Franco Mascayano

Franco Mascayano is an early-career investigator who considers applied research in stigma, mental health services, implementation science, global mental health, and psychiatric epidemiology.

Why do you do this work?

I can start by telling you a little bit about who I am. I am from Chile originally and I got into this field in 2013 or 2014. I was an MPH student at the time, and I remember I went to Argentina for a conference, and I met this guy from Columbia, Ezra. At the time, I had no idea what Global Mental health was. Before that, I had a local trajectory in mental health, but Global Health as a field wasn’t a thing for me. Although my team and I were heavily involved in designing and implementing policies in mental health, we didn’t seem ourselves as global health researchers. That is an example of how the categories/labels we have in mind and use in the Global North not necessarily correspond or make sense to people in the Global South.

So why do I do this work? I am very interested in the intersection between research and practice in a global frame, but it took me a long time to figure that out. That’s why I find funny when young people clearly state that they want to have an impact on global health. I could have never said that when I was their age. I think it’s because I come from a place where global health wasn’t, you know, taught at universities, people weren’t talking about it.

Could you speak to the advantages of collaborative and interdisciplinary work within this field and how you bring this perspective into your partnerships?

One good example was HEROES. This was a massive, bottom-up cohort study involving over 25 countries during the COVID-19 pandemic. This was a transformative experience for me because I was

exposed to many teams all over the world in a truly collaborative setting. In HEROES, people had a say, they were able to say, “this approach really doesn’t work in our setting” or “there are things that are very relevant to us that aren’t for people, in say, Brazil”. And so, we were flexible and we tried to be responsive to the different research teams’ needs. I would say that is the approach I truly believe in and one that I always try to do in any research that I am part of. Lessons from this study include being mindful about post-coloniality issues, local needs and what people really want to do, and how much time it would take to do a meaningful, transformative project. I get very suspicious when I hear people saying “yeah, we know some guys in Argentina or wherever and we’re going to do this and that and write grants and papers”. I think that’s a terrible practice. When I talk to guys in Latin America, I get different sides of the same story. I hear guys from the North say: “oh that was a big success”, but I hear guys from the Global South, many times, say that they have no idea about all these papers and grants, and that they were never invited.

Could you tell me about something you’re working on right now that you’re really excited about?

I’m very interested in doing epidemiological and mental health research using data from population-based registries. In Chile, there are population-based, national registries that are quite similar to what you see in Scandinavia. The best knowledge we have about the pathology of mental disorders, I would say, come from these countries. Given that these are national identifiers, everyone in Chile, including immigrants, are in these registries. If we get that project funded, it will be truly revolutionary because we can start by addressing questions that are quite well-known and well-studied in other settings, like the role of urbanicity on the onset of psychosis, but that it hasn’t been comprehensively examined in the Global South. Furthermore, given that we can follow up on people after they start treatment process in the public health system, we can also use data from this registry to see if/how care has an impact on people with mental conditions being at high-risk for being hospitalized, premature mortality, physical and mental comorbidities and so on.

What would you tell someone entering this field right now?

I would say, first of all, be humble, especially if you are someone from/in the Global North. Be humble because you probably will be exposed to people who are not. Because they’re telling you stories that aren’t the full story. And you could be quite fooled by that—as I was. So, be humble and be mindful of that. If you want to have a real, meaningful experience, try to set up a visit. Try to talk to people on the ground. I know there might be cultural and language barriers to overcome but these days, you can do it. Especially if you are working with people who are well-connected with local teams. You could be there. You could talk to key people. You could be connected to representatives to communities we serve. The political aspect of global mental health is something a young fellow should consider. It’s not like we’re doing science in a lab and that’s it. It’s about people, it’s about relationships, it’s about history, it’s about colonialism. I don’t think someone said that to me when I was younger.

Milli Wijenaike-Bogle, an MPH Candidate in the Department of Sociomedical Sciences, interviewed Franco Mascayano for this Q&A.