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Researchers at UQ oversee the research of mental disorders for the Global Burden of Disease (GBD) study – the largest ongoing study to quantify disorders and diseases in the world. They’re the only team working outside of the United States to do so, and their data influences the global agenda for mental health.
InSight+ spoke to current and former team leaders to find out why these researchers are special.
Associate Professor Damian Santomauro leads the Epidemiology and Burden of Disease Research team at the Queensland Centre for Mental Health Research (QCMHR). The team oversees the 12 mental disorders represented in the GBD, under the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
The Brisbane-based team is the only team outside of the United States that oversees the epidemiological modelling and burden estimation for an entire category of disease burden within the GBD Study.
Because the GBD has Australian roots.
Professor Chris Murray first published the GBD Study in the 1990s with Professor Alan Lopez – both Australian – while working at the World Health Organisation (WHO) in Geneva.
The pair created the DALY – Disability adjusted life years – to quantify the impact of a disorder’s morbidity, as well as its rates of mortality.
“The story is that Alan Lopez was working for WHO, and a very young Chris Murray comes down the hallway, knocks on Lopez’s door, and says, ‘You’re doing everything wrong.’” said A/Prof Santomauro.
“And instead of kicking him out Lopez said, ‘OK. What would you do instead?’”
“They came up with this idea of how to measure health loss in a different way, considering both the morbidity and mortality caused by different health conditions.”
A new way of quantifying health loss
Before the DALY, decision making regarding leading causes of global health loss were based on mortality statistics alone.
“It didn’t tell us much about morbidity and disability. They really wanted this metric that could look at both diseases that kill us, but also diseases that make us really sick when we’re alive,” said A/Prof Santomauro.
“The WHO funded a project that allowed them to estimate DALYs for various diseases and injuries.”
“The GBD was a milestone in how we understand mental disorders and their impact on populations. It was the first time mental disorders were recognised as leading causes of morbidity, globally.”
Professor Murray moved from the WHO to the University of Washington in the mid-2000s, founding the IMHE with seed money from the Bill and Melinda Gates Foundation. Professor Murray still oversees the Study. Professor Lopez was based in Australia at the time.
Initially, IMHE worked with satellite groups globally, including the QCMHR. Over time, Washington took on the majority of the work.
‘My predecessors at QCMHRsaid, ‘We should continue leading mental disorders, don’t you think? We do a good job,’” said A/Prof Santomauro.
“Fortunately, Washington agreed.”
Putting mental health on the agenda
Associate Professor Alize Ferrari is a Research Consultant at the School of Public Health, UQ, and Affiliate Associate Professor Institute for Health Metrics and Evaluation, University of Washington.
A/Prof Ferrari formerly led the Brisbane (GBD) Mental Disorders researchers at QCMHR.
“The GBD informs epidemiological and public health research; it has many research and clinical implications. It also has a political element; one of its most important functions is to inform the health resource allocation at government levels,” said A/Prof Ferrari.
“It informs which programs are funded, and where more programs are required. It’s the biggest scientific effort to understand the burden of almost 400 diseases and injuries.”
“Nobody was talking about the global health loss caused by mental disorders before the first GBD came out in 1996. We still have a long way to go when it comes to mental health treatment and prevention – but now, it’s established that major depressive disorder is a leading cause of disease, and it makes you really sick for a long time.”
“We know the importance of early intervention of mental disorders in school because of the impact on health loss and the economic impact it has later on in life.”
“I’m very proud. A lot of the work that we do day-to-day is in spreadsheets, and it’s very, very focused. But the brilliance of GBD is you still get many opportunities to take just two, three steps back and see the impact it has on overall population health,” said A/Prof Ferrari.
She said that it has had more specific implications, as well.
“Back in 2016-17, the Queensland government came to us because they didn’t have any direct burden of disease data for Indigenous Australian Queenslanders, and asked if we could help out.”
“QCMHR and the Institute for Urban Indigenous Health collaborated to produce the very first population mental health survey for Indigenous Australian Queenslanders.”
“Now, those metrics that we created are still used to inform the decision-making processes in South East Queensland.
A/Prof Santomauro says it’s surprising how many people use the GBD estimates.
“We published a paper in 2021 highlighting the burden of eating disorders, which facilitated new dialogue around eating disorders nationally.
“We also did a recent paper on autism and suicide, showing the elevated risk. Because of the evidence now being considered, and I’m aware of policy briefs flagging autistic people as a group that’s vulnerable for this outcome.”
“This is a rare area of work, where what we do has an almost immediate impact on the world.”
The Brisbane Team
“There are a few reasons the QCMHR team is the only team outside of IHME in Washington,” said A/Prof Ferrari.
“First of all, we are mental health researchers doing mental health research. Our team at QCMHR all have professional backgrounds within mental health research and are very passionate about improving the mental health of both our local communities in Queensland and international populations as well.“
“Most of us also have personal links that make us passionate about doing mental health research. It means we can engage with the data in a way that they can’t.”
“When you have that investment, it makes you more determined to get it right, to go the extra mile. And you know, you feel that responsibility to come up with estimates that are as precise as possible, and that can inform treatment and health services in a way that’s correct, not wrong and or misleading. We take that responsibility on our team quite seriously.”
“The other factor of our team doing this work is money, funding. We are very fortunate to work within a research centre partly funded by Queensland Health. They’ve made permanent funding available to our centre.”
Two members of the GBD team at QCMHR are permanently funded by the Queensland government, and are permanent staff.
A/Prof Ferrari said that in an environment when international funding for health research is becoming more difficult to obtain, the metrics produced by GBD become essential.
“It makes something like GBD, and the metrics we produce, even more important. Because we need help in prioritising where that limited funding should go.”
A/Prof Santomauro is passionate about the future of the Brisbane team looking after the mental disorder statistics for the GBD.
“We’re good at what we do. We don’t take anything for granted. We will keep delivering the best estimates we can for the health of the global population.”
Becca Whitehead is a freelance journalist and health writer. She lives in Naarm and is a regular contributor to the MJA’s InSight+.
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