Evaluation of capacity-building strategies for mental health system strengthening in low- and middle-income countries for service users and caregivers, policymakers and planners, and researchers.

Journal: BJPsych open

Volume: 5

Issue: 5

Year of Publication: 

Affiliated Institutions:  Associate Professorial Research Fellow, Personal Social Services Research Unit, London School of Economics and Political Science; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Reader in Global Mental Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK; Adjunct Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; and Complex Interventions Lead, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia. Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia. Chairman and Director, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid; and Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. Programme Manager for Mental Health, Regional Office for Europe, Department of Mental Health and Substance Abuse, World Health Organization, Switzerland. Professor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South Africa. Reader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Senior Consultant Psychiatrist/ Researcher, Butabika National Referral Hospital, Uganda. Reader in Medical Sociology, Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, UK. Professor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Research Professor and Director, Centre for Rural Health, School of Public Health and Nursing, University of KwaZulu-Natal, South Africa. Clinical Psychiatrist, Public Health Foundation of India and CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands. Professor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Research Fellow, Global Health and Infection Department, Brighton & Sussex Medical School; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Abstract summary 

Strengthening of mental health systems in low- and middle-income countries (LMICs) requires the involvement of appropriately skilled and committed individuals from a range of stakeholder groups. Currently, few evidence-based capacity-building activities and materials are available to enable and sustain comprehensive improvements.Within the Emerald project, the goal of this study was to evaluate capacity-building activities for three target groups: (a) service users with mental health conditions and their caregivers; (b) policymakers and planners; and (c) mental health researchers.We developed and tailored three short courses (between 1 and 5 days long). We then implemented and evaluated these short courses on 24 different occasions. We assessed satisfaction among 527 course participants as well as pre-post changes in knowledge in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). Changes in research capacity of partner Emerald institutions was also assessed through monitoring of academic outputs of participating researchers and students and via anonymous surveys.Short courses were associated with high levels of satisfaction and led to improvements in knowledge across target groups. In relation to institutional capacity building, all partner institutions reported improvements in research capacity for most aspects of mental health system strengthening and global mental health, and many of these positive changes were attributed to the Emerald programme. In terms of outputs, eight PhD students submitted a total of 10 papers relating to their PhD work (range 0-4) and were involved in 14 grant applications, of which 43% (n = 6) were successful.The Emerald project has shown that building capacity of key stakeholders in mental health system strengthening is possible. However, the starting point and appropriate strategies for this may vary across different countries, depending on the local context, needs and resources.S.E.L. received consulting fees from Lundbeck.

Authors & Co-authors:  Evans-Lacko Sara S Hanlon Charlotte C Alem Atalay A Ayuso-Mateos Jose Luis JL Chisholm Dan D Gureje Oye O Jordans Mark M Kigozi Fred F Lempp Heidi H Lund Crick C Petersen Inge I Shidhaye Rahul R Thornicroft Graham G Semrau Maya M

Study Outcome 

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Statistics
Citations :  Mills A. Health policy and systems research: defining the terrain; identifying the methods. Health Policy Plan 2012; 27: 1–7.
Authors :  14
Identifiers
Doi : e67
SSN : 2056-4724
Study Population
Male,Female
Mesh Terms
Other Terms
Low- and middle-income countries;capacity-building;mental health;mental health systems
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England