intellectual disability
in<00:02:51.250> childhood<00:02:51.640> through<00:02:52.450> to<00:02:52.660> depression
in childhood through to depression
in childhood through to depression
anxiety<00:02:53.349> substance<00:02:54.099> misuse<00:02:54.459> and<00:02:54.849> psychosis
anxiety substance misuse and psychosis
anxiety substance misuse and psychosis
and<00:02:55.540> adulthood<00:02:56.049> all<00:02:56.200> the<00:02:56.349> way<00:02:56.440> through<00:02:56.470> to
and adulthood all the way through to
and adulthood all the way through to
dementia<00:02:57.160> and<00:02:57.280> old<00:02:57.400> age<00:02:57.549> and<00:02:57.790> I'm<00:02:58.150> pretty<00:02:58.390> sure
dementia and old age and I'm pretty sure
dementia and old age and I'm pretty sure
that<00:02:59.110> each<00:02:59.829> and<00:03:00.040> every<00:03:00.220> one<00:03:00.400> of<00:03:00.430> us<00:03:00.640> present
that each and every one of us present
that each and every one of us present
here<00:03:01.209> today<00:03:01.510> can<00:03:02.019> think<00:03:02.260> of<00:03:02.380> at<00:03:02.470> least<00:03:02.620> one
here today can think of at least one
here today can think of at least one
person<00:03:03.040> at<00:03:04.030> least<00:03:04.450> one<00:03:04.750> person<00:03:05.200> who<00:03:05.920> is
person at least one person who is
person at least one person who is
affected<00:03:06.280> by<00:03:06.640> mental<00:03:07.030> illness<00:03:07.150> in<00:03:07.720> our<00:03:07.989> most
affected by mental illness in our most
affected by mental illness in our most
intimate<00:03:08.769> social<00:03:09.250> networks<00:03:10.060> I<00:03:11.370> see<00:03:12.370> some
intimate social networks I see some
intimate social networks I see some
nodding<00:03:12.730> heads<00:03:13.000> there<00:03:14.190> but<00:03:15.190> beyond<00:03:15.489> the
nodding heads there but beyond the
nodding heads there but beyond the
staggering<00:03:16.510> numbers<00:03:17.700> what's<00:03:18.700> truly
staggering numbers what's truly
staggering numbers what's truly
important<00:03:19.599> from<00:03:19.750> a<00:03:19.840> global<00:03:20.170> health<00:03:20.349> point<00:03:20.590> of
important from a global health point of
important from a global health point of
view<00:03:20.920> what's<00:03:21.130> truly<00:03:21.400> worrying<00:03:21.940> from<00:03:22.299> a<00:03:22.390> global
view what's truly worrying from a global
view what's truly worrying from a global
health<00:03:22.840> point<00:03:23.079> of<00:03:23.230> view<00:03:23.380> is<00:03:23.560> that<00:03:23.739> the<00:03:24.010> vast
health point of view is that the vast
health point of view is that the vast
majority<00:03:24.400> of<00:03:25.000> these<00:03:25.389> affected<00:03:25.930> individuals
majority of these affected individuals
majority of these affected individuals
do<00:03:27.010> not<00:03:27.310> receive<00:03:27.760> the<00:03:27.970> care<00:03:28.180> that<00:03:28.510> we<00:03:29.019> know<00:03:29.200> can
do not receive the care that we know can
do not receive the care that we know can
transform<00:03:29.889> their<00:03:30.130> lives<00:03:30.310> and<00:03:30.549> remember<00:03:31.090> we<00:03:31.420> do
transform their lives and remember we do
transform their lives and remember we do
have<00:03:31.840> robust<00:03:32.200> evidence<00:03:32.410> that<00:03:33.100> a<00:03:33.130> range<00:03:33.459> of
have robust evidence that a range of
have robust evidence that a range of
interventions<00:03:33.940> medicines<00:03:34.980> psychological
interventions medicines psychological
interventions medicines psychological
interventions<00:03:36.549> and<00:03:36.730> social<00:03:37.299> interventions
interventions and social interventions
interventions and social interventions
can<00:03:38.230> make<00:03:38.440> a<00:03:38.650> vast<00:03:39.100> difference<00:03:39.400> and<00:03:40.180> yet<00:03:40.590> even
can make a vast difference and yet even
can make a vast difference and yet even
in<00:03:41.709> the<00:03:41.739> best<00:03:41.980> resource<00:03:42.310> countries<00:03:42.700> for
in the best resource countries for
in the best resource countries for
example<00:03:43.000> here<00:03:43.480> in<00:03:43.630> Europe<00:03:43.930> roughly<00:03:44.560> 50%<00:03:45.010> of
example here in Europe roughly 50% of
example here in Europe roughly 50% of
affected<00:03:46.329> people<00:03:46.359> don't<00:03:46.840> receive<00:03:47.139> these
affected people don't receive these
affected people don't receive these
interventions<00:03:47.889> in<00:03:48.519> the<00:03:48.609> sorts<00:03:48.850> of<00:03:48.910> countries
interventions in the sorts of countries
interventions in the sorts of countries
I<00:03:49.420> work<00:03:49.780> in<00:03:50.160> that<00:03:51.160> so-called<00:03:51.579> treatment<00:03:52.209> gap
I work in that so-called treatment gap
I work in that so-called treatment gap
approaches<00:03:53.410> an<00:03:53.530> astonishing<00:03:54.220> 90%<00:03:57.600> it<00:03:58.600> isn't
approaches an astonishing 90% it isn't
approaches an astonishing 90% it isn't
surprising<00:03:58.989> then<00:03:59.530> that<00:03:59.769> if<00:04:00.519> you<00:04:00.609> should<00:04:00.760> speak
surprising then that if you should speak
surprising then that if you should speak
to<00:04:01.180> anyone<00:04:01.420> affected<00:04:02.079> by<00:04:02.380> mental<00:04:02.620> illness<00:04:02.769> the
to anyone affected by mental illness the
to anyone affected by mental illness the
chances<00:04:04.000> are<00:04:04.150> that<00:04:04.389> you<00:04:05.290> will<00:04:05.319> hear<00:04:05.590> stories
chances are that you will hear stories
chances are that you will hear stories
