Mental disorders constitute over 14% of all disability adjusted life years in China - among the greatest for non-communicable diseases. However, most parts of China lack a basic framework for an effective mental health care system. More than 90% of persons with mental disorders and as many as 25% of persons with severe and disabling psychotic disorders never receive psychiatric care. In the past decade, China has begun to make mental disorders a new priority for the public health sector, and has begun scaling up services programs and policies, including specific attention to children, adolescents, and the elderly. A new generation of mental health reformers is deeply involved in finding ways to provide creative, recovery-oriented services and preventive interventions in very low resource settings. To date, virtually none of this work is accompanied by scientifically The overall goal of the training program is to build commitment and capacity in the Shanghai Mental Health Center and the Peking University Institute of Mental Health to conduct mental health implementation research, initiating new programs of research and training that build on more than a decade of collaboration between these institutions and the Department of Global Health and Social Medicine, Harvard Medical School. designed research able to provide genuine evaluation of such services and improve their quality. Each institute has committed 8 members to be core faculty for this program, and each institute will identify specific mental health programs to serve as core sites for research training. The program will support training of 16 PhD students in China, 8 in each institute, providing one year of intensive training in implementation research and supporting one year of PhD dissertation research linked to the identified projects. Harvard faculty will serve as mentors. In addition, this program will recruit approximately 40 6-month visiting clinical fellows over the 5 years to participate in the core research projects, creating a network of implementation researchers around China. The program will hold annual national workshops to build technical capacity for implementation research and disseminate to mental health leaders and policy makers the importance of implementation research in improving mental health services for China. The training program will be initiated with 8 senior faculty from the two Chinese institutions going to the DGHSM at Harvard in Year 1 for a intensive workshops aimed at building a curriculum for training implementation researchers. In Years 2-5, 2 junior faculty members will spend 2 months in China and 4 months in Harvard receiving advanced training, and 2 senior faculty members will go to Harvard for 1 month advanced technical training or to work on data analysis and writing. The overall goal is to develop a sustainable program of research and research training in each institution, linking research to the development of innovative mental health services for China and the region.

Public Health Relevance

After many years of providing almost no services for most persons with mental illnesses, even for many who are most severely ill, China has begun to make the treatment of mental illness through humane, community-based programs a public health priority. Mental health reformers in China have the potential to develop new models for providing care with very limited resources that will have importance for all low income countries, and even for low income communities in the United States - but only if these reforms are accompanied by research to document what works and what does not and to evaluate programs as they develop. With the support of the Fogarty International Center, teams at Harvard Medical School, the Shanghai Mental Health Center, and the Peking University Institute for Mental Health will build a program to train a new generation of researchers to document and evaluate the effectiveness of these innovative mental health programs emerging in China.

National Institute of Health (NIH)
Fogarty International Center (FIC)
International Research Training Grants (D43)
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Special Emphasis Panel (ZRG1-ICP2-N (51))
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Michels, Kathleen M
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Harvard University
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