Dr. Gregory Fricchione, who with Dr. Chet Pierce, former MGH Psychiatrist-in-Chief, Jerry Rosenbaum, and colleagues, established the Pierce Division in 2003, today serves as the Division’s Director Emeritus. He specializes in neuropsychiatry and psychosomatic medicine and for over 40 years has helped care for patients with severe medical, neurological and surgical illnesses as a consultation-liaison psychiatrist. Dr. Fricchione has also served as Associate Chief of Psychiatry, Director of the Benson-Henry Institute for Mind Body Medicine, Director Emeritus of the Division of Psychiatry and Medicine, and Co-Director of the McCance Center for Brain Health in the Department of Neurology at MGH. He is the Benson Mind Body Medicine Professor of Psychiatry at Harvard Medical School. For both the Harvard Program in Refugee Trauma (HPRT) and the MGH/Red Sox Foundation Home Base Program for Service Members and Veterans he has served as a senior medical advisor. From 2000 to 2002, he served as The Carter Center Mental Health Program Director for President and Mrs. Carter while on leave of absence from Harvard Medical School.
He recently penned a history of the Pierce Division for the new HPRT alumni newsletter Beautiful Connections.
A Narrative History of The Chester M. Pierce, M.D. Division of Global Psychiatry
By Dr. Gregory Fricchione
May 23, 2025
I’ve been asked to write this essay on the Chester M. Pierce, M.D. Division of Global Psychiatry at MGH. I’ll start with a short review of its origins.
I took a leave of absence from Harvard Medical School (HMS) to serve as director of The Carter Center Mental Health Program in Atlanta between 2000 and 2002. In that role I had the good fortune of recruiting Chet Pierce, the renowned Harvard Professor of Psychiatry and Education and the pre- eminent African American Psychiatrist in the United States. One of the joys of my job was the opportunity it gave me to spend time with Chet and to be mentored by him.
Chet was committed to the idea that all psychiatrists needed to be educated about the need for global mental health. Chet was a visionary whose insights regarding global health have been supported over the years through studies like those investigating the global burden of disease (GBD). With his words ringing in my ears, when I returned to MGH in the summer of 2002, I approached our Psychiatrist-in-Chief, Jerry Rosenbaum, and asked him if we could start a global division of psychiatry. He said words to the effect, “Well we have no money for this, but feel free to go ahead and give it a whirl.” Later he did find us support, which was carried forward by his successor Maurizio Fava.
Meanwhile, in 2002, Chet realized his long-standing dream of holding what came to be known as the African Diaspora Meeting at MGH. Chet was legendary for not asking any donor for money so Jerry Rosenbaum and John Herman found a way to raise funds for this large international meeting that made this event possible. At this very successful meeting, psychiatrists of African descent from all over the world gathered in Boston and shared their challenges and solutions. This got our focus on global psychiatry going with special emphasis on the needs of sub-Saharan Africa.
In 2003 our global division, the first in a U.S. academic medical center, was officially established. The help of one of our faculty, David Henderson, was invaluable in setting it up. We also had strong support from Kathy Sanders, the then psychiatry residency training director and from former and subsequent residency directors- John Herman, Felicia Smith, Scott Beach, and Isabel Lagomasino. Louise Ivers, who directs the MGH Center for Global Health, has also been an important ally.
In our early years we focused on an educational initiative with the support of a grant from the U.S. Department of Education (2004-2008). This enabled us to offer residency training education in collaboration with Dalhousie University, Canada and the Mexican National Neurological and Psychiatric Institutes. Several residents took elective months overseas, one of whom was my chief resident at that time, Bepi Raviola.
In 2009 the division was officially named in honor of Professor Pierce, and Dave Henderson took over from me as Director. Dave served as director from 2009 to 2015 when he accepted the position of Chair of Psychiatry at the Boston University School of Medicine and at Boston Medical Center, whereupon I reassumed the role of Director.
From the beginning, the Pierce Division of Global Psychiatry’s (Pierce Division) mission has been to make clinical, educational and research contributions to world mental health. We hope to reduce the GBD by “sharing our strengths to grow stronger together”. We strive to contribute what we know while learning from our neighbors around the world. Our approach has four components that are integrated and mutually reinforcing: capacity building, policy development, research, and sustainability and evaluation. This allows us to acquire, disseminate, and translate knowledge across the field. Our strategy is driven by partnerships with in-country experts and strives to be clinically relevant, evidence-based, culturally sensitive, and focused on systems change. Over the last 22 years we have helped with initiatives in Ethiopia, Somaliland, Liberia, South Africa, Uganda, Ghana, Brazil, Peru, Lebanon, Saudi Arabia, Kuwait, Turkey, and Nepal. We have been aided by talented and committed volunteer psychiatrists and psychologists like Alex Tsai, Zeina Chemali, Menekse Alpay, Shreedhar Paudel, Liz Levey, Bizu Gelaye, Christina Borba, Oliver Freudenreich, Becca Brendel, Mimi Owusu, Maria Prom, Lamise Al-Salam, Rahel Bosson, Stephanie Smith, Stephanie Collier, Ed Wang, Albert Yeung, Rick Wolthusen, Kristina Korte and many others.