of<00:04:06.310> hidden<00:04:06.910> suffering<00:04:07.780> shame<00:04:08.769> and
of hidden suffering shame and
of hidden suffering shame and
discrimination<00:04:09.970> in<00:04:10.329> nearly<00:04:10.810> every<00:04:11.230> sector<00:04:11.470> of
discrimination in nearly every sector of
discrimination in nearly every sector of
their<00:04:12.099> lives<00:04:12.510> but<00:04:13.510> perhaps<00:04:13.660> most
their lives but perhaps most
their lives but perhaps most
heartbreaking<00:04:14.410> of<00:04:14.829> all<00:04:15.030> are<00:04:16.030> the<00:04:16.329> stories<00:04:16.780> of
heartbreaking of all are the stories of
heartbreaking of all are the stories of
the<00:04:17.769> abuse<00:04:18.549> of<00:04:18.760> even<00:04:19.180> the<00:04:19.269> most<00:04:19.299> basic<00:04:19.539> human
the abuse of even the most basic human
the abuse of even the most basic human
rights<00:04:20.500> such<00:04:21.340> as<00:04:21.400> the<00:04:21.609> young<00:04:21.789> woman<00:04:22.120> shown<00:04:22.780> in
rights such as the young woman shown in
rights such as the young woman shown in
this<00:04:23.139> image<00:04:23.470> here<00:04:23.740> that<00:04:24.160> are<00:04:24.280> played<00:04:24.460> out
this image here that are played out
this image here that are played out
every<00:04:24.789> day<00:04:25.620> sadly<00:04:26.620> even<00:04:27.250> in<00:04:27.639> the<00:04:27.729> very
every day sadly even in the very
every day sadly even in the very
institutions<00:04:28.690> that<00:04:28.780> were<00:04:29.320> built<00:04:29.530> to<00:04:29.770> care<00:04:30.130> for
institutions that were built to care for
institutions that were built to care for
people<00:04:30.460> with<00:04:30.580> mental<00:04:30.940> illnesses<00:04:31.330> the<00:04:31.930> mental
people with mental illnesses the mental
people with mental illnesses the mental
hospitals
hospitals
hospitals
it's<00:04:34.090> this<00:04:34.330> injustice<00:04:35.200> that<00:04:35.380> has<00:04:35.500> really
it's this injustice that has really
it's this injustice that has really
driven<00:04:35.980> my<00:04:36.220> mission<00:04:36.580> to<00:04:37.180> try<00:04:37.420> and<00:04:37.570> do<00:04:37.660> a<00:04:37.690> little
driven my mission to try and do a little
driven my mission to try and do a little
bit<00:04:38.080> to<00:04:38.740> transform<00:04:39.250> the<00:04:39.340> lives<00:04:39.490> of<00:04:39.670> people
bit to transform the lives of people
bit to transform the lives of people
affected<00:04:40.360> by<00:04:40.390> mental<00:04:40.780> illness<00:04:40.840> Anna<00:04:41.200> at<00:04:41.500> a
affected by mental illness Anna at a
affected by mental illness Anna at a
particularly<00:04:41.980> critical<00:04:42.250> action<00:04:42.820> that<00:04:42.940> I
particularly critical action that I
particularly critical action that I
focused<00:04:43.450> on<00:04:43.600> is<00:04:44.050> to<00:04:44.530> bridge<00:04:45.070> the<00:04:45.250> gulf<00:04:45.430> between
focused on is to bridge the gulf between
focused on is to bridge the gulf between
the<00:04:46.690> knowledge<00:04:46.900> we<00:04:47.230> have<00:04:47.260> that<00:04:47.710> can<00:04:47.830> transform
the knowledge we have that can transform
the knowledge we have that can transform
lives<00:04:48.610> the<00:04:48.850> knowledge<00:04:49.150> of<00:04:49.270> effective
lives the knowledge of effective
lives the knowledge of effective
treatments<00:04:50.170> and<00:04:50.320> how<00:04:50.650> we<00:04:50.710> actually<00:04:51.010> use<00:04:51.520> that
treatments and how we actually use that
treatments and how we actually use that
knowledge<00:04:52.000> in<00:04:52.360> the<00:04:52.990> everyday<00:04:53.260> world<00:04:53.730> and<00:04:54.730> an
knowledge in the everyday world and an
knowledge in the everyday world and an
especially<00:04:55.260> important<00:04:56.260> challenge<00:04:56.650> that<00:04:56.800> I've
especially important challenge that I've
especially important challenge that I've
had<00:04:57.010> to<00:04:57.130> face<00:04:57.370> is<00:04:57.700> the<00:04:58.090> great<00:04:58.270> shortage<00:04:58.780> of
had to face is the great shortage of
had to face is the great shortage of
mental<00:04:59.740> health<00:04:59.860> professionals<00:05:00.490> such<00:05:00.610> as
mental health professionals such as
mental health professionals such as
psychiatrists<00:05:01.390> and<00:05:01.450> psychologists
psychiatrists and psychologists
psychiatrists and psychologists
particularly<00:05:02.950> in<00:05:03.250> the<00:05:03.460> developing<00:05:03.910> world
particularly in the developing world
particularly in the developing world
now<00:05:05.530> I<00:05:05.560> trained<00:05:06.040> in<00:05:06.160> medicine<00:05:06.400> in<00:05:06.580> India<00:05:06.720> and
now I trained in medicine in India and
now I trained in medicine in India and
after<00:05:07.930> that<00:05:08.230> I<00:05:08.470> chose<00:05:08.770> psychiatry<00:05:09.370> as<00:05:09.460> my
after that I chose psychiatry as my
after that I chose psychiatry as my
specialty
specialty
specialty
much<00:05:10.690> to<00:05:10.840> the<00:05:10.930> dismay<00:05:11.140> of<00:05:11.320> my<00:05:11.680> mother<00:05:11.950> and<00:05:12.040> all
much to the dismay of my mother and all
much to the dismay of my mother and all
my<00:05:12.520> family<00:05:12.940> members<00:05:13.090> who<00:05:13.450> can't<00:05:13.960> afford
my family members who can't afford
my family members who can't afford
neurosurgery<00:05:15.040> would<00:05:15.190> be<00:05:15.340> a<00:05:15.370> more<00:05:15.580> respectable
neurosurgery would be a more respectable
neurosurgery would be a more respectable
