Steering global leadership

Around the world, psychologists are increasingly taking on key positions in government, humanitarian settings, and health, using their expertise in human behavior and well-being to shape governance and policy-making on a global scale. The Covid-19 pandemic highlighted the crucial need for the expertise of mental health professionals and behavioral scientists.

Psychologists are leading efforts to create global guidelines for the diagnosis and care of mental health conditions, spaces that have long been dominated by psychiatrists. They are also consulting on population-level challenges such as social isolation and loneliness, as well as providing guidance on leadership and well-being to the United Nations (UN), World Health Organization (WHO), and other key agencies. Their training makes them particularly well suited to working in international spaces, said Mark van Ommeren, PhD, head of the mental health unit in the WHO’s Department of Mental Health, Brain Health, and Substance Use.

“Curiosity and seeking to understand other cultures are necessary for international work, and culture is very much about the lens one looks with into the world,” he said. “Psychologists are well trained in looking at things in different ways and not assuming that your own lens is the only one that is valid.”

Applying social, behavioral, and mental health insights on a global scale can make the world a better place—but U.S. psychology can also benefit from closer cooperation with other countries. Jessica Jackson, PhD, a psychologist who works as an antiracism and mental health consultant for the UN, points to the immigrants, refugees, and diversity of cultures within the United States alone.

“To be a good psychologist in the U.S. today, you actually need to start thinking from a global lens,” she said.

Though a natural fit for efforts to bolster global mental health, psychologists are relative newcomers in a space traditionally led by psychiatrists or other physicians. For the first time, the WHO’s Department of Mental Health, Brain Health, and Substance Use has a psychologist, Dévora Kestel, MSc, at its helm. That leadership signals an increased value on psychology to improve mental health around the world.

“Twenty years ago, many experts thought that all that would be relevant for societies with fewer resources were medicines and possibly social interventions—that psychological interventions were too complex and thus not affordable at scale,” said van Ommeren, who has training in counseling psychology and epidemiology.

Since then, more than 100 randomized controlled trials have shown that interventions such as cognitive behavioral therapy (CBT) can be implemented in low-income countries with high levels of efficacy, often by helpers without postsecondary education. Van Ommeren and his colleagues prioritize interventions that can be scaled and delivered broadly, such as behavioral activation, a CBT approach that involves engaging in enjoyable or rewarding activities and can help with depression after just a few sessions.

“We are a public health agency that is governed by governments. What governments want is a mental health system that maximally serves their population,” van Ommeren said. “With that lens, when selecting interventions, you worry less about the difference in effect size between 1.0 and 0.8, for example, and more about major differences in the resources required to scale different interventions to large numbers of people.”

A psychologist, Geoffrey Reed, PhD, also oversaw the first comprehensive update in nearly 30 years of the chapter on mental, behavioral, and neurodevelopmental disorders in the WHO’s International Classification of Diseases (ICD-11). Reed, a professor of medical psychology at the Columbia University Vagelos College of Physicians and Surgeons, said a psychological perspective is woven throughout the chapter, as well as in an associated diagnostic manual for applying those criteria in clinical settings, which serves a similar function in international contexts to the Diagnostic and Statistical Manual of Mental Disorders (Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders, WHO, 2024).

“What we’re really trying to do is convey to people what the essence of each condition is, rather than simply following a bunch of rules, so that clinicians gain a deeper understanding of the phenomenon,” said Reed, who directs the Columbia-WHO Center for Global Mental Health.

For example, Reed helped introduce the dimensional classification of personality disorders in the ICD-11. That method involves evaluating the severity of a condition and the contributing personality characteristics to create a “personality profile,” rather than choosing from a series of discrete disorders. The manual takes a similar approach to psychotic disorders, which Reed said is more consistent with a recovery perspective. This provides broader options for treatment targets, including quality of life, instead of focusing only on reducing symptoms (A Psychological Approach to Diagnosis: Using the ICD-11 as a Framework, APA, 2024).

Global health is more than just mental health, however, and Julianne Holt-Lunstad’s research on loneliness led to her appointment on the WHO’s Technical Advisory Group on Social Connection. There, she is supporting the development of a global social connection index and compiling evidence for interventions that can help address isolation at the population level. She has also advised the U.K. government on the appointment of their first minister for loneliness.

“Importantly, psychology goes beyond just the mental health associations, as these psychological and behavioral processes are relevant to physical health, economic, safety, and other kinds of outcomes,” said Holt-Lunstad, PhD, a professor of psychology and neuroscience and director of the Social Connection and Health Lab at Brigham Young University.

The emphasis psychologists place on understanding the common humanity of people from all backgrounds also lays the foundation for a unique yet effective approach to leadership.

At Amnesty International Morocco, Soufiane Atrassi, who holds a degree in clinical psychology, leads the country’s local office and is developing a series of psychology-informed training sessions to help staffers within his section handle challenges they face in the field, such as verbal abuse.

