Global and Population Mental Health

Kathleen Sikkema, PhD

Dr. Kathy Sikkema is a clinical psychologist who specializes in health and community psychology and conducts community based intervention research focused on HIV prevention and mental health treatment in the U.S. and in low and middle income countries.

 

Why do you do this work?

I am a clinical psychologist and was always interested in mental health.  As a doctoral student I started working clinically with people that had HIV and AIDS, 35 years ago, and, by the late nineties, I started to work globally in HIV. I always was interested in mental health even though we were more focused on prevention due to the lack of HIV treatment. The “why” would be that I've been working in the field of HIV and mental health for many decades, and as global mental health was defined as a subfield of global health, I realized the work I did in AIDS in low resource settings was relevant to global mental health more broadly. So, I continued with my own area of expertise, but learned a lot more about the field and committed to growing it here at the Mailman School of Public Health.

What is your proudest moment working within global mental health?

In the universities where I have worked, and now, at Columbia, having the opportunity to bring new people into the field, create programs, and build a collective effort to address mental health. While it

The University of Cape Town Research Team Back row (L to R): Dr. John Joska, Nokuphumla Nofeliti, Nomakaziwe Siko, Neliswa Ketelo, Dr. Stephan Rabie Front row (L to R): Nomvula Mdwaba, Esona-Sethu Ndwandwa, Yoliswa Mtingeni, Thulani Niengele, Sybil Majokweni, Thandiwe Mngxuma

is a general statement, in terms of pride, it would be contributing to the expansion of the field with the goal of improving mental health for all.

How do you envision the future of global mental health as a field? What contributions would you hope to have made?

I would first note, poor mental health is often comorbid with other health conditions. For example, in my own work if we address mental health and trauma specifically, we might also improve HIV care engagement and clinical outcomes. This likely is also the case for example, with cancer, diabetes, or heart disease.  Second, we need to think of mental health and the benefits of addressing socio-emotional distress and preventing mental disorders for mental health in and of itself, including to enhance well-being and resilience. So, that's certainly the way I view global mental health when I think about it from a public health lens.

Within the last decade we have elevated the importance of addressing the social determinants of mental health and the need to incorporate community engagement utilizing a prevention framework. So, this isn't a new thought. I can't claim that. But I think as we develop innovative approaches and prioritize efforts to address population mental health, that is an area of global mental health in which Mailman can lead and advance public mental health.

Where is your favorite place that your work has taken you?

My favorite place is Cape Town. I’ve worked in South Africa for over 20 years.  I went to South Africa for the first time in 2000 for the International AIDS Conference in Durban. The disparities, lack of

Some of the Project Someleze Investigative Team at the Psychotherapy Conference in Cape Town on March 9th, 2023 (L to R): Dr. Stephan Rabie, Amaleah Mirti, Esona-Sethu Ndwandwa, Dr. Kathy Sikkema, Dr. John Joska, Dr. Lena Andersen, Sybil Majokweni

access to treatment for AIDS, and the socio-political challenges in South Africa at that time felt to me like the late 1980s when I was a doctoral student.  I got angry again, in a good way. I really had a sense that I would like to work there, could hopefully contribute, and was fortunate to meet fantastic collaborators over the years. Our research would not be possible without our South African colleagues.

Cape Town is a challenging place to do HIV and mental health research because of the disparities in health and wealth, the history of apartheid, and all the complex social, political, and cultural elements that affect our work. But that complexity is part of what makes it my favorite. There's a strong focus on mental health. Many of my collaborators are making progress in mental health policy and are committed to increasing access to mental health care.  It's a beautiful and geographically stunning place but with numerous on-the-ground challenges. Additionally, our community partners and academic colleagues are exceptionally committed, and it is such a pleasure to work with an outstanding team. So, it's my favorite place, because of how I feel when I am there, the people with whom we work and just the challenges that it brings. 

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