option<00:05:16.840> for<00:05:17.050> their<00:05:17.200> brilliant<00:05:17.530> son<00:05:17.910> any<00:05:18.910> case
option for their brilliant son any case
option for their brilliant son any case
I<00:05:19.330> went<00:05:19.570> on<00:05:19.750> I<00:05:19.930> soldiered<00:05:20.380> on<00:05:20.470> with<00:05:20.620> psychiatry
I went on I soldiered on with psychiatry
I went on I soldiered on with psychiatry
and<00:05:21.160> found<00:05:21.370> myself<00:05:21.490> training<00:05:22.360> in<00:05:22.540> Britain<00:05:22.900> and
and found myself training in Britain and
and found myself training in Britain and
some<00:05:23.230> of<00:05:23.350> the<00:05:23.440> best<00:05:24.040> hospitals<00:05:24.640> in<00:05:24.730> this
some of the best hospitals in this
some of the best hospitals in this
country<00:05:25.210> I<00:05:25.240> was<00:05:25.360> very<00:05:25.510> privileged<00:05:25.990> I<00:05:26.170> worked
country I was very privileged I worked
country I was very privileged I worked
in<00:05:26.860> a<00:05:26.950> team<00:05:27.160> of<00:05:27.370> incredibly<00:05:28.180> talented
in a team of incredibly talented
in a team of incredibly talented
compassionate<00:05:29.230> but<00:05:29.680> most<00:05:29.890> importantly
compassionate but most importantly
compassionate but most importantly
highly<00:05:30.970> trained<00:05:31.410> specialized<00:05:32.410> mental<00:05:32.680> health
highly trained specialized mental health
highly trained specialized mental health
professionals<00:05:33.930> soon<00:05:34.930> after<00:05:35.230> my<00:05:35.320> training<00:05:35.680> I
professionals soon after my training I
professionals soon after my training I
found<00:05:35.980> myself<00:05:36.130> working<00:05:36.700> first<00:05:36.910> in<00:05:37.060> Zimbabwe
found myself working first in Zimbabwe
found myself working first in Zimbabwe
and<00:05:37.660> then<00:05:37.750> in<00:05:37.840> India<00:05:37.990> and<00:05:38.320> I<00:05:38.380> was<00:05:38.410> confronted
and then in India and I was confronted
and then in India and I was confronted
by<00:05:39.520> an<00:05:39.580> altogether<00:05:40.060> new<00:05:40.330> reality<00:05:41.100> this<00:05:42.100> was<00:05:42.280> a
by an altogether new reality this was a
by an altogether new reality this was a
reality<00:05:42.850> of<00:05:43.060> a<00:05:43.480> world<00:05:43.510> in<00:05:43.960> which<00:05:44.170> there<00:05:44.650> were
reality of a world in which there were
reality of a world in which there were
almost<00:05:44.950> no<00:05:45.190> mental<00:05:45.640> health<00:05:45.820> professionals<00:05:46.330> at
almost no mental health professionals at
almost no mental health professionals at
all<00:05:46.830> in<00:05:47.830> Zimbabwe<00:05:48.370> for<00:05:48.400> example<00:05:48.940> there<00:05:49.419> were
all in Zimbabwe for example there were
all in Zimbabwe for example there were
just<00:05:49.630> about<00:05:49.840> a<00:05:49.900> dozen<00:05:50.169> psychiatrists<00:05:51.040> most<00:05:52.030> of
just about a dozen psychiatrists most of
just about a dozen psychiatrists most of
whom<00:05:52.390> lived<00:05:52.600> and<00:05:52.750> worked<00:05:52.930> in<00:05:53.080> Harare<00:05:53.410> City
whom lived and worked in Harare City
whom lived and worked in Harare City
leaving<00:05:54.250> only<00:05:54.490> a<00:05:54.669> couple<00:05:55.180> to<00:05:55.720> address<00:05:55.990> the
leaving only a couple to address the
leaving only a couple to address the
mental<00:05:56.470> health<00:05:56.590> care<00:05:56.800> needs<00:05:57.010> of<00:05:57.190> nine<00:05:57.640> million
mental health care needs of nine million
mental health care needs of nine million
people<00:05:58.630> living<00:05:59.350> in<00:05:59.560> the<00:05:59.770> countryside<00:06:00.510> in
people living in the countryside in
people living in the countryside in
India<00:06:01.870> I<00:06:01.930> found<00:06:02.230> a<00:06:02.380> situation<00:06:02.890> was<00:06:03.160> not<00:06:03.190> a<00:06:03.370> lot
India I found a situation was not a lot
India I found a situation was not a lot
better<00:06:03.790> to<00:06:04.570> give<00:06:04.720> you<00:06:04.780> a<00:06:04.810> perspective<00:06:04.990> if<00:06:05.350> I
better to give you a perspective if I
better to give you a perspective if I
had<00:06:05.620> to<00:06:05.860> translate<00:06:06.820> the<00:06:07.090> proportion<00:06:07.570> of
had to translate the proportion of
had to translate the proportion of
psychiatrists<00:06:08.380> in<00:06:08.500> the<00:06:08.620> population<00:06:09.130> that<00:06:09.250> one
psychiatrists in the population that one
psychiatrists in the population that one
might<00:06:09.580> see<00:06:09.790> in<00:06:09.850> Britain<00:06:10.150> to<00:06:10.630> India<00:06:11.020> one<00:06:11.860> might
might see in Britain to India one might
might see in Britain to India one might
expect<00:06:12.160> roughly<00:06:13.380> 150,000<00:06:14.380> psychiatrists<00:06:15.220> in
expect roughly 150,000 psychiatrists in
expect roughly 150,000 psychiatrists in
India<00:06:16.290> in<00:06:17.290> reality
India in reality
India in reality
take<00:06:18.730> a<00:06:18.760> guess<00:06:19.890> the<00:06:20.890> actual<00:06:21.250> number<00:06:21.550> is<00:06:21.669> about
take a guess the actual number is about
take a guess the actual number is about
3,000<00:06:22.720> about<00:06:23.020> two<00:06:23.230> percent<00:06:23.650> of<00:06:23.890> that<00:06:24.100> number
3,000 about two percent of that number
3,000 about two percent of that number
it<00:06:25.390> became<00:06:25.720> quickly<00:06:25.870> apparent<00:06:26.050> to<00:06:26.410> be<00:06:26.530> that<00:06:26.740> I
it became quickly apparent to be that I
it became quickly apparent to be that I
