Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Janet M. Turan, Sparkman Center for Global Health and Department of Health Policy and Organization, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA jmturan@uab.edu.
Michael J. Vinikoor, Research Department, Center for Infectious Disease Research in Zambia, Lusaka, Zambia.
Austin Y. Su, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Mauricio Rangel-Gomez, Behavioral Science & Integrative Neuroscience Research Branch, Division of Neuroscience and Basic Behavioral Science, National Institute of Mental Health, Bethesda, Maryland, USA.
Annika Sweetland, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Ruth Verhey, Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Dixon Chibanda, Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Robert Paulino-Ramírez, Instituto de Medicina Tropical and Salud Global, Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic.
Chynere Best, Center for Global Mental Health Equity, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Caroline Masquillier, Faculty of Medicine and Health Sciences, Department of Family and Population and Health, University of Antwerp, Antwerp, Belgium.
Josefien van Olmen, Faculty of Medicine and Health Sciences, Department of Family and Population and Health, University of Antwerp, Antwerp, Belgium.
Paul Gaist, Office of AIDS Research, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA.
Brandon A. Kohrt, Center for Global Mental Health Equity, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

11-1-2023

Journal

BMJ global health

Volume

8

Issue

Suppl 7

DOI

10.1136/bmjgh-2023-013572

Keywords

COVID-19; HIV; Health services research; Mental Health & Psychiatry; Public Health

Abstract

Over the past two decades there have been major advances in the development of interventions promoting mental health and well-being in low- and middle-income countries (LMIC), including delivery of care by non-specialist providers, incorporation of mobile technologies and development of multilevel community-based interventions. Growing inequities in mental health have led to calls to adopt similar strategies in high-income countries (HIC), learning from LMIC. To overcome shared challenges, it is crucial for projects implementing these strategies in different global settings to learn from one another. Our objective was to examine cases in which mental health and well-being interventions originating in or conceived for LMIC were implemented in the USA. The cases included delivery of psychological interventions by non-specialists, HIV-related stigma reduction programmes, substance use mitigation strategies and interventions to promote parenting skills and family functioning. We summarise commonly used strategies, barriers, benefits and lessons learnt for the transfer of these innovative practices among LMIC and HIC. Common strategies included intervention delivery by non-specialists and use of digital modalities to facilitate training and increase reach. Common barriers included lack of reimbursement mechanisms for care delivered by non-specialists and resistance from professional societies. Despite US investigators' involvement in most of the original research in LMIC, only a few cases directly involved LMIC researchers in US implementation. In order to achieve greater equity in global mental health and well-being, more efforts and targeted funding are needed to develop best practices for global health reciprocal innovation and iterative learning in HIC and LMIC.

Department

Global Health

Link to Full Text

Share

COinS