Mental health problems represent a significant proportion of the global burden of disease (~10% disability-adjusted life years) yet receive a disproportionately low level of funding (less than 1% of most countries’ healthcare budget) (Patel et al., 2016; Whiteford, Ferrari, Degenhardt, Feigin, & Vos, 2015). The situation is especially fraught in low- and middle-income countries (LMICs). Between 76% and 85% of people with severe mental disorders receive no treatment for their mental health problem in LMICs and untreated mental health problems account for 25.3% and 33.5% of all years lived with a disability in LMICs, respectively (World Health Organization, 2011). Governments from LMICs spend the lowest percentages on mental health worldwide and receive very little support from international aid and NGOs for mental health (Kakuma et al., 2011; Razzouk et al., 2010; Saxena, Thornicroft, Knapp, & Whiteford, 2007). Clinical trials are rarely conducted in low-income countries so the effectiveness of treatments in culturally diverse, low-income settings is largely unknown (Becker & Kleinman, 2013). Furthermore, a lack of appropriately trained health professionals in LMICs undermines the feasibility of a range of therapeutic approaches developed in the Western context (Becker & Kleinman, 2013; Saxena et al., 2007).
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