Global mental health and trauma: the current evidence and the long road ahead

I n the last few years, a growing amount of evidence highlighted the urgent need for research aimed at assessing mental health status in low-and middle-income countries (LMICs): this revealed a substantial gap between the burden caused by mental disorders and the resources devoted to prevent and treat them (Kakuma et al., 2011). In fact, while more than 80% of the global population lives in LMICs, these countries only manage B20% of the total resources to treat mental illnesses As a consequence, more than 75% of people with mental health disorders do not receive care at all, despite substantial role disability (Demyttenaere et al., 2004). Also research on traumatic stress revealed a predominance of high-income countries (HICs) over LMICs, with a great amount of studies carried out and published by authors affiliated with HICs (Fodor et al., 2014), and the consequent difficulty in transferring evidence results in LMICs contexts (like humanitarian settings). In response to this call for an evaluation of a ''global mental health,'' substantial scientific effort was devoted to address the psychological and social needs of populations living in humanitarian settings in LMICs. This special issue of the European Journal of Psycho-traumatology collected some of the work that has been done so far in LMICs. Manuscripts address important issues such as the quantification of effects of cumulative trauma exposure in war survivors (Wilker et al., 2015); factors related to psychological distress in orphans living in Tanzania (Hermenau, Eggert, Landolt, & Hecker, 2015); the relationship between trauma exposure and spirit possession (Hecker, Braitmayer, & Van Duijl, 2015); trauma-related mental health problems in humanitarian staff (Strohmeier & Scholte, 2015); and sociotherapy approach developed and implemented in Rwanda (Jansen et al., 2015). The paper by Wilker et al. (2015) analyzed the role of cumulative trauma exposure as a risk factor for developing posttraumatic stress disorder (PTSD), by assessing reliability and predictive validity of trauma measures in a sample of 227 Ugandan rebel war survivors. Measures showed good reliability and authors concluded that the assessments of event types, together with the additional consideration of event frequencies, may represent a valid and reliable instrument to evaluate cumulative trauma exposure. Hermenau et al. (2015) undertook a comparison between a group of 89 orphans living in Tanzania and 89 matched non-orphans to explore orphans' experiences of maltreatment and perceived stigmatization, and to identify possible factors related to psychological distress. In short, findings from this study …