Evaluation of capacity-building strategies for mental health system strengthening in low- and middle-income countries for service users and caregivers, policymakers and planners, and researchers
Sara Evans-Lacko,
Charlotte Hanlon,
Atalay Alem,
Jose Luis Ayuso-Mateos,
Dan Chisholm,
Oye Gureje,
Mark Jordans,
Fred Kigozi,
Heidi Lempp,
Crick Lund,
Inge Petersen,
Rahul Shidhaye,
Graham Thornicroft,
Maya Semrau
Affiliations
Sara Evans-Lacko
Associate Professorial Research Fellow, Personal Social Services Research Unit, London School of Economics and Political Science; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Charlotte Hanlon
Reader in Global Mental Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK; Adjunct Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; and Complex Interventions Lead, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia
Atalay Alem
Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
Jose Luis Ayuso-Mateos
Chairman and Director, Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid; and Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
Dan Chisholm
Programme Manager for Mental Health, Regional Office for Europe, Department of Mental Health and Substance Abuse, World Health Organization, Switzerland
Oye Gureje
Professor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South Africa
Reader, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Fred Kigozi
Senior Consultant Psychiatrist/ Researcher, Butabika National Referral Hospital, Uganda
Heidi Lempp
Reader in Medical Sociology, Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
Professor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Inge Petersen
Research Professor and Director, Centre for Rural Health, School of Public Health and Nursing, University of KwaZulu-Natal, South Africa
Rahul Shidhaye
Clinical Psychiatrist, Public Health Foundation of India and CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
Graham Thornicroft
Professor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Maya Semrau
Research Fellow, Global Health and Infection Department, Brighton & Sussex Medical School; and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
BackgroundStrengthening of mental health systems in low- and middle-income countries (LMICs) requires the involvement of appropriately skilled and committed individuals from a range of stakeholder groups. Currently, few evidence-based capacity-building activities and materials are available to enable and sustain comprehensive improvements.AimsWithin the Emerald project, the goal of this study was to evaluate capacity-building activities for three target groups: (a) service users with mental health conditions and their caregivers; (b) policymakers and planners; and (c) mental health researchers.MethodWe developed and tailored three short courses (between 1 and 5 days long). We then implemented and evaluated these short courses on 24 different occasions. We assessed satisfaction among 527 course participants as well as pre–post changes in knowledge in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). Changes in research capacity of partner Emerald institutions was also assessed through monitoring of academic outputs of participating researchers and students and via anonymous surveys.ResultsShort courses were associated with high levels of satisfaction and led to improvements in knowledge across target groups. In relation to institutional capacity building, all partner institutions reported improvements in research capacity for most aspects of mental health system strengthening and global mental health, and many of these positive changes were attributed to the Emerald programme. In terms of outputs, eight PhD students submitted a total of 10 papers relating to their PhD work (range 0–4) and were involved in 14 grant applications, of which 43% (n = 6) were successful.ConclusionsThe Emerald project has shown that building capacity of key stakeholders in mental health system strengthening is possible. However, the starting point and appropriate strategies for this may vary across different countries, depending on the local context, needs and resources.Declaration of interestS.E.L. received consulting fees from Lundbeck.
