WHO Collaborating Centre for Capacity Building and Training in Global Mental Health at Columbia University

About The Program

Columbia’s World Health Organization Collaborating Centre for Capacity Building and Training in Global Mental Health (Columbia WHO CC), formerly the Columbia Global Mental Health Program, is an organization based at Columbia University Medical Center that champions innovative research, education, and advocacy in global mental health. The Columbia WHO CC is run by the Columbia-WHO Center for Global Mental Health.

The staff of the Columbia WHO CC and its affiliates deliver postgraduate educational programs that prepare clinicians and researchers to advance the field of global mental health, develop training programs that build capacity for research and clinical care in low- and middle-income countries, conduct basic and applied research with global relevance, advance community awareness and understanding of mental illness, and advocate for human rights of people with mental illness. Each of these activities work towards the goal of reducing the burden of mental illness worldwide.

 

Support for the Development of the ICD-11

The major current research project of the Columbia WHO CC is to support the development and implementation of the Mental, Behavioural, and Neurological Disorders chapter of the 11th edition of the International Classification of Disease (ICD-11).

 

Background

A clinically useful and culturally informed system of diagnosis is essential to advance mental health globally. Without a common lexicon, stakeholders cannot accurately describe clinical disorders, document effective interventions, or report public health data. The Columbia WHO CC designs and develops global field studies and trainings as part of the development of the ICD-11. The Columbia WHO CC collaborates with the WHO Secretariat to provide leadership in the areas of research design and data management for this collaboration. This collaboration represents one of the largest and most diverse clinical research initiatives on mental health ever assembled.

Columbia WHO CC is led by Dr. Geoffrey Reed, who leads the initiative as Senior Project Officer for ICD-11 development. Other Columbia faculty involved in this project include Dr. Kathleen Pike, who serves on the WHO Field Studies Coordination Group, and Dr. Tahilia Rebello, who serves as the Project Coordinator. Other members of the global mental health community at Columbia serve as research collaborators along with a network of clinical researchers and institutions from around the globe.

Aims

The first step in addressing the global mental health treatment gap is to do a better job of efficiently and accurately identifying those who need mental health treatment in those settings where they are most likely to come into contact with the health care system. Specific research questions include:

  • Are the proposed diagnostic guidelines easy to understand and use? (utility – feasibility)
  • Do the proposed diagnostic guidelines accurately reflect or capture patients’ symptom presentations? (utility – goodness of fit)
  • Are the proposed diagnostic guidelines and specifiers useful/ helpful in formulating of treatment plans for patients? (utility)
  • Do the proposed diagnostic criteria capture the patients’ symptom presentation consistently over time and across clinicians? (test-retest-reliability and inter-rater reliability)
  • Is there convergent validity of diagnoses with expert panel reviews or with other available external criteria? (validity)

 

Research Strategies

The Columbia WHO CC develops and conducts internet-based field studies through the Global Clinical Practice Network (GCP.Network), an online network of more than 15,000 individual mental health and primary care practitioners representing more than 158 countries. GCP.Network members provide critical feedback about the guidelines through these field studies, which is used to ensure that the new guidelines are usable and reliable across the world.

Clinic-based studies are conducted through the network of collaborating International Field Study Centers (IFSC) that have been appointed by WHO. Located around the world, the IFSCs provide the foundation for conducting field studies that evaluate the ICD-11 recommendations in clinical practice across a range of cultural contexts.

 

ICD-11 Trainings

After a decade-long scientifically rigorous development process, the World Health Organization (WHO) will finalize and release the Clinical Descriptions and Diagnostic Guidelines (CDDG) for Mental, Behavioural, and Neurodevelopmental Disorders in the ICD-11, which was approved by the World Health Assembly in May 2019. With the release of a new diagnostic system, mental health professionals must become familiar with changes introduced in the classification. It is critical that there are mechanisms in place for disseminating information about the key changes and how to implement them in clinical practice in an effective, clear, and widespread manner. This is an essential part of the global adoption of the ICD-11.

The Columbia WHO CC is leading the development of a systematic training program aimed at providing clinicians with the knowledge and competencies required to effectively implement the ICD-11. Online trainings will be implemented a web-based online learning management system platform and made available to clinicians around the world including those who are a part of  WHO’s Global Clinical Practice Network. This online training platform will be available in 2020.