7. Abstract With over 1.3 billion people, India faces enormous health challenges, particularly for neuropsychiatric care. There are fewer than 7,000 psychiatrists or neurologists. India?s training infrastructure for research in psychiatric intervention and implementation is also rudimentary, hampering innovative solutions for these problems. To address the challenges, we have provided individually mentored hands-on research and didactic training to over 59 trainees. The majority are women; 7 became department chairs and they have published over 78 peer reviewed papers. Thanks to a multiplier effect of trainees-turned-trainers, we have garnered over $ 5 million in research grants and initiated ?south-south? co-operation with Egyptian colleagues. Over 20 years, we have attained our targets and gained momentum. Our current D43 is focused on intervention research-based training in schizophrenia, principally cognitive dysfunctions (2014-9). In this competing renewal we seek broader, accelerated impact through interlinked extensions of our current work, each extension enhancing the next: (i) We will attain broader impact by continuing hands on training for novel interventions in cognitive dysfunctions spanning psychiatric disorders and post-stroke patients, relying on NIMH Research Domain Criteria. (ii) To enable real world impact for interventions, we will add implementation research training based on the Consolidated Framework for Implementation Research, addressing delivery of evidence-based care, creating processes for successful interventions, and identifying constructs associated with local challenges and successes. (iii) We will expand our hub building work by continuing ongoing work in Delhi and targeting 3 new academic and non- governmental organizations; the latter serve particularly deprived communities. (iv) We will promote health policy advocacy to the Government of India. Our overarching goal is a cadre of neuropsychiatric health researchers who will conduct novel research, train future researchers, and influence health policy in India. Our training will rely on multi-disciplinary Indian and overseas mentors to provide medium-term (6 months) or long-term research-based training (1-3 years) to 40 professionals. We will add neurologists to our current training for starting and mid-level mental health professionals and new medical graduates. For all trainees, the essential selection criterion will be a trainee-generated research idea relevant to our themes. Implementing their ideas will be the goal of our individualized mentor-based training, supplemented by flexible didactic course work. To enhance sustainability, we will reprise and expand our successful ?grantathons? designed to help trainees win research funds, problem solve for individual research and address hub level issues. Inducting prior trainees as training faculty will produce a cascading effect. In sum, we propose an innovative, flexible, multi-site ?without walls? capacity building program for training high caliber, ethical researchers and for establishing hubs in India, relying on seasoned training faculty.
Mental disorders cause severe burden across the world, particularly in low and middle-income countries. Our ongoing research will be used as the foundation for training highly motivated mental and neurological health professionals in India, which has over 1.3 billion citizens and enormous health problems. Our proposal fulfills key goals of the Fogarty International Center, the National Institute of Mental Health and the National Institute for Neurological disorders and Stroke; it will enhance treatment research for mental disorders and thus could also help US citizens.
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