Javier Escobar, M.D., is a founder of a consortium of researchers that
convenes an annual meeting on critical issues in Latino mental health.
Photo courtesy of Javier Escobar
The bird's-eye view of things is a luxury few people enjoy.
But some, like psychiatrist Javier Escobar, M.D., are able—because of
birth and acculturation and experience and training—to see the global
contours of things.
From his birth in Medellin, Colombia, and his medical training there at the
University of Antioquia, to his early training in psychiatry in Spain, where
he was first influenced by psychoanalysis and a wide reading of classic
European psychiatric texts, and later to his rise in the American academic
community as an expert on psychopharmacology, psychiatric epidemiology,
cross-cultural psychiatry, and global health—Escobar has compiled an
eclectic record of experience and achievement. This experience has made him a
leader in understanding how psychiatric illness transcends boundaries and
borders, racial and ethnic categories.
Today, he is associate dean for global health at the University of Medicine
and Dentistry of New Jersey (UMDNJ) Robert Wood Johnson Medical School.
Escobar is also a founder of a consortium of researchers interested in
mentoring young scientists dedicated to studying mental health issues in
Latino communities. That group convenes an annual meeting on critical issues
in Latino mental health, the sixth of which took place in March in Santa Fe,
N.M., on the theme "Treatment of Latinos With Mental Disorders:
Conceptual and Empirical Approaches."
Annelle Primm, M.D., M.P.H., director of APA's Office of Minority and
National Affairs, called Escobar a leader in the field of psychiatric research
in diverse populations and cited his mentorship of young researchers as a
contribution that will endure beyond his time.
"The annual conference he organizes attracts some of the best and
brightest of young people interested in careers in mental health and substance
abuse research," Primm told Psychiatric News. "The
nurturing, coaching, and enrichment that Dr. Escobar and his colleagues from
various mental health professional disciplines provide to the mentees at the
conferences and in between are priceless. This ensures a steady supply in the
development pipeline of Latino mental health and substance abuse researchers,
who receive sustained guidance over time.
"Ultimately, these investments will yield a greater supply of Latino
researchers, which will contribute to better quality mental health and
substance abuse care for Latino populations."
He was christened Javier Ignacio Escobar, after Francis Xavier and Ignatius
of Loyola—the first an early Jesuit missionary, the second the founder
of the Jesuits, renowned for their scholarly dedication.
His origins in Medellin, the capital of Antioquia, a district of Colombia,
may have presaged his interest in the mingling and influence of diverse
cultures. Genetic studies appear to have confirmed local legend that the
region has inherited not only Spanish but Sephardic influences left by Jews
who left Spain following their expulsion in 1492.
Escobar attended medical school at the University of Antioquia, where he
spent six years and an internship year at a hospital doing compulsory service
in a rural town outside of Medellin. "I delivered countless babies and
performed an estimated 40 Caesarian sections," he said.
Following graduation, he moved with his wife to Spain, where he studied
psychiatry under Juan Lopez-Ibor, M.D., well known for his pioneering work in
understanding anxiety as a biological disorder and in psychosomatic
With European institutions still operating according to a German model of
teaching and learning, Escobar recalled the experience largely as one of
deference to the legendary Lopez-Ibor. "We participated in lectures and
saw a few patients, but we were mainly there to be in the shadow of the big
professor," Escobar said.
But it was also there that Escobar was exposed to the classics of European
psychiatry, including writings by Sigmund Freud, Karl Jaspers, and Kurt
Snyder. "That experience really gave me the basis of classical
psychopathology that Europeans had been developing for centuries,"
Escobar said. "Today all our North American students are reading is the
DSM and DSM-related publications."
A member of the task force developing the DSM-V, Escobar says
reincorporation of some of that more traditional understanding of
psychopathology would be good for the field. "If we want to redefine
some of the diagnoses, we need to invoke a little bit of that old
history," he told Psychiatric News.
Later, Escobar moved to the United States, where he earned a master's
degree in psychiatry/medical genetics in 1973 from the University of
Within six years he was named an associate professor at UCLA. It was there
among California's enormous Latino community that his career as a researcher
blossomed; he was principal investigator for a number of studies in
psychiatric epidemiology of mental illness in Latino and non-Latino
populations, and from 1981 to 1987, he was co-principal investigator for the
Los Angeles Epidemiological Catchment Area Project (ECA), one of five sites
included in the landmark ECA study by the National Institute of Mental Health
In 1994 he joined the faculty at the Robert Wood Johnson School of Medicine
at UMDNJ as professor and chair of the Department of Psychiatry.
The range of his research interests is enormous, with a special focus on
somatization in primary care, but he has maintained a leading interest in
Latino mental health.
His work has added to a literature supporting the theory that certain
aspects of traditional cultures can be protective against mental illness.
Escobar and colleagues published a study of 1,500 users of primary care
services in California, which found that compared with patients born in the
United States, immigrants had a significantly lower prevalence of depression
and posttraumatic stress disorder and better physical functioning scores
despite their lower socioeconomic status.
That study was published in the September 1998 British Journal of
"Traditionally, Hispanic families have been described as close-knit,
extended-family networks that offer a great deal of support," Escobar
wrote in an editorial in the Archives of General Psychiatry that
year. "Also, compared with whites, Mexican Americans have a higher
proportion of two-parent families and lower rates of divorce and
From 1999 to 2003, he was a member of NIMH's National Advisory Mental
Health Council and led the council group that prepared the report"
Racial and Ethnic Diversity in Mental Health Careers: An Investment in
"We found the underrepresentation of Latinos and African Americans
among those who were doing research to be embarrassing," Escobar told
Psychiatric News. "It was less than 5 percent when these
populations were 25 percent of the general population."
It was, in part, out of those findings that Escobar and other interested
researchers applied for a grant to mentor young researchers in Latino mental
health issues. The project was initially funded through 2007 and renewed for
another five years through 2012 with NIMH money that has helped to support,
among other projects, the March conference in Santa Fe.
Last year Escobar stepped down as department chair to assume his current
position as associate dean for global health for the medical school. Though
his new position has caused him to look beyond mental health to such global
problems as HIV, malaria, and trachoma (an eye disease caused by chlamydia
that can result in blindness and has ravaged parts of Africa and Latin
America), he remains involved in international mental health.
During a sabbatical year from the medical school in 2003, Escobar served as
a senior advisor to Thomas Insel, M.D., director of NIMH, to assist in forming
an Office of Global Mental Health.
"I became aware of all of the global issues in mental health that
tend to be neglected," he said.
Escobar said that though philanthropists like Bill Gates have given
millions of dollars to fight AIDS, malaria, and other infectious disease,
disorders such as depression often go unrecognized or undertreated because
people tend to present in primary care with physical symptoms.
Still, he pointed to a number of hopeful developments in international
mental health. Among these is a new mental health educational module developed
by the Global Health Education Council, a network of educators devoted to
educating other researchers and medical professionals about global health
Escobar is also a consultant to a project in Colombia looking at large
families with a high prevalence of bipolar illness to identify genes related
to the illness. He continues to be involved in the NIMH mentoring project,
advising young researchers such as Gabriel de Eurasquin, M.D., an Argentine
psychiatrist at Washington University in St. Louis, who is studying a native
Indian population in northern Argentina with a high prevalence of
"We have been down there in Argentina training people to use
diagnostic instruments and showing them videotapes about mental
illness," he said. "These things will keep me involved in mental
"Racial and Ethnic Diversity in Mental Health Careers: An
Investment in America's Future" is posted at<www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/nimh-diversity.pdf>.
Information on the Global Health Education Council is posted at<www.globalhealth.org>.▪