by Michelle Mullen
When Dr. Craig Katz traveled to El Salvador after a devastating 2001 earthquake, he joined a small team of doctors offering mental health support to displaced families.
It was a relief mission that would ultimately reshape his life.
“We were working with the local nongovernmental organization there that was like a community support organization,” he said. “It was our first experience, and it was rather challenging actually, because many of us were not used to working under those conditions.”
That trip marked the beginning of Katz’s long career in global psychiatry.
“So much of the disaster work has to be outreach oriented,” he said. “You can’t just sit back.”
Katz, a Riverdale resident and professor at the Icahn School of Medicine at Mount Sinai, has spent more than two decades helping build mental health infrastructure in developing countries.
His book, “Unseen: Field Notes of a Global Psychiatrist,” draws from those experiences.
“I just felt like writing this book and being able to convey, with all possible richness, what it’s like to have a mental health problem in a place where there are no resources would really open people’s eyes,” he said. “Rather than telling, I wanted to show.”
The book follows two fictional men, Sam and Berko, one living with depression and the other with schizophrenia, in an unnamed country inspired by Katz’s work in countries like Liberia, Haiti, India and St. Vincent.
“I wanted it to be truly kind of global,” he said. “I didn’t name the place because it’s supposed to be like all these places we’ve been.”
The decision to focus on depression and schizophrenia was intentional.
“Depression is the most common mental health condition around the globe,” Katz said. “It’s also extremely underrecognized in low- and middle-income countries. Schizophrenia, on the other hand, tends to get all the attention because it can be dramatic.”
His path to psychiatry wasn’t a straight one.
“My father, may he rest in peace, always said I was going to be a psychiatrist, and I always laughed at him,” he said. “But one day on the M4 bus on the way to medical school, I just had this moment — I should be a psychiatrist. And I’m not given to epiphanies, but here I am.”
Early disaster works also shaped how he sees care. After traveling to Sri Lanka in 2004 following the Indian Ocean tsunami, Katz was asked a question that has stayed with him.
“A teacher stood up and said, ‘Thank you for coming, but where were you before?’” he recalled. “It really affected me. Most places are a disaster from a mental health perspective before any disaster hits.”
That moment shifted his focus from short-term response to long-term development.
“I wanted to do more to improve access to care, not when there’s a disaster, but just in people’s daily lives, which often can be a disaster themselves,” he said.
At Mount Sinai, Katz founded the Global Mental Health Program, which trains nurses and doctors in countries with few psychiatrists.
“We don’t go treat people,” he said. “We teach, and we try to do it in a humble way because we also know that there are traditional healing methods that have something to offer.”
Among those working alongside him is Dr. Jan Schuetz-Mueller, vice chair of clinical affairs in the department of psychiatry and associate director of the program.
“Craig was actually a faculty here, and he was offering a sort of special track in the training for global mental health,” he said. “I was one of his trainees, and as part of that, I traveled to one of our sites, which is Belize.”
His first trip revealed both progress and persistent gaps.
“Belize actually has a quite good and robust mental health program,” Schuetz-Mueller said. “But it’s striking to see the reality of how people have to get by with such few resources in terms of the workforce — how many people there are to take care of individuals with psychiatric illness — but also the options they have.”
Across countries, medication shortages are a constant challenge.
“The supply of medications ebbs and flows,” Schuetz-Mueller said. “There isn’t a consistent supply available. People make do with what they have. They try to work with clerical staff, churches, faith healers. These are de facto psychiatrists in many developing countries.”
Still, he added, the dedication never wavers.
“Wherever you go, there are always some people who care very deeply about this subject and about the patients,” he said. “They’re usually strained to the limit, but they really want to help.”
Katz said those lessons abroad continue to inform his work in New York.
“I’ve seen people in horrible circumstances who say, ‘God will take care of me,’” he said. “Religion helps people so much, and we don’t do enough with it here in the United States.”
He hopes “Unseen” encourages readers to confront what too often goes ignored.
“Even here in the United States, mental health — unless it’s really bad — we don’t wear it on our sleeves,” he said. “I wanted people to see what is unseen.”
Keywords
Craig Katz psychiatrist,
Unseen book global mental health,
Mount Sinai Global Mental Health Program,
Riverdale author,
disaster psychiatry,
mental health in low-resource countries