Giuseppe Raviola, MD, MPH
Senior Lecturer, Faculty of Global Health Delivery
Giuseppe (Bepi) Raviola, MD, MPH, is an Assistant Professor of Psychiatry, and Global Health and Social Medicine, at Harvard Medical School. He is Director of Mental Health for Partners In Health (PIH), and Director of the Program in Global Mental Health and Social Change at Harvard Medical School. He serves as Harvard’s lead for the Rwanda Human Resources for Health program in Psychiatry. His work in global health began in 2000, when as a medical student he completed one of the first studies in sub-Saharan Africa examining the mental health and well-being of early career physicians working in the context of high HIV disease burden, and limited resources, at East Africa’s largest public hospital. He completed his Psychiatry training at MGH-McLean Hospitals, and training in Child and Adolescent Psychiatry at Dartmouth-Hitchcock Medical Center where he learned about the delivery of rural mental health care in the US context. Throughout his training he pursued opportunities to learn about mental health systems of care in various countries, and community psychiatry in the US.
In 2009 Dr. Raviola began work in Rwanda, supporting the development of a mental health team at Inshuti Mu Buzima (PIH Rwanda) that supports the Rwanda Biomedical Center’s goals of national decentralization. This work has evolved to seek to integrate mental health into primary care through the expansion of a community-based mentorship and enhanced supervision (MESH) model to address severe mental disorders across all of Burera District, now serving approximately 4,000 patients. This intervention includes the delivery of mental health care by generalist, government-employed health center nurses; the evaluation of clinical, functioning and economic outcomes; and the expansion of these services to other districts including an RBC-led effort in Musanze District. IMB has tested the MESH Model for Mental Health in Rwanda’s Burera District, expanding it to the entire district, with the ultimate aim of it serving as a comprehensive system for improving the delivery of decentralized mental health care throughout Rwanda. Currently the effort includes piloting of more focused psychosocial and psychotherapeutic components, with the aim of minimizing the use of medications. In 2011 Dr. Raviola founded two fellowships at Harvard, the Dr. Mario Pagenel Fellowship in Global Mental Health Delivery, and the Abundance Foundation Fellowship in Global Mental Health Implementation Science, with fellowships serving the IMB work in Rwanda.
In 2010 Dr. Raviola took leadership of the PIH mental health response to the 2010 Haiti earthquake, and he has led PIH’s efforts to integrate safe, effective, evidence-based and culturally sound mental health services across all ten sites. He concurrently led a new departmental quality program in the Department of Psychiatry at Boston Children’s Hospital that provides oversight of safety, quality, and outcomes initiatives in child and adolescent mental health care. His academic work has centered on the integration and application of quality improvement and public health approaches in innovating clinical practice, teaching and research in the domains of psychiatry and global mental health, particularly in developing new intervention programs in mental health integrated within primary care systems in low resource settings. Under his leadership at PIH, the organization has worked to integrate mental health services into the health systems it supports, testing models of care in locations where there is a significant lack of specialists. This has included the creation of community-based mental health systems in Haiti and Rwanda, and supporting mental health program development in Mexico (Chiapas), Peru (Lima), Liberia, Sierra Leone, Malawi, Lesotho, Siberia, Navajo Nation in New Mexico, and the Rosebud Sioux Reservation in South Dakota. This work meets a critical local and global need for innovative, community-delivered, preventive and clinical mental health solutions, given the significant global burden of mental disorders and a universal shortage of specialists. Dr. Raviola actively teaches and mentors students and trainees at all levels, including in the Harvard Masters of Medical Science in Global Health Delivery (MMSc-GHD). With Professor Vikram Patel he currently co-leads a cross-university initiative in Global Mental Health and Sustainable Development at Harvard.