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In conversation with Berkin Gökbudak: what does 'open' and 'inclusive' mean in mental health and why it is so important

In conversation with Berkin Gökbudak: what does 'open' and 'inclusive' mean in mental health and why it is so important

The theme for this year’s European Psychiatric Congress (EPA) 2024, ‘Mental Health: Open & Inclusive’ strikes a deep chord, and I’m sure that I am not alone here. It’s a powerful reminder of the progress that we have made but also puts a spotlight on the work that still needs to be done. For my colleagues and I at Johnson & Johnson, being open and inclusive are integral to Our Credo and to our ambition in Neuroscience – to ensure a future where we can alter the trajectory of nervous system disorders and eliminate the burden they place on global health.

I recently had the pleasure of sitting down with my colleague, Berkin Gökbudak, Senior Director of Commercial Strategy for Neuroscience, PH & CVM in EMEA where we delved into what this theme means for us and our teams. Here’s an extract from our discussion:

ME: What is the importance of the EPA Congress to you and your work, Berkin?

BERKIN: Thanks, Tamara – we often see each other but in passing or in meetings, so it’s lovely to have time to connect and reflect. For me, EPA24 is not just a vital congress for scientific exchange that informs the future direction of psychiatry in Europe, it’s a pivotal platform for the psychiatry community to address stigma in mental health and reaffirm our collective purpose of ensuring equal and timely access to prevention, treatment, and care for everyone living with serious mental health disorders. Would you agree?

ME: Completely. I would also add one more point - which is that by engaging with clinicians and patient advocacy organisations we can better understand the pressing and evolving challenges in different mental health disorders and drive forward innovative patient-centred solutions.

Now I want to focus on this year’s theme and its meaning. Inclusivity in mental health is a topic that I am incredibly passionate about. It’s one I recently posted on to mark International Women’s Day. Inclusivity not only enriches scientific inquiry, it accelerates breakthroughs in mental health.[1] An issue which I highlighted before, concerns the pronounced lack of ‘expert’ female clinician voices at congresses, for instance, as well as in other scientific forums. This is something I feel we must address – an inclusive scientific community produces better outcomes. This isn’t just about addressing gender imbalance, and I’m proud of how J&J is addressing disparities in mental health outcomes by including ethnic minorities, and other diverse populations in our clinical research – reflective of subpopulations where rates of mental health problems are rising most[2][3], so we can better understand the issues here and develop informed management strategies that are effective across diverse populations.

BERKIN: We also need to consider the other part of the theme: ‘open’. Whilst depression affects 40 million people across Europe – a value equivalent to the national population of Spain – stigma remains a critical challenge in the depression landscape.[4][5] You could argue that stigma is the opposite of being open, as it leads to people suffering in silence, closing themselves off to support, and not being open about their mental health with those around them. More than 70% of people with serious mental health disorders remain untreated by healthcare professionals due to significant stigma, insufficient diagnoses, or lack of services.[6][7][8]

ME: Absolutely – I think we must collectively work harder to foster environments where individuals feel safe and supported in seeking help, free from the fear of judgment or stigma. It’s what makes me proud to work within a team that is striving to address this through patient-facing campaigns such as Breaking Depression.

BERKIN: I love that! As a relative newcomer to the company, this initiative was something that I was aware of, and I was excited to join an organisation that’s confronting stigma head on. We know that 80% of patients agreed that ‘stigma and discrimination can be worse than the impact of the mental health condition itself.’[9] A big part of breaking this stigma is providing tools and resources to people living with depression, to help them and their caregivers and support network see there is a way out. I also think what’s critical here is partnerships with the patient community - with key organisations like GAMIAN and EUFAMI. I believe we have a shared responsibility to foster open conversations, raise awareness, and strive to ensure that all stakeholders including HTA and regulatory bodies, understand that the depth and scope of mental health challenges demands a matched response and action to support timely access to innovation across the board.

ME: I love this example – it’s so true! It’s no secret that I am a big fan of digital innovation and its applicability to helping solve some of the biggest healthcare challenges we face. I also think it’s important that, in the interest of being open and inclusive, we explore the ripple effect across every aspect of an individual’s life that mental health conditions can create.[10] This can include health, relationships, employment, and education.[10]

BERKIN: 100%. We are both in agreement on the urgency and scale of the challenge considering these points. I recently read a report that stated that in the past year alone, half the EU population - 46 percent – experienced an emotional or psychosocial problem, such as feeling depressed or anxious.[11] We also know that the incidence of depression is rising in Europe and is expected to become the leading cause of disease burden by 2030.[12] Big numbers call for big solutions. We’ve spoken about it at length, so this won’t be new to you Tamara, but we need to, in partnership with our key stakeholders, continue to advocate for and drive a patient-centred approach to treatment and care. This means tailoring interventions to meet individual needs and preferences, ensuring every patient receives personalised support on their journey to recovery.[13]