couldn't<00:06:27.400> follow<00:06:27.700> the<00:06:28.060> sorts<00:06:28.510> of<00:06:28.570> mental
couldn't follow the sorts of mental
couldn't follow the sorts of mental
health<00:06:29.050> care<00:06:29.169> models<00:06:29.560> that<00:06:29.830> I<00:06:29.860> have<00:06:30.130> been
health care models that I have been
health care models that I have been
trained<00:06:30.580> in<00:06:30.700> one<00:06:30.910> that<00:06:31.090> relied<00:06:31.360> heavily<00:06:31.390> on
trained in one that relied heavily on
trained in one that relied heavily on
specialized<00:06:33.430> expensive<00:06:34.060> mental<00:06:34.330> her
specialized expensive mental her
specialized expensive mental her
professionals<00:06:34.930> to<00:06:35.080> provide<00:06:35.410> mental<00:06:35.770> health
professionals to provide mental health
professionals to provide mental health
care<00:06:36.130> in<00:06:36.280> countries<00:06:36.880> like<00:06:37.090> India<00:06:37.450> and
care in countries like India and
care in countries like India and
Zimbabwe<00:06:38.140> I<00:06:38.380> had<00:06:38.860> to<00:06:38.980> think<00:06:39.130> out<00:06:39.340> of<00:06:39.400> the<00:06:39.580> box
Zimbabwe I had to think out of the box
Zimbabwe I had to think out of the box
about<00:06:40.450> some<00:06:40.720> other<00:06:40.960> model<00:06:41.560> of<00:06:41.680> care<00:06:42.450> it<00:06:43.450> was
about some other model of care it was
about some other model of care it was
then<00:06:43.810> that<00:06:44.050> I<00:06:44.350> came<00:06:44.470> across<00:06:44.710> these<00:06:45.130> books
then that I came across these books
then that I came across these books
and<00:06:46.249> in<00:06:46.369> these<00:06:46.489> books<00:06:46.729> I<00:06:46.909> discovered<00:06:47.389> the<00:06:47.809> idea
and in these books I discovered the idea
and in these books I discovered the idea
of<00:06:48.409> task-shifting
of task-shifting
of task-shifting
in<00:06:49.759> global<00:06:50.419> health<00:06:50.539> the<00:06:51.499> idea<00:06:51.739> is<00:06:51.830> actually
in global health the idea is actually
in global health the idea is actually
quite<00:06:52.279> simple<00:06:52.580> the<00:06:52.969> idea<00:06:53.209> is<00:06:53.419> when<00:06:53.989> you're
quite simple the idea is when you're
quite simple the idea is when you're
short<00:06:54.349> of<00:06:54.559> specialized<00:06:55.099> health<00:06:55.639> care
short of specialized health care
short of specialized health care
professionals<00:06:56.449> use<00:06:57.379> whoever<00:06:57.800> is<00:06:57.919> available
professionals use whoever is available
professionals use whoever is available
in<00:06:58.610> the<00:06:58.699> community<00:06:59.169> trained<00:07:00.169> them<00:07:00.439> to<00:07:00.769> provide
in the community trained them to provide
in the community trained them to provide
a<00:07:01.339> range<00:07:01.550> of<00:07:01.759> health<00:07:01.879> care<00:07:02.119> interventions<00:07:02.300> and
a range of health care interventions and
a range of health care interventions and
in<00:07:02.779> these<00:07:02.929> books<00:07:03.259> I<00:07:03.619> read<00:07:04.129> inspiring<00:07:04.879> examples
in these books I read inspiring examples
in these books I read inspiring examples
for<00:07:05.899> example<00:07:05.989> of<00:07:06.469> how<00:07:06.619> ordinary<00:07:07.189> people<00:07:07.550> had
for example of how ordinary people had
for example of how ordinary people had
been<00:07:08.179> trained<00:07:08.449> to<00:07:08.599> deliver<00:07:08.929> babies<00:07:09.550> diagnose
been trained to deliver babies diagnose
been trained to deliver babies diagnose
and<00:07:10.759> treat<00:07:10.909> early<00:07:11.179> pneumonia<00:07:12.019> to<00:07:12.649> great
and treat early pneumonia to great
and treat early pneumonia to great
effect<00:07:12.979> and<00:07:13.789> it<00:07:13.879> struck<00:07:14.149> me<00:07:14.300> that<00:07:14.509> if<00:07:14.839> you
effect and it struck me that if you
effect and it struck me that if you
could<00:07:15.050> train<00:07:15.229> ordinary<00:07:15.649> people<00:07:16.039> to<00:07:16.249> deliver
could train ordinary people to deliver
could train ordinary people to deliver
such<00:07:16.909> complex<00:07:17.360> health<00:07:17.539> care<00:07:17.689> interventions
such complex health care interventions
such complex health care interventions
then<00:07:18.949> perhaps<00:07:19.099> they<00:07:19.369> could<00:07:19.519> also<00:07:19.669> do<00:07:19.909> the<00:07:20.029> same
then perhaps they could also do the same
then perhaps they could also do the same
with<00:07:20.449> mental<00:07:20.990> health<00:07:21.139> care<00:07:21.759> well<00:07:22.759> today<00:07:22.999> I'm
with mental health care well today I'm
with mental health care well today I'm
very<00:07:24.110> pleased<00:07:24.379> to<00:07:24.409> report<00:07:24.619> to<00:07:24.919> you<00:07:25.009> that<00:07:25.189> there
very pleased to report to you that there
very pleased to report to you that there
have<00:07:26.089> been<00:07:26.209> many<00:07:26.479> experiments<00:07:27.379> in<00:07:27.559> tar
have been many experiments in tar
have been many experiments in tar
shifting<00:07:28.729> in<00:07:28.819> mental<00:07:29.149> health<00:07:29.300> care<00:07:29.539> across
shifting in mental health care across
shifting in mental health care across
the<00:07:30.319> developing<00:07:30.830> world<00:07:31.099> over<00:07:31.490> the<00:07:31.580> past
the developing world over the past
the developing world over the past
decade<00:07:32.240> and<00:07:32.509> I<00:07:32.599> want<00:07:32.779> to<00:07:32.869> share<00:07:33.050> with<00:07:33.139> you<00:07:33.289> the
