The overriding objective of our Hub for Latin America (HLA) is to improve the condition of people with severe mental disorders in Latin America. We propose to do so by making a focused contribution to narrowing the """"""""mental health gap"""""""". Our long-term goal is to improve health services for people with severe mental disorders until they are equivalent to the best health services offered to people with highly prioritized general health conditions. We envision an integrated system of primary care and secondary mental health services that we refer to as Community Health Care for individuals with Severe Mental Disorders (CHC-SMD). We adopt a multi-pronged approach that is tailored to the distinctive context of the urban areas of Latin America. Our goals for the 5-year grant period are to launch strategic initiatives that will generate significant progress toward CHC-SMD in this region, and to build a platform for ongoing progress over a longer time period. The HLA brings together key researchers and stakeholders from six cities across Latin America (Santiago, Chile;Rio de Janeiro, Brazil;Buenos Aires, Cordoba, Neuquen, Argentina;Medellin, Colombia) with researchers in New York City in a concerted effort to make progress toward a shared vision of CHC-SMD. The Components are designed to be synergistic so that the impact of the whole HLA is greater than the sum of its parts. The Research Component, for example, proposes to pilot a regional randomized controlled trial (RCT). In order for the HLA to proceed as planned to conduct a full scale regional RCT, the Capacity Building Component will need to train leaders at the HLA sites to conduct RCTs and coordinate regional studies. At the same time, the pilot RCT will help generate this capacity by providing practical experience in RCTs and regional studies. Our overall specific aims are (a) to deploy and evaluate task shifting approaches that can accelerate progress toward CHC-SMD;(b) to train young leaders with the capacities required to generate ongoing progress toward CHC-SMD;and (c) to bring together multiple stakeholders to contribute to implementing and shaping CHC-SMD.

Public Health Relevance

Within Latin American cities people with severe mental disorders are a vulnerable population whose lives are often characterized by extreme poverty, social exclusion from education, employment, and participation in civil society, multiple traumas including violence and abuse, reduced access to health care and high mortality rates. Equitable development, as endorsed by international conventions, requires the inclusion of this vulnerable population in the benefits of development and the protection of their civil and human rights. The overriding objective of our Hub for Latin America (HLA) is to improve the condition of this vulnerable group through an integrated system of primary care and secondary mental health services tailored to the distinctive context of the urban areas of Latin America.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Program--Cooperative Agreements (U19)
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Application #
Study Section
Special Emphasis Panel (ZMH1)
Program Officer
Pringle, Beverly
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Fiscal Year
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Columbia University (N.Y.)
Public Health & Prev Medicine
Schools of Public Health
New York
United States
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