[Worldwide perspectives very welcome and relevant here.]

One of the common overarching concerns I hear for psychiatry, both here and elsewhere, is the basic idea that our basically medical model is not well-suited to the increasingly broad range of at-least-partly-psychosocial problems that psychiatry gets implicitly tasked with solving, both in terms of being able to meet demand and in terms of the downsides of trying.

This question is probably going to be asked more and more, as the West faces the consequences of overtasking a limited number of clinicians, and particularly as the developing world Westernizes and likely sees an increase in psychiatric problems. In neither case can we count on enormous academic systems that train thousands to millions of clinicians who each spend 8-12 years in post-secondary education.

While this is often a source of frustration and burnout, for me and others, I also think this is an area where thinking about alternatives can be helpful. So, my thought question: Given a relatively blank slate to fashion a practical mental health system from a public health point of view, and a reasonable budget (but still plenty of pressure to be cost-effective and judicious), what would be your core interventions?

Two concepts to stimulate thinking:

https://www.bbc.com/future/article/20181015-how-one-bench-and-a-team-of-grandmothers-can-beat-depression [very different model of lay counseling that mobilizes an underutilized population; has real risks/benefits in application

https://bhbusiness.com/2020/02/26/walmart-health-offers-counseling-for-1-per-minute/ [ambivalent about this partnering, but I still think all Wal-Marts need an LCSW]