By Susan Gallagher
Duke Global Health Institute (DGHI) professor Kathy Sikkema will leave Duke University on June 30 to begin a position as the chair of the Department of Sociomedical Sciences in the Mailman School of Public Health at Columbia University.
Sikkema, the Gosnell Family Professor of Global Health, Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, is the founding director of DGHI’s global mental health initiative, director of doctoral studies at DGHI and director of the Social and Behavioral Science Core in Duke’s Center for AIDS Research. She has conducted HIV-related research in South Africa for nearly 20 years and serves as the faculty lead for DGHI’s priority partnership in Cape Town.
A clinical psychologist with an emphasis in health and community psychology, Sikkema conducts community-based trials on the development and evaluation of HIV-related interventions focused on traumatic stress and coping, HIV prevention and HIV care engagement. Her research supporting her evidence-based interventions has been funded by the National Institutes of Health for almost 30 years and has resulted in more than 200 publications in peer reviewed journals.
We recently talked with her to learn more about her time at DGHI and her thoughts on the future of global mental health. Here are some excerpts from our conversation.
DGHI: You launched the Global Mental Health Initiative at DGHI in 2014, and you’ve led it since then. Tell us a little bit about the initiative.
Sikkema: Seven or eight years ago, many people at DGHI were interested in global mental health, but we didn’t have a formal focus on it. We convened a meeting to explore interest at Duke in this area, and about 35 people attended. We were pleasantly stunned by how many people didn’t necessarily do global mental health research but saw their work as related and wanted to do more in that area. As global mental health developed, student interest grew at both the undergrad and graduate levels.
Global mental health was getting established as a field and increasingly seen as an emerging priority in global health. The curve was starting and we jumped in. So in 2014, we established global mental health as a research priority at the institute. Our goals were to recruit faculty, expand resources, build on our education efforts and increase the visibility of global mental health at Duke and internationally. We’ve awarded pilot grants, hosted speakers and forums and broadened our collaborations with international partners.
I’m proud of our achievements and it has truly been fun to lead the initiative with such fantastic colleagues. It’s rewarding when peers acknowledge the strength of global mental health at Duke.
DGHI: How do you think the global mental health field has evolved in recent years, and where do you see it going in the future?
Sikkema: Although we’ve made great progress in the field, in some ways, when it comes to mental health, most countries are still a low-resource country.
While stigma around mental disorders remains a challenge, I think it’s decreasing—especially with outspoken well-known advocates encouraging people to talk more about mental health and in due time increasing support and changing norms. It also helps that the field is establishing a strong evidence base supporting how to get treatment to regions where there are no mental health specialists.
Looking forward, I think the field of global mental health will further expand to address resilience, noting that being healthy—including mental health—doesn’t mean only the absence of disease.
I also hope the future will bring increasing focus on ways to prevent mental disorders from the outset. The priority has been on treatment because the need has been so great—and there are still many people who need treatment—but I think as a scientific field of inquiry we also need to be thinking more about prevention, especially among children.
Another future direction is to think about mental health at a social and structural level in addition to diagnosis and treatment. We can have greater impact by addressing what happens at a population level—poverty, discrimination and poor food access—and considering how these factors impact mental health.
DGHI: You took over the helm of DGHI’s doctoral programs in 2012. What are the goals of those programs, and what did you enjoy about your leadership role?
Sikkema: In our doctoral certificate program, PhD students from a wide variety of disciplines take global health courses and do global health-related fieldwork. In the scholars program, DGHI provides funding and mentorship for selected PhD students across Duke to complete a global health dissertation. The program also helps create a network of future leaders in global health.
One primary goal for the scholars was to respect and value their primary discipline and to provide fellowships to students whose primary focus is integrating that discipline within an interdisciplinary approach to global health. We wanted the scholars in particular to be able to say, “My PhD is in X, and my focus is global health.” To date, the doctoral scholars represent 12 disciplines. It’s a lot of fun to listen and learn from these different perspectives and methods.
Honestly, I loved running the doctoral programs. It has always been very invigorating for me to listen to them talk about their research, help them create opportunities and mentor them through conducting a global dissertation.
Overall, mentoring has been an important and deeply rewarding part of my work at DGHI, including the PhD students, post-docs and faculty on my research team and in global mental health more broadly.
DGHI: What will you be doing in your new role at Columbia?
Sikkema: I’ll be the chair of the Department of Sociomedical Sciences in the Mailman School of Public Health. The department actually has a very interesting history, founded in 1968 to integrate social sciences as essential in the study and practice of public health.
The department is highly interdisciplinary: it’s made up of people from public health, sociology, anthropology, psychology, history and political science. The department’s focus is on studying broader level social influences on health—like racism, discrimination and stigma—as well as behavioral and individual factors.
I plan to continue my research in South Africa and facilitate the growth of global mental health. And, of course, I’ll continue doing the mentoring and teaching that I loved at Duke.
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Overall, mentoring has been an important and deeply rewarding part of my work at DGHI.Kathy Sikkema