decade and I want to share with you the
decade and I want to share with you the
findings<00:07:33.860> of<00:07:34.009> three<00:07:34.369> particular<00:07:34.969> such
findings of three particular such
findings of three particular such
experiments<00:07:35.809> all<00:07:36.110> three<00:07:36.379> of<00:07:36.469> which<00:07:36.559> focused
experiments all three of which focused
experiments all three of which focused
on<00:07:37.129> depression<00:07:37.729> the<00:07:38.119> most<00:07:38.300> common<00:07:38.689> of<00:07:38.809> all
on depression the most common of all
on depression the most common of all
mental<00:07:39.259> illnesses<00:07:39.800> in<00:07:40.539> rural<00:07:41.539> Uganda<00:07:41.839> Paul
mental illnesses in rural Uganda Paul
mental illnesses in rural Uganda Paul
Bolton<00:07:43.219> and<00:07:43.309> his<00:07:43.429> colleagues<00:07:43.819> using
Bolton and his colleagues using
Bolton and his colleagues using
villagers<00:07:45.669> demonstrated<00:07:46.669> that<00:07:46.759> they<00:07:46.909> could
villagers demonstrated that they could
villagers demonstrated that they could
deliver<00:07:47.539> interpersonal<00:07:48.499> psychotherapy<00:07:48.949> for
deliver interpersonal psychotherapy for
deliver interpersonal psychotherapy for
depression<00:07:49.879> and<00:07:50.319> using<00:07:51.319> a<00:07:51.379> randomized
depression and using a randomized
depression and using a randomized
control<00:07:52.189> design<00:07:52.519> showed<00:07:53.059> that<00:07:53.300> 90<00:07:53.749> percent<00:07:53.779> of
control design showed that 90 percent of
control design showed that 90 percent of
the<00:07:54.529> people<00:07:54.649> receiving<00:07:55.219> this<00:07:55.279> intervention
the people receiving this intervention
the people receiving this intervention
recovered<00:07:56.269> as<00:07:56.389> compared<00:07:57.019> to<00:07:57.079> roughly<00:07:57.409> 40
recovered as compared to roughly 40
recovered as compared to roughly 40
percent<00:07:57.829> in<00:07:58.309> the<00:07:58.459> comparison<00:07:59.029> villages
percent in the comparison villages
percent in the comparison villages
similarly<00:08:01.249> using<00:08:01.639> a<00:08:01.849> randomized<00:08:02.240> control
similarly using a randomized control
similarly using a randomized control
trial<00:08:02.899> in<00:08:03.110> rural<00:08:03.709> Pakistan<00:08:04.179> Aarti<00:08:05.179> Freeman
trial in rural Pakistan Aarti Freeman
trial in rural Pakistan Aarti Freeman
and<00:08:05.929> his<00:08:06.079> colleagues<00:08:06.499> showed<00:08:06.919> that<00:08:07.639> lady
and his colleagues showed that lady
and his colleagues showed that lady
health<00:08:08.269> visitors<00:08:08.689> who<00:08:08.899> are<00:08:08.929> community
health visitors who are community
health visitors who are community
maternal<00:08:09.949> health<00:08:10.129> workers<00:08:10.550> in<00:08:10.879> Pakistan's
maternal health workers in Pakistan's
maternal health workers in Pakistan's
health<00:08:11.839> care<00:08:12.019> system<00:08:12.379> could<00:08:12.709> deliver
health care system could deliver
health care system could deliver
cognitive<00:08:13.789> behavior<00:08:14.119> therapy<00:08:14.149> for<00:08:14.749> mothers
cognitive behavior therapy for mothers
cognitive behavior therapy for mothers
who<00:08:15.139> were<00:08:15.229> depressed<00:08:15.529> again<00:08:16.129> showing
who were depressed again showing
who were depressed again showing
dramatic<00:08:16.879> differences<00:08:17.419> in<00:08:17.599> the<00:08:17.959> recovery
dramatic differences in the recovery
dramatic differences in the recovery
rates<00:08:18.679> roughly<00:08:19.069> 75<00:08:19.639> percent<00:08:19.999> of<00:08:20.119> mothers
rates roughly 75 percent of mothers
rates roughly 75 percent of mothers
recovered<00:08:20.839> as<00:08:21.169> compared<00:08:21.619> to<00:08:21.679> about<00:08:21.919> 45
recovered as compared to about 45
recovered as compared to about 45
percent<00:08:22.849> in<00:08:23.179> the<00:08:23.360> comparison<00:08:23.869> villages<00:08:24.259> and
percent in the comparison villages and
percent in the comparison villages and
in<00:08:25.129> my<00:08:25.249> own<00:08:25.429> trial<00:08:25.789> in<00:08:26.059> Goa<00:08:26.329> in<00:08:26.569> India<00:08:26.749> we<00:08:27.679> again
in my own trial in Goa in India we again
in my own trial in Goa in India we again
showed<00:08:28.279> that<00:08:28.729> lay<00:08:28.939> counsellors<00:08:29.539> drawn<00:08:29.839> from
showed that lay counsellors drawn from
showed that lay counsellors drawn from
local<00:08:30.349> communities<00:08:30.800> could<00:08:31.249> be<00:08:31.369> trained<00:08:31.639> to
local communities could be trained to
local communities could be trained to
deliver<00:08:31.879> psychosocial<00:08:32.599> interventions<00:08:33.349> for
deliver psychosocial interventions for
deliver psychosocial interventions for
depression<00:08:33.919> and<00:08:34.009> anxiety<00:08:34.099> leading<00:08:35.029> to<00:08:35.120> 70
depression and anxiety leading to 70
depression and anxiety leading to 70
percent<00:08:35.659> recovery<00:08:36.229> rates<00:08:36.439> as<00:08:36.589> compared<00:08:37.069> to<00:08:37.130> 50
percent recovery rates as compared to 50
percent recovery rates as compared to 50
percent<00:08:37.819> in<00:08:37.969> the<00:08:38.360> comparison<00:08:38.899> primary<00:08:39.289> health
percent in the comparison primary health
percent in the comparison primary health
centers<00:08:40.419> now<00:08:41.419> if<00:08:41.569> I<00:08:41.719> had<00:08:41.810> to<00:08:41.870> draw<00:08:42.050> together
centers now if I had to draw together
centers now if I had to draw together