ME: You’ve hit the nail on the head, Berkin. We need to continue to explore novel, comprehensive, and effective solutions to address these pressing mental health challenges. We need to lead with a precision and personalised neuroscience approach to create new solutions and new initiatives to support the patient and clinical community. Advances in biomarkers and brain imaging are enabling our understanding of the connection between symptoms and brain biology.[14] The way depression manifests in an individual may seem quite variable, but there are potential brain-based reasons that explain the wide differences in symptoms.[15][16] We are exploring the potential of biomarker sciences to enhance our understanding of diseases, aid in patient identification, and accelerate the development of innovative therapies.[14][17] Specifically, we are investigating how biomarkers might help to identify subpopulations of patients most likely to benefit from a therapy in neuropsychiatric conditions, like MDD and severe MDD.[14][17]

BERKIN: Yes, we must all double down on ensuring an innovation mindset - which was so evident during the COVID 19 pandemic – continues to be applied across the healthcare spectrum, to ensure that patients have timely and equitable access to novel therapeutic solutions. After all, the sooner patients can access promising new solutions, the sooner we might start to see improved outcomes.

ME: These are the key words; ‘improved outcomes’. I’m confident that, by working together, we are entering the golden age of psychiatry, and delivering on the promise of precision psychiatry is within our reach.[13] With added collective impetus we can accelerate the adoption of advanced technologies, and novel therapeutic solutions, to ensure tailored and personalised interventions so that no one is left behind - there is no health without mental health.

BERKIN: Yes! Moving forward together – to use the theme of EPA – in an open and inclusive way to make this happen!

I hope you found my discussion with Berkin to be useful. If you work in or are part of the Neuroscience community, I’d be interested to hear your thoughts.



[1] Rebello V and Uban KA. A call to leverage a health equity lens to accelerate human neuroscience research. Front Integr Neurosci. 2023 Apr 17;17:1035597. doi: 10.3389/fnint.2023.1035597.

[2] Sharma A, et al. Improving diversity in medical research. Nat Rev Dis Primers. 2021 Oct 14;7(1):74. doi: 10.1038/s41572-021-00316-8. PMID: 34650078.

[3] Apers H, Van Praag L, Nöstlinger C, Agyemang C. Interventions to improve the mental health or mental well-being of migrants and ethnic minority groups in Europe: A scoping review. Glob Ment Health (Camb). 2023 Apr 20;10:e23. doi: 10.1017/gmh.2023.

[4] World Health Organisation. Raising awareness of depression. Available at:,or%204.3%25%20of%20the%20population. Last accessed: April 2024.

[5] Mental Health Foundation. Stigma and Discrimination. Available at: Last accessed: April 2024.

[6] Henderson C, et al. Mental illness stigma, help seeking, and public health programs. Am J Public Health. 2013 May;103(5):777-80. doi: 10.2105/AJPH.2012.301056.

[7] Faisal-Cury A, et al. Depression underdiagnosis: Prevalence and associated factors. A population-based study. J. Psychiatr. Res., 2022; 151: 157-165. doi:10.1016/j.jpsychires.2022.04.025.

[8] Thornicroft G. Stigma and discrimination limit access to mental health care. Epidemiol Psichiatr Soc. 2008 Jan-Mar;17(1):14-9. doi: 10.1017/s1121189x00002621.

[9] Thornicroft G, et al. How to stop stigma: Implementing the lancet commission on ending stigma and discrimination in Mental Health.The Lancet Psychiatry. 2023;11:2;88–89. Available at:

[10] Proudman D, et al. The Growing Burden of Major Depressive Disorders (MDD): Implications for Researchers and Policy Makers. Pharmacoeconomics. 2021;39(6):619-625.

[11] Europa. Eurobarometer. Available at: Last accessed: April 2024.

[12] WHO. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Available at: Last accessed: April 2024.

[13] Češková E and Šilhán P. From Personalized Medicine to Precision Psychiatry? Neuropsychiatr Dis Treat. 2021 Dec 14;17:3663-3668. doi: 10.2147/NDT.S337814.

[14] Yen C, Lin CL, Chiang MC. Exploring the Frontiers of Neuroimaging: A Review of Recent Advances in Understanding Brain Functioning and Disorders. Life (Basel). 2023 Jun 29;13(7):1472. doi: 10.3390/life13071472. PMID: 37511847; PMCID: PMC10381462

[15] Zhang FF, et al. Brain structure alterations in depression: Psychoradiological evidence. CNS Neurosci Ther. 2018 Nov;24(11):994-1003. doi: 10.1111/cns.12835. Epub 2018 Mar 5. PMID: 29508560; PMCID: PMC6489983.

[16] Thng G, et al. Comparing personalized brain-based and genetic risk scores for major depressive disorder in large population samples of adults and adolescents. Eur Psychiatry. 2022 Jul 28;65(1):e44. doi: 10.1192/j.eurpsy.2022.2301. PMID: 35899848; PMCID: PMC9393914.

[17] Malik S, et al. Biomarkers of Major Depressive Disorder: Knowing is Half the Battle. Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):12-25. doi: 10.9758/cpn.2021.19.1.12.