scholarly journals Identifying challenges and recommendations for advancing global mental health implementation research: A key informant study of the National Institute of Mental Health Scale-Up Hubs

2021 ◽  
Vol 57 ◽  
pp. 102557
Author(s):  
John A. Naslund ◽  
Jasmine Kalha ◽  
Juliana L. Restivo ◽  
Ishmael Amarreh ◽  
Tamora Callands ◽  
...  
Keyword(s):  
Mental Health ◽  
Implementation Research ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Health Scale ◽  
Key Informant

Global psychiatry

2017 ◽  
pp. 674-680
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Workers ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Health Workers ◽  
Middle Income ◽  
Humanitarian Emergencies ◽  
Psychiatric Illnesses ◽  
Aids Pandemic

‘Global psychiatry’ discusses the global mental health movement. Across the globe, and especially in low- and middle-income settings, there is a high prevalence of untreated psychiatric illness. In lower resourced settings there is often the need to address the added influence of poverty. The chapter discusses the question of how to scale up services and models, including using lay mental health workers and also integration of mental health care into primary health care settings to better meet the needs of those suffering from psychiatric illnesses across the globe. Four areas are discussed in more detail—the HIV/AIDS pandemic, perinatal mental illness, child and adolescent mental health, and humanitarian emergencies.

scholarly journals Brain drain: a challenge to global mental health

2016 ◽  
Vol 13 (3) ◽  
pp. 61-63 ◽  
Author(s):  
Bibilola D. Oladeji ◽  
Oye Gureje
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Brain Drain ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Healthcare ◽  
Psychiatric Training ◽  
Skilled Workers ◽  
African Countries ◽  
Middle Income

The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.

scholarly journals Barriers and Drivers to Stakeholder Engagement in Global Mental Health Projects

2020 ◽  
Author(s):  
Jill Murphy ◽  
Onaiza Qureshi ◽  
Tarik Endale ◽  
Georgina Miguel Esponda ◽  
Soumitra Pathare ◽  
...  
Keyword(s):  
Mental Health ◽  
Stakeholder Engagement ◽  
Global Mental Health ◽  
Scale Up ◽  
Health Interventions ◽  
Successful Implementation ◽  
Effective Implementation ◽  
Mental Health Funding ◽  
Health Funding ◽  
Mental Health Interventions

Abstract Background: Engagement with diverse stakeholders, including policy makers, care providers and end users, is essential for successful implementation of global mental health interventions. Despite being a fundamental factor in the implementation process, evidence about challenges and drivers to stakeholder engagement is limited in the global mental health literature. Methods: We conducted semi-structured qualitative interviews with n=29 recipients of global Grand Challenges Canada Global Mental Health funding to assess barriers and drivers to global mental health implementation across a portfolio of Grand Challenges Canada-funded projects. We used framework analysis to identify key themes related to implementation barriers and facilitators. This paper reports on barriers and facilitators to stakeholder engagement, with results related to capacity development and service delivery reported elsewhere in this volume. Results: Barriers and drivers to stakeholder engagement were identified across four themes: 1) Contextual Considerations, 2) Resources, 3) Participation, Uptake and Empowerment, and 3) Stigma. While complex contextual challenges create barriers, mechanisms such as formative research can facilitate a deeper contextual understanding that supports effective implementation planning. Limited financial and human resources and competing priorities can lead to substantial challenges. Investing in and leveraging existing local resources and expertise can help to mitigate these barriers. The challenge of achieving active participation from stakeholders and diverging expectations about the nature of participation were identified as barriers, while providing opportunities for meaningful participation and empowerment acted as facilitators. Stigma at the institutional and individual level was also identified as a substantial barrier to engagement. Conclusion: Stakeholder engagement is critical to successful implementation of global mental health interventions, particularly for promoting scale-up and sustainability. The findings of this study are relevant to implementors in global mental health. They also have implications for global mental health funding agencies and policy organizations, who can support improved stakeholder engagement in several ways. Investing in high-quality formative research, supporting capacity building in methods such as integrated knowledge translation and participatory priority-setting, investing in longer-term funding schemes to support sustainable partnerships and scale-up and supporting researchers to build skills in policy engagement would help to foster successful engagement and thus support effective implementation of global mental health innovations.

The applicability of trials of complex mental health interventions

2015 ◽  
Author(s):  
Lara Fairall ◽  
Merrick Zwarenstein ◽  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Scale Up ◽  
Complex Interventions ◽  
Real Life ◽  
Implementation Process ◽  
Potential Contribution ◽  
Plos Medicine ◽  
Mental Health Interventions ◽  
Development Evaluation

The evidence on what interventions are currently known to be effective in mental health is summarized in the 2009 PLoS Medicine series on packages of care for mental, neurological, and substance-use disorders in LAMIC and the WHO mhGAP guidelines published in 2010. But far less is known about how best to deliver and scale-up these interventions in real-life settings. How to translate this evidence into practice, in ways that are culturally appropriate and sensitive has been identified as the key research priority in global mental health. This chapter discusses the potential contribution of trials to the genesis of interventions that are both effective and highly applicable to real-world settings by considering two frameworks : the development–evaluation–implementation process proposed by the Medical Research Council (MRC) in Britain in their 2000 and 2008 guidance on developing and evaluating complex interventions and the PRagmatic Explanatory Continuum Indicator Summary (PRECIS) tool.

