After eight years at the National Institute of Mental Health, Pamela Collins joined the UW in January to lead its global mental health program, a joint effort of the Departments of Global Health and of Psychiatry and Behavioral Sciences.
The daughter of a Lutheran minister-turned-professor and a speech pathologist, Collins learned the value of service and science at a young age. Her parents instilled in her a love of travel, and she developed interests in psychology, cultural anthropology and languages. By the time Collins got to medical school, she wanted to learn how to meet mental health needs at the population level.
What other life experiences inspired you?
I was in Haiti during the early years of the AIDS epidemic. It was my first time in a country with a predominantly black population. I was part of a majority, and it got me thinking about how social context influences so many of our experiences, including health and well-being.
Why focus on HIV, women and mental health?
I visited South Africa during my residency and within a year of its new democracy. While shadowing practitioners doing HIV-prevention training with nurses – all of whom were women – I learned about their struggles: communicating across cultures, gender disempowerment, learning to work together in a newly racially integrated system, and dealing with their own fears about HIV. Managing the epidemic would require addressing all of these factors, and that was fascinating to me.
Why did you decide to come to the UW?
I work with two strong departments that are solving challenging problems locally, nationally and globally. This is a university with outstanding faculty and research, and I look forward to meeting colleagues interested in building collaborations. Also, our location in the Northwest has inspired people for many years to develop innovative solutions for mental healthcare needs in this vast region.
What is the most compelling issue in the field of global mental health?
The need for adequate care is not met in most places in the world, including the U.S. and other high-income countries. The complex challenge is getting people high quality, culturally-sensitive and contextually-relevant mental health care services. It’s not something that any country has mastered.
How is the UW uniquely positioned to tackle this issue?
Being able to take interventions we know work, adapt them appropriately, and determine the best ways of taking them to scale is key. That’s the gap that implementation science bridges, and that’s a tremendous strength at the UW. We also have strong domestic and international partnerships, expertise in interventions, including those for collaborative care, and a drive to use technology to create entirely new solutions.
What is your vision for the program?
To reduce the burden of mental disorders in low-resource settings around the world through innovative research, education and training, as well as through the translation of research to policy development.
In what new directions do you hope to guide the program?
We have an opportunity to learn alongside our colleagues in mental health systems around the world. Cost and accessibility to mental health care are barriers everywhere. Innovations from some low-resource settings have been extremely successful for delivering effective mental health care. We can test whether what providers or systems are doing in South Africa, for example, could be effective in Seattle or in our region. We need to learn from the best work, wherever it is happening.
I think we’re also prepared to tackle the challenge of preventing mental disorders. There is already a great deal of interest in this at the UW through perinatal mental health. We know that taking care of a mother’s mental health not only reduces the burden of disease for that individual woman, but it improves the outcomes for her child as well.
How do you see the program fitting within the Population Health Initiative?
The research and education that we do around a broad framing of mental health, in terms of well-being and mental capital as well as mental illness, is key for the Population Health Initiative. Various exposures across the life course can influence mental health, well-being and risk for disorder. These can range from our genes and early life experiences, the built environment and housing, to cultural influences on the value of parenting and education, as well as income, race and ethnicity. We need multidisciplinary efforts to address this complex web, and we need a global effort to understand these factors across different populations.