Evidence for Action: Stimulating Research to Address the Global Mental Health Treatment Gap

Pringle, Beverly; Williams, Makeda; Collins, Pamela Y.

doi:10.1007/978-3-030-57296-9_94

Cited by 4 publications

(6 citation statements)

References 53 publications

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“…The institute's findings influence the formulation of mental health policies by providing policymakers with the latest evidence on mental health interventions, prevention strategies, and the impact of mental illnesses on society. NIMH's role in translating research into policy ensures that mental health policies are informed by the most current and robust scientific knowledge (Pringle et al, 2021). The integration of mental health services into mainstream healthcare has been a focal point of recent mental health policies in the United States.…”

Section: Mental Health Policies In the United Statesmentioning

confidence: 99%

Mental Health Policies: A Comparative Review Between the Usa and African Nations

Ifeoma Pamela Odilibe,

Opeoluwa Akomolafe,

Jeremiah Olawumi Arowoogun

et al. 2024

imsrj

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This comparative review examines mental health policies in the United States and various African nations, shedding light on the divergent approaches taken to address the complex challenges posed by mental health disorders. The analysis underscores the contextual nuances that shape mental health policy formulation and implementation in these distinct regions. In the United States, a comprehensive mental health policy framework has evolved over the years, characterized by a combination of federal and state initiatives. The Mental Health Parity and Addiction Equity Act, alongside the Affordable Care Act, has sought to integrate mental health services into mainstream healthcare, promoting accessibility and reducing stigma. Additionally, the National Institute of Mental Health plays a pivotal role in advancing research and evidence-based interventions. Contrastingly, African nations exhibit a wide spectrum of mental health policy landscapes, reflecting the diverse socioeconomic and cultural contexts across the continent. Some countries have made significant strides in policy development, emphasizing community-based approaches and integration with primary healthcare systems. However, challenges persist, including limited resources, mental health workforce shortages, and stigma associated with mental health conditions. The review explores the role of cultural factors in shaping mental health policies, emphasizing the need for culturally sensitive approaches in African nations. It also highlights the disparities in resource allocation and mental health infrastructure between the USA and African countries, contributing to variations in service accessibility and quality of care. Furthermore, the study emphasizes the importance of ongoing efforts to destigmatize mental health issues, improve public awareness, and strengthen community support systems. The review concludes by calling for increased international collaboration, knowledge exchange, and resource mobilization to address the mental health disparities between the USA and African nations, fostering a global commitment to holistic mental healthcare. Keywords: Health, Policies, Mental, Care, Stigmatize.

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Section: Mental Health Policies In the United Statesmentioning

confidence: 99%

Mental Health Policies: A Comparative Review Between the Usa and African Nations

Ifeoma Pamela Odilibe,

Opeoluwa Akomolafe,

Jeremiah Olawumi Arowoogun

et al. 2024

imsrj

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“…The global mental health field has emerged to address inequities in resource-constrained settings both domestically in the U.S. and internationally ( 17 ). There is an urgent call for closing the mental health treatment gap by building capacity among non-specialist workers tasks to deliver community-based interventions ( 1 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

“We are the sun for our community:” Partnering with community health workers/promotores to adapt, deliver and evaluate a home-based collaborative care model to improve equity in access to quality depression care for older U.S. Latino adults who are underserved

Steinman

Gasca

Hoeft

et al. 2023

Front. Public Health

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BackgroundWhile depression is a leading cause of poor health, less than half of older adults receive adequate care. Inequities in both access and outcomes are even more pronounced for socially disadvantaged older adults. The collaborative care model (CCM) has potential to reduce this burden through community-based organizations (CBOs) who serve these populations. However, CCM has been understudied in diverse cultural and resource-constrained contexts. We evaluated the implementation and effectiveness of PEARLS, a home-based CCM adapted with and for community health workers/promotores (CHWs/Ps).MethodsWe used an instrumental case study design. Our case definition is a community-academic partnership to build CHW/P capacity for evidence-based depression care for older U.S. Latino adults in the Inland Empire region of California (2017–2020). We aimed to understand adaptations to fit local context; acceptability, feasibility, and fidelity; clinical effectiveness; and contextual determinants of implementation success or failure. Data sources included quantitative and qualitative administrative and evaluation data from participants and providers. We used descriptive statistics and paired t-tests to characterize care delivery and evaluate effectiveness post-intervention, and deductive thematic analysis to answer other aims.FindingsThis case study included 152 PEARLS participants and nine data sources (N = 67 documents). The CBO including their CHWs/Ps partnered with the external implementation team made adaptations to PEARLS content, context, and implementation strategies to support CHWs/Ps and older adults. PEARLS was acceptable, feasible and delivered with fidelity. Participants showed significant reductions in depression severity at 5 months (98% clinical response rate [mean (SD), 13.7 (3.9) drop in pre/post PHQ-9; p < 0.001] and received support for 2.6 social needs on average. PEARLS delivery was facilitated by its relative advantage, adaptability, and trialability; the team's collective efficacy, buy-in, alignment with organization mission, and ongoing reflection and evaluation during implementation. Delivery was challenged by weak partnerships with clinics for participant referral, engagement, reimbursement, and sustainability post-grant funding.DiscussionThis case study used existing data to learn how home-based CCM was adapted by and for CHWs/Ps to reduce health inequities in late-life depression and depression care among older Latino immigrants. The CBOs and CHWs/Ps strong trust and rapport, addressing social and health needs alongside depression care, and regular internal and external coaching and consultation, appeared to drive successful implementation and effectiveness.