all<00:08:42.709> these<00:08:42.979> different<00:08:43.039> experiments<00:08:43.579> and<00:08:43.939> are
all these different experiments and are
all these different experiments and are
shifting<00:08:44.630> and<00:08:44.779> there<00:08:45.139> of<00:08:45.439> course<00:08:45.620> been<00:08:45.800> many
shifting and there of course been many
shifting and there of course been many
other<00:08:46.189> examples<00:08:46.370> and<00:08:47.000> try<00:08:47.269> and<00:08:47.420> identify<00:08:47.540> what
other examples and try and identify what
other examples and try and identify what
are<00:08:48.439> the<00:08:48.500> key<00:08:48.680> lessons<00:08:48.920> we<00:08:49.339> can<00:08:49.459> learn<00:08:49.519> that
are the key lessons we can learn that
are the key lessons we can learn that
makes<00:08:50.480> for<00:08:50.689> a<00:08:50.720> successful<00:08:51.410> tar<00:08:51.740> shifting
makes for a successful tar shifting
makes for a successful tar shifting
operation<00:08:52.790> I've<00:08:53.329> coined<00:08:53.990> this<00:08:54.439> particular
operation I've coined this particular
operation I've coined this particular
acronym<00:08:55.519> thunder<00:08:56.350> what<00:08:57.350> sundar<00:08:57.800> stands<00:08:58.250> for
acronym thunder what sundar stands for
acronym thunder what sundar stands for
in<00:08:58.699> Hindi
in Hindi
in Hindi
is<00:08:59.579> attractive<00:09:00.449> it<00:09:01.290> seems<00:09:01.589> to<00:09:01.740> me<00:09:01.889> that<00:09:02.069> there
is attractive it seems to me that there
is attractive it seems to me that there
are<00:09:02.459> five<00:09:02.759> key<00:09:03.119> lessons<00:09:03.480> that<00:09:03.600> I've<00:09:03.899> shown<00:09:04.110> on
are five key lessons that I've shown on
are five key lessons that I've shown on
this<00:09:04.410> slide<00:09:04.679> that<00:09:04.889> are<00:09:05.160> critically<00:09:05.579> important
this slide that are critically important
this slide that are critically important
for<00:09:06.209> effective<00:09:06.809> tar<00:09:07.230> shifting<00:09:07.649> the<00:09:08.220> first<00:09:08.490> is
for effective tar shifting the first is
for effective tar shifting the first is
that<00:09:09.149> we<00:09:09.300> need<00:09:09.329> to<00:09:09.480> simplify<00:09:10.350> the<00:09:10.589> message
that we need to simplify the message
that we need to simplify the message
that<00:09:11.429> we're<00:09:11.610> using<00:09:11.819> stripping<00:09:12.629> away<00:09:12.749> all<00:09:12.869> the
that we're using stripping away all the
that we're using stripping away all the
jargon<00:09:13.619> that<00:09:13.769> medicine<00:09:14.459> has<00:09:14.819> invented<00:09:15.360> around
jargon that medicine has invented around
jargon that medicine has invented around
itself
itself
itself
we<00:09:17.220> need<00:09:17.399> to<00:09:17.519> unpack<00:09:17.999> complex<00:09:18.779> healthcare
we need to unpack complex healthcare
we need to unpack complex healthcare
interventions<00:09:19.410> into<00:09:20.040> smaller<00:09:20.339> components
interventions into smaller components
interventions into smaller components
that<00:09:21.269> can<00:09:21.420> be<00:09:21.480> more<00:09:21.749> easily<00:09:21.959> transferred<00:09:22.740> to
that can be more easily transferred to
that can be more easily transferred to
less<00:09:23.069> strained<00:09:23.429> individuals<00:09:23.999> we<00:09:24.990> need<00:09:25.170> to
less strained individuals we need to
less strained individuals we need to
deliver<00:09:25.499> healthcare<00:09:25.889> not<00:09:26.399> in<00:09:26.519> large
deliver healthcare not in large
deliver healthcare not in large
institutions<00:09:26.879> but<00:09:27.480> close<00:09:27.749> to<00:09:27.929> people's<00:09:28.259> homes
institutions but close to people's homes
institutions but close to people's homes
and<00:09:28.980> we<00:09:29.069> need<00:09:29.220> to<00:09:29.339> deliver<00:09:29.579> healthcare<00:09:29.910> using
and we need to deliver healthcare using
and we need to deliver healthcare using
whoever<00:09:31.290> is<00:09:31.529> available<00:09:31.679> and<00:09:32.160> affordable<00:09:32.399> in
whoever is available and affordable in
whoever is available and affordable in
our<00:09:32.970> local<00:09:33.329> communities<00:09:33.839> and<00:09:34.369> importantly<00:09:35.369> we
our local communities and importantly we
our local communities and importantly we
need<00:09:35.939> to<00:09:36.059> reallocate<00:09:36.540> the<00:09:36.990> few<00:09:37.259> specialists
need to reallocate the few specialists
need to reallocate the few specialists
who<00:09:38.009> are<00:09:38.069> available<00:09:38.579> to<00:09:38.939> perform<00:09:39.089> roles<00:09:39.509> such
who are available to perform roles such
who are available to perform roles such
as<00:09:39.929> capacity<00:09:40.529> building<00:09:40.829> and<00:09:41.009> supervision<00:09:42.589> but
as capacity building and supervision but
as capacity building and supervision but
for<00:09:43.709> me<00:09:43.829> tar<00:09:44.699> shifting<00:09:45.149> is<00:09:45.240> an<00:09:45.360> idea<00:09:45.689> with
for me tar shifting is an idea with
for me tar shifting is an idea with
truly<00:09:46.949> global<00:09:47.279> significance<00:09:47.839> because<00:09:48.839> even
truly global significance because even
truly global significance because even
though<00:09:49.199> it<00:09:49.439> has<00:09:49.589> arisen<00:09:50.279> out<00:09:50.639> of<00:09:50.819> the
though it has arisen out of the
though it has arisen out of the
situation<00:09:52.529> of<00:09:52.619> the<00:09:52.679> lack<00:09:52.920> of<00:09:52.949> resources<00:09:53.429> that
situation of the lack of resources that
