A clinically useful and culturally informed system of diagnosis is essential to advance mental health globally. Without a common lexicon, we cannot accurately describe clinical disorders, document effective interventions, or report public health data. This research initiative focuses on field studies for the development of the World Health Organization (WHO) International Classification of Diseases-11 (ICD-11). This collaboration represents one of the largest and most diverse clinical research initiatives on mental health ever assembled.
WHO has the unique mandate to provide a diagnostic classification system for all health conditions, including mental and behavioral disorders, for all 194 member nations. This research program is focused on conducting field studies that inform the development of the International Classification of Diseases-11 (ICD-11). The GMHP at Columbia has established a collaboration with WHO and provides leadership in the areas of research design and data management for the collaboration. Dr. Kathleen Pike serves on the WHO scientific leadership team (the Field Studies Coordination Group) and members of the GMHP serve as research collaborators along with a network of clinical researchers and institutions from around the globe.
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)
We are conducting internet-based field studies through the Global Clinical Practice Network (GCPN), which consists of more than 15,000 individual mental health and primary care practitioners representing more than 156 countries.
Clinic-based studies are being 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.