For instance, Zeina Chemali has developed and implemented a neuropsychiatry training program that has been delivered to wide acclaim in South Africa, Ethiopia, Uganda, Rwanda, Liberia, Sierra Leone and of course in Lebanon, her homeland. Meanwhile, Alex Tsai has been a research mentor par excellence.
The Division has also gained from its connection to the Benson-Henry Institute (BHI). Collaborations have occurred throughout the world given the need for primary, secondary and tertiary prevention approaches that can be offered inexpensively and virtually.
In collaboration with Dave Henderson and his team at Boston University we have been home to a successful NIMH T-32 Global Psychiatric Post-Doctoral Clinical Research Training Program. A cadre of young global psychiatry researchers has been educated to carry important global mental health research, and several have been successful in winning their K awards. We have been blessed over the years with remarkable research mentors including the Pierce Division Associate Director for Research Alex Tsai, Conall O’Cleirigh, Bizu Gelaye, Karestan Koenen and gifted in-country researchers who mentor our fellows and trainees. We have assisted the MIT Broad Institute’s NeuroGAP program led by Steve Hyman and Karestan Koenen to establish research collaborations in Ethiopia and Uganda.
In 2016 the second African Diaspora meeting was held in Cape Town, South Africa. And the third such meeting was held in Cape Town in 2019. One outgrowth of those meetings was the African Global Mental Health Institute, which is now located at Boston University Medical Center and the University of Kwa Zulu Natal with Dave Henderson and Bonga Chiliza as co-directors.
The Pierce Division over the years has been instrumental in starting residency training programs in Liberia and Somaliland. On occasion it has assisted the University of Toronto in its now heralded collaboration with Addis Ababa University, The Toronto Addis Ababa Psychiatry Residency Program. The Pierce Division has also aided in the development of mental health policy in Liberia and Ethiopia.
We are very pleased to say that the Pierce Division enters its phase 2.0 this year. It is exciting that Bepi Raviola returned to MGH as Associate Director of the Pierce Division with 15 years of experience as the Mental Health Director of the world- famous NGO Partners-in-Health (PIH) under his belt. Working closely with the late Dr. Paul Farmer at PIH, he established what has become one of the world’s premier global mental health delivery systems, helping to reform the oldest psychiatric asylum in sub-Saharan Africa, develop a new psychiatry residency in Sierra Leone and catalyze comprehensive health system reforms in Lesotho, Malawi, Mexico, Peru, Kazakhstan, and the United States. Bepi has also worked in post-genocide Rwanda, where he is now serving as the acting Chair of Psychiatry at the University of Global Health Equity School of Medicine. On the educational front, Bepi has already worked with the MGH/McLean Psychiatry Residency Director Isabel Lagomasino, and Rahel Bosson and Alex Keuroghlian, on the development of a new MGH/McLean Adult Psychiatry Community and Global Psychiatry Track. And given the birth of the new Academic Medical Center Department of Psychiatry under Maurizio Fava’s leadership and with his backing, Bepi looks forward to collaborating on the development of a Mass General Brigham (MGB) Collaborative in Global Mental Health Delivery.
In September 2025, with this bold agenda in mind, Bepi will become the Director of the Pierce Division and the Gottlieb Chair in Global and Community Psychiatry at MGB.
Another jewel in the crown of Global Psychiatry at MGH for many decades has been the Harvard Program in Refugee Trauma (HPRT) under the leadership of Professor Richard Mollica. Richard is truly the founder of the field of refugee trauma psychiatry and his groundbreaking work is more important now than ever given the chaotic state of a world in polycrisis.
Over the last few months, we have been excited and invigorated in our meetings with HPRT. The prospect of uniting the core global mental health assets of the Pierce Division, HPRT and its alumni group of over 2500 clinicians the world over, with clinicians and researchers from Brigham and Women’s Hospital and McLean Hospital in an MGB Collaborative for Global Psychiatry in association with the mental health program of PIH represents a truly remarkable opportunity to revolutionize the mission of mental health around the world and in the US.
As the great Harvard physician, psychologist and philosopher, William James, once wrote in his famous essay, The Moral Equivalent of War: “Great indeed is Fear; but it is not, as our military enthusiasts believe and try to make us believe, the only stimulus known for awakening the higher ranges of men’s spiritual energy.”
When I look back at those early days and to Chet’s vision and see how our growth along with serendipity has created this path before us, I am filled with gratitude and hope for the future. There is indeed an abundance of spiritual energy in the Chester M. Pierce MD Division of Global Psychiatry…and we will need every drop of it!