situation of the lack of resources that
you<00:09:54.119> find<00:09:54.269> in<00:09:54.749> developing<00:09:55.199> countries<00:09:55.619> I<00:09:55.709> think
you find in developing countries I think
you find in developing countries I think
it<00:09:56.009> has<00:09:56.129> a<00:09:56.399> lot<00:09:56.910> of<00:09:56.939> significance<00:09:57.209> for<00:09:57.720> better
it has a lot of significance for better
it has a lot of significance for better
resourced<00:09:58.350> countries<00:09:58.470> as<00:09:58.769> well<00:09:58.920> why<00:09:59.490> is<00:09:59.550> that
resourced countries as well why is that
resourced countries as well why is that
well<00:10:00.600> in<00:10:00.809> part<00:10:01.079> because<00:10:01.800> healthcare<00:10:02.309> in<00:10:02.790> the
well in part because healthcare in the
well in part because healthcare in the
developed<00:10:03.420> world<00:10:03.480> the<00:10:03.869> health<00:10:04.319> care<00:10:04.529> costs<00:10:04.949> in
developed world the health care costs in
developed world the health care costs in
the<00:10:05.339> developing<00:10:05.790> world<00:10:05.850> are<00:10:06.240> rapidly
the developing world are rapidly
the developing world are rapidly
spiraling<00:10:07.589> out<00:10:07.709> of<00:10:07.740> control<00:10:07.860> and<00:10:08.399> a<00:10:08.459> huge
spiraling out of control and a huge
spiraling out of control and a huge
chunk<00:10:08.939> of<00:10:09.209> those<00:10:09.809> costs<00:10:10.199> are<00:10:10.529> human<00:10:10.920> resource
chunk of those costs are human resource
chunk of those costs are human resource
costs<00:10:11.610> but<00:10:12.600> equally<00:10:13.110> important<00:10:13.559> is<00:10:13.740> because
costs but equally important is because
costs but equally important is because
health<00:10:14.519> care<00:10:14.699> has<00:10:14.819> become<00:10:14.970> so<00:10:15.329> incredibly
health care has become so incredibly
health care has become so incredibly
professionalized<00:10:16.980> that<00:10:17.699> has<00:10:17.819> become<00:10:18.119> very
professionalized that has become very
professionalized that has become very
remote<00:10:18.629> and<00:10:18.839> removed<00:10:19.230> from<00:10:19.350> local
remote and removed from local
remote and removed from local
communities<00:10:20.160> for<00:10:20.749> me<00:10:21.749> what's<00:10:22.290> truly<00:10:22.529> sundar
communities for me what's truly sundar
communities for me what's truly sundar
about<00:10:23.759> the<00:10:23.879> idea<00:10:24.179> of<00:10:24.209> tar<00:10:24.449> shifting<00:10:24.899> though
about the idea of tar shifting though
about the idea of tar shifting though
isn't<00:10:25.829> that<00:10:25.920> it<00:10:26.040> simply<00:10:26.429> makes<00:10:26.549> health<00:10:26.819> care
isn't that it simply makes health care
isn't that it simply makes health care
more<00:10:27.089> accessible<00:10:27.509> and<00:10:27.869> affordable<00:10:28.429> but<00:10:29.429> that
more accessible and affordable but that
more accessible and affordable but that
it<00:10:30.119> is<00:10:30.299> also<00:10:30.600> fundamentally<00:10:31.139> empowering<00:10:31.709> it
it is also fundamentally empowering it
it is also fundamentally empowering it
empowers<00:10:32.999> ordinary<00:10:33.540> people<00:10:33.959> to<00:10:34.170> be<00:10:34.889> more
empowers ordinary people to be more
empowers ordinary people to be more
effective<00:10:35.790> in<00:10:36.029> caring<00:10:36.600> for<00:10:36.629> the<00:10:36.869> health<00:10:37.019> of
effective in caring for the health of
effective in caring for the health of
others<00:10:37.439> in<00:10:37.589> their<00:10:37.679> community<00:10:38.160> and<00:10:38.339> in<00:10:39.029> doing
others in their community and in doing
others in their community and in doing
so<00:10:39.509> to<00:10:39.540> become<00:10:39.809> better<00:10:40.110> guardians<00:10:40.619> of<00:10:40.769> their
so to become better guardians of their
so to become better guardians of their
own<00:10:41.220> health<00:10:41.490> indeed<00:10:42.389> from<00:10:42.779> ATAR<00:10:43.139> shifting<00:10:43.589> is
own health indeed from ATAR shifting is
own health indeed from ATAR shifting is
the<00:10:43.829> ultimate<00:10:44.220> example<00:10:44.309> of<00:10:44.850> the
the ultimate example of the
the ultimate example of the
democratization<00:10:45.899> of<00:10:46.439> medical<00:10:47.160> knowledge<00:10:47.279> and
democratization of medical knowledge and
democratization of medical knowledge and
therefore<00:10:48.540> medical<00:10:49.499> power<00:10:51.379> just<00:10:52.379> over<00:10:52.589> 30
therefore medical power just over 30
therefore medical power just over 30
years<00:10:53.100> ago<00:10:53.220> in<00:10:54.029> the<00:10:54.119> nations<00:10:54.420> of<00:10:54.509> the<00:10:54.600> world
years ago in the nations of the world
years ago in the nations of the world
assembled<00:10:55.259> in<00:10:55.350> alma<00:10:55.679> mater<00:10:55.829> and<00:10:56.189> made<00:10:56.399> this
assembled in alma mater and made this
assembled in alma mater and made this
iconic<00:10:56.970> declaration<00:10:57.689> well<00:10:58.290> I<00:10:58.439> think<00:10:58.589> all<00:10:58.829> of
iconic declaration well I think all of
iconic declaration well I think all of
you<00:10:59.069> can<00:10:59.279> guess<00:10:59.459> that<00:10:59.819> 12<00:11:00.089> years<00:11:00.269> on<00:11:00.420> we're
you can guess that 12 years on we're
you can guess that 12 years on we're
still<00:11:01.019> nowhere<00:11:01.379> near<00:11:01.589> that<00:11:01.949> goal
still nowhere near that goal
still nowhere near that goal