scholarly journals Barriers and drivers to stakeholder engagement in global mental health projects

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jill Murphy ◽  
Onaiza Qureshi ◽  
Tarik Endale ◽  
Georgina Miguel Esponda ◽  
Soumitra Pathare ◽  
...  
Keyword(s):  
Mental Health ◽  
Stakeholder Engagement ◽  
Global Mental Health ◽  
Scale Up ◽  
Formative Research ◽  
Successful Implementation ◽  
Care Providers ◽  
Effective Implementation ◽  
Mental Health Funding ◽  
Health Funding

Abstract Background Engagement with diverse stakeholders, including policy makers, care providers and service users and communities, is essential for successful implementation of global mental health interventions. Despite being a fundamental factor in the implementation process, evidence about challenges and drivers to stakeholder engagement is limited in the global mental health literature. Methods We conducted semi-structured qualitative interviews with 29 recipients of Grand Challenges Canada Global Mental Health funding to assess barriers and drivers to global mental health implementation across a portfolio of projects. We used framework analysis to identify key themes related to implementation barriers and drivers. This paper reports on barriers and drivers to stakeholder engagement, with results related to capacity development and service delivery reported elsewhere in this journal. Results Barriers and drivers to stakeholder engagement were identified across four themes: (1) Contextual Considerations, (2) Resources, (3) Participation, Uptake and Empowerment, and (4) Stigma. While complex contextual challenges create barriers, mechanisms such as formative research can facilitate a deeper contextual understanding that supports effective implementation planning. Limited financial and human resources and competing priorities can lead to substantial challenges. Investing in and leveraging existing local resources and expertise can help to mitigate these barriers. The challenge of achieving active participation from stakeholders and diverging expectations about the nature of participation were identified as barriers, while providing opportunities for meaningful participation and empowerment acted as drivers. Stigma at the institutional, community and individual level was also identified as a substantial barrier to engagement. Conclusion The findings of this study are relevant to implementers in global mental health. They also have implications for global mental health funding agencies and policy organizations, who can support improved stakeholder engagement by investing in high-quality formative research, supporting capacity building for policy engagement, investing in longer-term funding schemes to support sustainable partnerships and scale-up, thus fostering successful engagement and supporting effective implementation of global mental health innovations.

scholarly journals Towards a more nuanced global mental health

2014 ◽  
Vol 204 (6) ◽  
pp. 415-417 ◽  
Author(s):  
Ross G. White ◽  
S. P. Sashidharan
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

SummaryThe World Health Organization has made concerted efforts to scale up mental health services in low- and middle-income countries through the Mental Health Gap Action Programme (mhGAP) initiative. However, an overreliance on scaling up services based on those used in high-income countries may risk causing more harm than good.

scholarly journals EnDPoINT: protocol for an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine health services in Ethiopia

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037675 ◽  
Author(s):  
Maya Semrau ◽  
Oumer Ali ◽  
Kebede Deribe ◽  
Asrat Mengiste ◽  
Abraham Tesfaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Physical Health ◽  
Lymphatic Filariasis ◽  
Implementation Research ◽  
Research Study ◽  
Scale Up ◽  
Psychosocial Care ◽  
Disability Prevention ◽  
Care Package

IntroductionNeglected tropical diseases (NTDs) causing lower limb lymphoedema such as podoconiosis, lymphatic filariasis (LF) and leprosy are common in Ethiopia. Routine health services for morbidity management and disability prevention (MMDP) of lymphoedema caused by these conditions are still lacking, even though it imposes a huge burden on affected individuals and their communities in terms of physical and mental health, and psychosocial and economic outcomes. This calls for an integrated, holistic approach to MMDP across these three diseases.Methods and analysisThe ‘Excellence in Disability Prevention Integrated across NTDs’ (EnDPoINT) implementation research study aims to assess the integration and scale-up of a holistic package of care—including physical health, mental health and psychosocial care—into routine health services for people with lymphoedema caused by podoconiosis, LF and leprosy in selected districts in Awi zone in the North–West of Ethiopia. The study is being carried out over three phases using a wide range of mixed methodologies. Phase 1 involves the development of a comprehensive holistic care package and strategies for its integration into the routine health services across the three diseases, and to examine the factors that influence integration and the roles of key health system actors. Phase 2 involves a pilot study conducted in one subdistrict in Awi zone, to establish the care package’s adoption, feasibility, acceptability, fidelity, potential effectiveness, its readiness for scale-up, costs of the interventions and the suitability of the training and training materials. Phase 3 involves scale-up of the care package in three whole districts, as well as its evaluation in regard to coverage, implementation, clinical (physical health, mental health and psychosocial) and economic outcomes.Ethics and disseminationEthics approval for the study has been obtained in the UK and Ethiopia. The results will be disseminated through publications in scientific journals, conference presentations, policy briefs and workshops.

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