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Mental health - CBM research progress

06-02-2012
A large group photo in lush hotel gardens in Africa
© CBM
CBM Mental Health leadership training course in Nigeria. The two men front/centre – facilitators – are Prof Harry Minas from Melbourne and Prof Oye Gureje from University of Ibadan (the site for the course, and the CBM partner)

February 2012 – CBM (with partner organisations worldwide) has recently commissioned several works in the field of mental health research. These are outlined below, and provide a good foundation for future projects that will focus on low income settings, empowerment and inclusion.

Evaluation and progress

CBM aims to improve the quality of life of persons with disabilities in the poorest parts of the world. In order to do this, we must constantly assess what we do in light of progress in the evidence-base that underlies our work.

Global mental health is going through a dramatic development as a discipline, with a significant rise in activities, particularly in the area of research. CBM, through the work of its Community Mental Health Advisory Working Group, aims not only to utilise this growth of knowledge, but also to set the agenda where we see it necessary to strengthen the particular work we do.

Priorities that CBM brings to the table include a focus on raising the evidence base for implementation of interventions in low income settings, with a focus on the most vulnerable people. We see inclusion of persons with disabilities (and those about whom research is being conducted) in the whole research process as being vital to ensuring that research (and the impact of research) is relevant to their  needs.

As a result of this policy, several pieces of work have been commissioned, and in each case, our partners have been central to the research being done.

Case Studies Methodology

The Case Studies Methodology project, with London School of Hygiene and Tropical Medicine, completed its development of a practical manual for evaluating mental health services in 2010. Good quality evaluation, and the ability to compare strengths and weaknesses of programmes, is essential if we are to improve services.

The Case Study methodology format is being used in various evaluations by a number of organisations, including in Vietnam, Sri Lanka and India. It is also being used as a format for work being done through the globalmentalhealth.org (password required) website, and in the University of Melbourne Global Mental Health programme.

Already, one publication has used this methodology to compare programmes in Nigeria, Timor Leste and India¹. Two projects in Nigeria are also now pilot sites for development of a practical outcomes evaluation tool, which we hope to roll out in CBM’s partner programme in West Africa, as well as make available to other organisations.

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¹Cohen A, Eaton J, Radtke B, George C, Manuel V, DeSilva M, Patel V. Three models of community mental health services in low-income countries. International Journal of Mental Health Systems 2011; 5:3 (read or download PDF here)

WHO mhGAP programme

CBM has sponsored development of key resources for the WHO’s mhGAP programme. Several of our partner projects are involved in piloting WHO mhGAP materials, and CBM had several partners represented at the WHO mhGAP Training Materials development workshop in Oct 2011.

Lancet series

CBM experts have contributed to the latest review on global mental health in the Lancet. Launched in 2011 in Cape Town, it provides an up-to-date follow-up of the landmark Lancet 2007 series, and reviews progress in the field, as well as covering areas like child mental health, poverty, and humanitarian settings not covered in the first series.

Programme evaluation

CBM is committed to working with local and international researchers to evaluate programmes to research standards.

One example of this is The Mental Health Awareness Programme, being evaluated by local researchers at Abia State University/Federal Medical Centre in partnership with the Institute of Psychiatry, London. Preliminary results show a positive effect of the intervention (training Village Health Workers to raise awareness of mental health issues in their communities), particularly in number of clients accessing local services.

Self-help groups, publications, humanitarian settings and scaling up mental health services

As part of our commitment to promote self-advocacy, we have sponsored development of two field guides to developing self-help groups (SHGs). The first, produced by BasicNeeds Uganda, is now complete (The Self Advocacy Toolkit - For Mental Health Service Users - PDF, ~1.35MB) and was based on experience with SHGs there; and a second, being developed by MindFreedom USA, is partnering with the user movement in various African countries.

CBM Advisory Working Group members have also contributed to book chapters on mental health in Africa², humanitarian settings and scaling up mental health services.

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²Ghodse H (Ed). International Perspectives on Mental Health. RCPsych Publications. London, 2011 (order online here)

Future priorities

Future priorities in research for mental health in CBM are likely to have the aim of influencing the research agenda towards producing work that has relevance to improving services in low income settings, and that has a focus on empowerment.

We will always aim to promote inclusion of persons affected by the research in the whole research process.

Related articles

CBM and Community Mental Health

People with psychosocial disabilities may have limited access to services and may be excluded from full participation in community life, particularly in developing countries. CBM and partners take a community-based approach in tackling these issues.

20-11-2012

Inclusion is essential

Dr Julian Eaton


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