“These trainings are valuable as they work on our emotional intelligence and our assertiveness,” Atrassi said. “They help us better manage these complex situations and remain professional and effective in our work.”

Recent years have also seen an increase in psychologists seeking international consulting roles, said Ryan Warner, PhD, a counseling psychologist, full-time consultant, and member of APA Division 13 (Society of Consulting Psychology). After working as a clinician in the U.S. Air Force, Warner launched a consulting company to help guide international organizations with strengthening leadership, diversity, and wellness in the workplace. At the UN, he coaches appointed diplomats and senior leaders on public speaking and other skills related to leadership development.

“A lot of these diplomats just jumped into their role—they really didn’t have any formal training around how to be a professional speaker communicating to a global audience on a daily basis,” he said.

Jackson said her psychology training has helped her find common ground among diverse stakeholders at the UN, where she works on antiracism and mental health learning and development resources. But that role has also required her to rethink what she knows about mental health, including everything from symptoms, treatment, and stigma to licensing and continuing education.

For example, isolating is a common symptom of depression, but it might look different in a country where most people place a higher emphasis on collectivism. A person who lives with seven other family members may still attend family dinners, but—assuming they are not responsible for meal preparation and serving—do so less frequently. That could be a sign of distress that a psychologist trained on Western views of depression could miss, Jackson said.

“In the U.S., we have a very rigid understanding of mental health. But if we check our assumptions, what does mental health look like outside of those rigid parameters?” she said.

In government, psychological training affords a new view on policy and governance that can foster improved cooperation, inclusion, and decision-making. Psychologist Sergio Cristancho, PhD, served a 2-year term as Colombia’s vice minister of knowledge, innovation, and productivity, where he designed national policies and regulations related to science, technology, and innovation; led the creation of the country’s first National Scientific Council; and internationally represented the country’s scientific interests, including bioeconomy/biodiversity, food and health sovereignty, energy transition, and peace.

During his time in office, Cristancho helped shape Organisation for Economic Co-operation and Development (OECD) guidelines on citizen engagement in innovation policy. He also developed national policy tools that enabled universities, regional governments, industry groups, and communities to use scientific research to address the diverse social and economic priorities of Colombia’s 32 states and their diverse populations.

Cristancho, who now leads research and innovation at the Universidad del Rosario in Bogotá, said his psychology training has helped him foster dialogue and co-creation among diverse groups, from underserved Indigenous and migrant communities to scientific experts from various fields. Lessons learned from his policy work have subsequently informed his research program on community and intercultural mental health.

“I also found that training in the scientific method gives us the capacity to use a systematic approach to solving complex problems,” he said. “The fact that we give a lot of weight to evidence allows us to bring a high level of rigor and quality to administration and leadership roles.”

While psychology training lays a strong foundation for international leadership work, many experts in these positions report the importance of developing key skills through continuing education or on the job.

“If we really want more psychologists to be leaders in institutions across society and around the world, it’s important that undergraduate and graduate curricula incorporate training on the skills needed to succeed,” Cristancho said, including courses in leadership, strategic planning, data synthesis and analysis, and evidence-based policymaking.

For those who are interested in exploring work at the international level, Warner notes that opportunities may be surprisingly within reach.

“In the virtual world we now live in, you can do international work from the comfort of your home,” he said. “The barriers for getting started are not as high as people may think.”

But psychologists should be wary of other, less obvious hurdles they may face when pursuing work abroad. Because of the country’s privileged position in regard to resources, U.S. researchers have published extensively on mental health. That can give the illusion that the United States has more experience on certain topics, Jackson said, when the condition may be just as common but less researched in other cultures. For example, Malaysia only decriminalized suicide in 2023; before that, research on the subject was very difficult to conduct and Malaysians relied largely on scientific literature from the U.S. and Scandinavian countries.

While the United States has contributed greatly to the body of psychological science in these and other cases, it’s still important to do so with cultural humility. When collaborating with international experts on the ICD-11, Reed stressed the importance of using different ways to evaluate excellence in countries where less research funding is available than it is in the United States. In many countries, publishing original research requires additional work on top of a 60-hour-per-week clinical load and substantial administrative and teaching responsibilities (Guler, J., et al. International Journal of Clinical and Health Psychology, Vol. 18, No. 3, 2018).

Psychologists can demonstrate a commitment to international collaboration in several ways, Reed suggests, such as pursuing cultural competence training or considering learning a second language.

“I have now had the experience of having to give talks in a language that wasn’t my first language, and at first, it was really painful and embarrassing,” he said. “This increased my empathy a lot.”

Jackson suggests devoting time to learning about the history of mental health around the world, including by listening to international colleagues about their backgrounds and experiences. It’s key to recognize the contributions of others and admit where Western cultures have gotten things wrong regarding mental health, she said.

“When we engage in this work, we need to keep in mind that there’s a lot we can learn from what healing looks like in other countries,” Jackson said.