Globally, mental disorders are the 1st leading cause of disability-adjusted life years among people between 15- 49 years of age, and the 1st cause of years lived with disability for all ages. This is especially true in low- and middle-income countries (LMICs) where over 75% of people with mental disorders receive no care despite substantial disability, and where treatment is provided, it is rarely based on evidence-based practices and human rights violations still occur frequently. In spite of important efforts to decrease this global mental health (GMH) treatment gap, few successes have been sustainably scaled up in LMICs. We propose the renewal of our GMH Research Fellowship: Interventions that make a difference, at Columbia Psychiatry/New York State Psychiatric Institute, to provide innovative postdoctoral training in dissemination and implementation (D&I) science with the aim of decreasing the GMH treatment gap. We maintain our innovative goal of training scholars to collaborate with our LMIC partners and across disciplines and to develop independent research careers that address the challenges of scaling up mental health prevention and access to efficacious treatment in LMIC. We have expanded the Program to increase emphasis in policy and sustainability, and include attention to low-resource settings in the U.S., where underserved populations are abundant. With its theoretical rigor, methodological innovation, and practical application, our program leverages existing programs and facilities at Columbia, our Global partners and distinguished researchers in the field to provide training to the next generation of GMH scientists with a 2-fold focus: 1st, deployment-focused intervention research, such that fellows learn to develop interventions to be deployed in resource poor areas. With the collaboration of communities and policy makers, fellows are trained to adapt and field-test tried and true interventions that address recognition, assessment, prevention and treatment deemed sustainable by policy makers and community stakeholders. 2nd, intervention dissemination, implementation, services and policy research, where fellows examine how prevention, assessment and treatment interventions can be sustainably scaled-up in specific LMIC settings. With robust mentorship, hands-on experience, and didactic instruction, our Program employs three complementary and mutually reinforcing learning strategies. Fellows (1) engage in their own pilot projects focusing on sustainability and using task-shifting/sharing and other access-enhancing strategies mentored by experienced U.S. and Global partners investigators; (2) receive specialized training in GMH, including D&I, policy research, and instruction in the responsible conduct of research; and (3) receive training in skills that will enable them to excel as competitive researchers (e.g., writing scientific papers, reviews, presenting at scientific meetings, competing for grant support). We propose to maintain a cohort of 4 Fellows, each with a 3-year appointment and with new appointments made as Fellows graduate. With the successful outcomes of our graduates, our Program is already having a major impact on GMH research.
People in Low and Middle Income Countries and in low-resource areas of the U.S. do not receive proper mental health care. This Global Mental Health Research Fellowship will train scientists to enhance access and implementation of effective, feasible, sustainable and scalable mental health interventions that are adapted to the culture and context of each setting, making more efficient use of less specialized human resources available in various systems of care.
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