This past Monday, April 25th, was the annual luncheon and meeting of the Columbia Council for the Advancement of Global Mental Health Research. Council members, current and past grant recipients, faculty, and staff gathered in person and online to celebrate this growing network and learn about projects that are underway. The excitement was palpable.
The Council is composed of people who contribute to a fund that supports four research projects each year. Grant recipients conduct research in various settings throughout the world. The common thread is that all the projects aim to increase understanding and build capacity to address pressing community mental health needs. This year’s grant recipients shared updates on their projects in Mozambique and Armenia.
Multimorbidities in Mozambique. In health care, we have a lot of specialties. One expert focuses on cardiac conditions, another on diabetes, another on asthma, etc.. In reality, certain health conditions tend to travel together, and when they do, treatment efforts delivered in an integrated manner are much more effective. Annika Sweetland, DrPH, MPH, and Francine Cournos, MD are exploring how to apply this lens to managing the complex multimorbidities of TB, HIV, common mental disorders, and substance use disorders within primary care in Mozambique. These conditions are frequently co-occurring and negatively synergistic. HIV, mental, and substance use disorders are risk factors for TB; TB and HIV are risk factors for mental and substance use disorders. Having multiple conditions is associated with increased morbidity, mortality, and infectious disease transmission. Sweetland and Cournous are working with collaborators in Mozambique to develop an integrated care strategy that has the potential to dramatically change care delivery and improve health outcomes for people with these conditions in Mozambique.
Alcohol Use in Armenian Youth. On top of the global COVID-19 pandemic, Armenia has experienced the compounding effect of a devastating war in recent years. Christina Mehranbod, MPH, Jeremy Kane, PhD, MPH, Kim Hekimian, PhD and Christopher Morrison, PhD, MPH are working to identify opportunities for preventive interventions to reduce alcohol use and related harms in Yerevan, the capital city of Armenia. Their multifold objectives, which are modeled after a public health approach, include:assessing the distribution and density of alcohol outlets and alcohol advertisements in neighborhoods, exploring attitudes, behavioral norms, and cultural contexts related to alcohol use and mental health, and assessing health care providers’ views of potential screening and intervention methods to address unhealthy alcohol use in young adults. Their ultimate aim is to inform programming and policies to develop affordable interventions that reduce harmful alcohol use and improve mental health.
Moving from Medication-only to a Recovery – Oriented Psychosocial Treatment Model for Individuals with Schizophrenia in Mozambique. In Mozambique, schizophrenia is the leading cause of hospitalizations in psychiatric units and the second leading impetus for seeking psychiatric services. However, the national mental health system is still being developed and expanded, and with an insufficient number of trained mental health providers, antipsychotic medication is often the only treatment available. Rogerio Mulumba, MD, Iruma Bello, PhD, Lisa Dixon, MD, MPH, and Milton L. Wainberg, MD are partnering with local professionals and community members to identify local attitudes towards the treatment of and recovery from schizophrenia. Based on their findings, they plan to develop culturally-resonant psychosocial interventions that can be used in combination with medication management delivered in local community health centers.
Displacement and Mental Health. In the northern Mozambican province of Cabo Delgado, an escalating religious insurgency has resulted in approximately 2,000 civilian deaths and 674,000 internally displaced people (IDPs) who have migrated to the neighboring Nampula Province and provincial capital. Bolstering existing efforts to expand comprehensive public mental health care in the region, Jennifer Mootz, PhD, & Michael Wessells, PhD are exploring technologies that could potentially facilitate the detection and treatment of urban IDPs’ mental health needs. The urgency of this work is especially great given that IDPs are typically settling in resource-limited settings where professional services and infrastructure are extremely limited.
Zooming in and Zooming Out. Good global mental health work requires a masterful mix of generalizing and specializing. We work to identify general principles that can guide research and interventions across diverse settings. We also need to be acutely attentive to the specific and specialized needs of each setting. Working in close partnership with individuals from the community, we ensure that anything we do has integrity in the local context. All of this year’s projects offer immediate value to their particular contexts. The work will also inform future efforts in other parts of the world where similar issues exist and emerge.
The Columbia Council for the Advancement of Global Mental Health Research is co-chaired by Jere Miller, Stephanie Guyett, and Chuck Goldstein. This Council is a growing community of ambassadors who support mental health research. Twelve projects have been funded to date, and we are in the process of receiving applications for the coming year. By taking our extant knowledge and mixing that with what we learn in each particular context, bit by bit, our global capacity to understand and address the mental health needs of individuals and communities around the world expands. Many thanks to all the members of our Columbia Council for making this many-layered story of community possible.