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“…In terms of health research, it has been long recognised that evidence is needed to support the use of methodological processes with priority setting, as well as the procedures involved to identify the studies [ 12 ]. Yet understanding their use with mental health research remains underexplored [ 13 ]. Potential reasons for this are a propensity for priority setting to generate and report on priorities rather than the methods to obtain the results, and lack of funding compared to other areas of healthcare suggesting this too impacts on what priorities are decided [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…This is a knowledge-gap that requires attention given the efficacy of priority setting is “determined by the use of systematic, explicit and transparent processes to increase research funding” ([ 8 ], p.2), while funding for mental health research is disproportionate to other health topics. Methodological procedures are preferably evidence-based to be a vehicle to generate robust results, since mental health research requires to have the greatest potential public health benefit while proficient and fair with use of constrained resources [ 8 , 12 , 13 ]. Explicit procedures may also contribute to an inclusiveness of different voices within projects, rather than the tradition of only academics deliberating what research is prioritised.…”

Section: Introductionmentioning

confidence: 99%

“…Namely, patients and their significant others who are ultimately impacted by the changes from research, while procedural transparency can help these groups to assess the rigour in how research was prioritised [ 10 ]. To that end, procedural knowledge that contributes to effective priority setting is essential, and to date, there appears no comprehensive review in what approaches can be adopted and why, with prioritising mental health research [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Methodological procedures for priority setting mental health research: a systematic review summarising the methods, designs and frameworks involved with priority setting

Deering

Brimblecombe

Matonhodze

et al. 2023

Health Res Policy Sys

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Background Research priority setting aims to identify research gaps within particular health fields. Given the global burden of mental illness and underfunding of mental health research compared to other health topics, knowledge of methodological procedures may raise the quality of priority setting to identify research with value and impact. However, to date there has been no comprehensive review on the approaches adopted with priority setting projects that identify mental health research, despite viewed as essential knowledge to address research gaps. Hence, the paper presents a summary of the methods, designs, and existing frameworks that can be adopted for prioritising mental health research to inform future prioritising projects. Method A systematic review of electronic databases located prioritisation literature, while a critical interpretive synthesis was adopted whereby the appraisal of methodological procedures was integrated into the synthesis of the findings. The synthesis was shaped using the good practice checklist for priority setting by Viergever and colleagues drawing on their following categories to identify and appraise methodological procedures: (1) Comprehensive Approach—frameworks/designs guiding the entire priority setting; (2) Inclusiveness –participation methods to aid the equal contribution of stakeholders; (3) Information Gathering—data collecting methods to identify research gaps, and (4) Deciding Priorities—methods to finalise priorities. Results In total 903 papers were located with 889 papers removed as either duplicates or not meeting the inclusion and exclusion criteria. 14 papers were identified, describing 13 separate priority setting projects. Participatory approaches were the dominant method adopted but existing prioritisation frameworks were modified with little explanation regarding the rationale, processes for adaptation and theoretical foundation. Processes were predominately researcher led, although with some patient involvement. Surveys and consensus building methods gathered information while ranking systems and thematic analysis tend to generate finalised priorities. However, limited evidence found about transforming priorities into actual research projects and few described plans for implementation to promote translation into user-informed research. Conclusion Prioritisation projects may benefit from justifying the methodological approaches taken to identify mental health research, stating reasons for adapting frameworks alongside reasons for adopting particular methods, while finalised priorities should be worded in such a way as to facilitate their easy translation into research projects.

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Evidence for Action: Stimulating Research to Address the Global Mental Health Treatment Gap

Cited by 4 publications

References 53 publications

Mental Health Policies: A Comparative Review Between the Usa and African Nations

Mental Health Policies: A Comparative Review Between the Usa and African Nations

“We are the sun for our community:” Partnering with community health workers/promotores to adapt, deliver and evaluate a home-based collaborative care model to improve equity in access to quality depression care for older U.S. Latino adults who are underserved

Methodological procedures for priority setting mental health research: a systematic review summarising the methods, designs and frameworks involved with priority setting

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