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Closing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique

Authors:

Annika C. Sweetland ,

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY
About Annika C.
DrPH, MSW
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Maria A. Oquendo,

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY
About Maria A.
MD
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Mohsin Sidat,

Universidade Eduardo Mondlane, Maputo, Mozambique
About Mohsin
MD, MSc, PhD
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Palmira F. Santos,

Ministry of Health, Mental Health Department, Maputo, Mozambique
About Palmira F.
PsyD, MMHPS, PhD
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Sten H. Vermund,

Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
About Sten H.
MD, PhD
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Cristiane S. Duarte,

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY
About Cristiane S.
PhD
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Melissa Arbuckle,

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY
About Melissa
MD, PhD
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Milton L. Wainberg

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY
About Milton L.
MD
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Abstract

Background

Neuropsychiatric disorders are the leading cause of disability worldwide, accounting for 22.7% of all years lived with disability. Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, although nonallopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need mental health treatment and those who have access to it include stigma and lack of awareness, limited material and human resources, and insufficient research capacity. We argue that investment in dissemination and implementation research is critical to face these barriers. Dissemination and implementation research can improve mental health care in low-income settings by facilitating the adaptation of effective treatment interventions to new settings, particularly when adapting specialist-led interventions developed in high-resource countries to settings with few, if any, mental health professionals. Emerging evidence from other low-income settings suggests that lay providers can be trained to detect mental disorders and deliver basic psychotherapeutic and psychopharmacological interventions when supervised by an expert.

Objectives

We describe a new North-South and South-South research partnership between Universidade Eduardo Mondlane (Mozambique), Columbia University (United States), Vanderbilt University (United States), and Universidade Federal de São Paulo (Brazil), to build research capacity in Mozambique and other Portuguese-speaking African countries.

Conclusions

Mozambique has both the political commitment and available resources for mental health, but inadequate research capacity and workforce limits the country’s ability to assess local needs, adapt and test interventions, and identify implementation strategies that can be used to effectively bring evidence-based mental health interventions to scale within the public sector. Global training and research partnerships are critical to building capacity, promoting bilateral learning between and among low- and high-income settings, ultimately reducing the mental health treatment gap worldwide.

How to Cite: Sweetland, A.C., Oquendo, M.A., Sidat, M., Santos, P.F., Vermund, S.H., Duarte, C.S., Arbuckle, M. and Wainberg, M.L., 2014. Closing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique. Annals of Global Health, 80(2), pp.126–133. DOI: http://doi.org/10.1016/j.aogh.2014.04.014
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Published on 26 Jun 2014.
Peer Reviewed

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