still<00:11:03.629> today<00:11:04.490> armed<00:11:05.490> with<00:11:05.579> that<00:11:05.670> knowledge
still today armed with that knowledge
still today armed with that knowledge
that<00:11:06.660> ordinary<00:11:07.170> people<00:11:07.529> in<00:11:07.620> the<00:11:07.679> community
that ordinary people in the community
that ordinary people in the community
can<00:11:08.790> be<00:11:08.910> trained<00:11:09.299> and<00:11:09.569> with<00:11:10.110> sufficient
can be trained and with sufficient
can be trained and with sufficient
supervision<00:11:11.160> and<00:11:11.309> support<00:11:11.370> can
supervision and support can
supervision and support can
liver<00:11:12.570> a<00:11:12.840> range<00:11:13.320> of<00:11:13.530> health<00:11:13.680> care
liver a range of health care
liver a range of health care
interventions<00:11:14.160> effectively<00:11:15.030> perhaps<00:11:15.690> that
interventions effectively perhaps that
interventions effectively perhaps that
promise<00:11:16.890> is<00:11:17.100> within<00:11:17.520> reach<00:11:17.790> now<00:11:18.410> indeed<00:11:19.640> to
promise is within reach now indeed to
promise is within reach now indeed to
implement<00:11:21.150> the<00:11:21.240> slogan<00:11:21.660> of<00:11:21.750> health<00:11:21.960> for<00:11:22.140> all
implement the slogan of health for all
implement the slogan of health for all
we<00:11:22.890> will<00:11:23.070> need<00:11:23.250> to<00:11:23.400> involve<00:11:23.880> all<00:11:24.180> in<00:11:24.540> that
we will need to involve all in that
we will need to involve all in that
particular<00:11:25.350> journey<00:11:25.890> and<00:11:26.610> the<00:11:26.790> case<00:11:26.940> of
particular journey and the case of
particular journey and the case of
mental<00:11:27.420> health<00:11:27.570> in<00:11:28.140> particular<00:11:28.350> we<00:11:28.890> would
mental health in particular we would
mental health in particular we would
need<00:11:29.160> to<00:11:29.340> involve<00:11:29.610> people<00:11:30.360> who<00:11:30.450> are<00:11:30.540> affected
need to involve people who are affected
need to involve people who are affected
by<00:11:31.200> mental<00:11:31.230> illness<00:11:31.860> and<00:11:32.010> their<00:11:32.280> caregivers
by mental illness and their caregivers
by mental illness and their caregivers
it<00:11:33.750> is<00:11:33.870> for<00:11:34.020> this<00:11:34.140> reason<00:11:34.260> that<00:11:35.220> some<00:11:35.460> years
it is for this reason that some years
it is for this reason that some years
ago<00:11:35.850> the<00:11:36.030> movement<00:11:36.390> for<00:11:36.720> global<00:11:36.990> mental
ago the movement for global mental
ago the movement for global mental
health<00:11:37.440> was<00:11:37.560> founded<00:11:37.980> as<00:11:38.070> a<00:11:38.130> sort<00:11:38.430> of<00:11:38.490> a
health was founded as a sort of a
health was founded as a sort of a
virtual<00:11:38.850> platform<00:11:39.740> upon<00:11:40.740> which
virtual platform upon which
virtual platform upon which
professionals<00:11:42.060> like<00:11:42.150> myself<00:11:42.210> and<00:11:42.960> people
professionals like myself and people
professionals like myself and people
affected<00:11:43.950> by<00:11:43.980> mental<00:11:44.310> illness<00:11:44.460> could<00:11:44.940> stand
affected by mental illness could stand
affected by mental illness could stand
together<00:11:45.560> shoulder<00:11:46.560> to<00:11:46.590> shoulder<00:11:46.710> an
together shoulder to shoulder an
together shoulder to shoulder an
advocate<00:11:48.150> for<00:11:48.270> the<00:11:48.360> rights<00:11:48.510> of<00:11:48.780> people<00:11:49.050> with
advocate for the rights of people with
advocate for the rights of people with
mental<00:11:49.470> illness<00:11:49.800> to<00:11:50.640> receive<00:11:50.970> the<00:11:51.120> care<00:11:51.270> that
mental illness to receive the care that
mental illness to receive the care that
we<00:11:51.570> know<00:11:51.720> can<00:11:51.900> transform<00:11:52.350> their<00:11:52.530> lives<00:11:52.650> and<00:11:52.980> to
we know can transform their lives and to
we know can transform their lives and to
live<00:11:53.970> a<00:11:54.000> life<00:11:54.210> with<00:11:54.420> dignity<00:11:54.890> and<00:11:55.890> in<00:11:56.280> closing
live a life with dignity and in closing
live a life with dignity and in closing
when<00:11:57.930> you<00:11:58.020> have<00:11:58.230> a<00:11:58.530> moment<00:11:58.950> of<00:11:59.160> peace<00:11:59.250> acquired
when you have a moment of peace acquired
when you have a moment of peace acquired
in<00:11:59.820> these<00:11:59.940> a<00:12:00.030> very<00:12:00.180> busy<00:12:00.660> few<00:12:00.780> days<00:12:00.870> or<00:12:01.290> perhaps
in these a very busy few days or perhaps
in these a very busy few days or perhaps
afterwards<00:12:02.000> spare<00:12:03.000> a<00:12:03.030> thought<00:12:03.120> for<00:12:03.990> the
afterwards spare a thought for the
afterwards spare a thought for the
person<00:12:04.440> you<00:12:04.530> thought<00:12:04.710> about<00:12:04.860> who<00:12:05.220> has<00:12:05.400> a
person you thought about who has a
person you thought about who has a
mental<00:12:05.820> illness<00:12:05.880> or<00:12:06.180> persons<00:12:06.570> that<00:12:06.780> you
mental illness or persons that you
mental illness or persons that you
thought<00:12:07.200> about<00:12:07.350> who<00:12:07.860> have<00:12:08.070> mental<00:12:08.430> illness
thought about who have mental illness
thought about who have mental illness
and<00:12:08.940> their<00:12:09.900> to<00:12:10.050> care<00:12:10.200> for<00:12:10.320> them<00:12:10.470> thank<00:12:11.040> you
you
Vikram Patel, TED, TED-Ed, TED, ED, TEDEducation, mental, health, illness, mind, psychiatrist, psychiatry
