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Global Mental Health

About

Our Expertise

Our faculty, research associates and students bring expertise in epidemiology, clinical psychology, health systems research, biostatistics and research methods, prevention science and implementation research methods to the field of public mental health in the global context. 

We work with national and international non-governmental organizations (NGOs), aid agencies, multilateral and UN organizations and governments in low-and middle-income countries. These collaborations allow us to identify and measure salient mental health and psychosocial problems through qualitative data collection methods, guide the selection and design of locally appropriate mental health interventions to address locally prioritized problems, and monitor and evaluate services. We continue to support international and national organizations of all sizes to improve mental healthcare access, and quality of care for communities in LMIC.

In addition to treatment research, we are focused on prevention: we develop and evaluate programs aimed at factors known to increase the risk and/or severity of mental health problems, including poverty reduction and violence prevention programming. 

 

Capacity Building and Training 

We have a strong commitment to capacity building of field-based staff and local collaborators, policy makers and government officials, and academic trainees. In providing technical assistance to NGOs and governments, we build organizational and staff capacity in the conduct of rigorous mental health needs assessments and the use of data to inform program using our Design, Implementation, Monitoring and Evaluation (DIME) process

Capacity building is done through direct training and mentored collaboration on activities that constitute the DIME process, including using qualitative and quantitative methods to evaluate a target population's needs, developing screening tools for recruitment into interventions, and conducting impact assessments. Capacity building of policy makers and government officials is done through formal and informal presentations and the development of strong partnerships from the start of a project or program. Capacity building of academic trainees is done through formal Masters and Doctoral degree programs and Postdoctoral Fellowships at the Johns Hopkins Bloomberg School of Public Health and elsewhere.

 

Intervention Development and Evaluation

Since 2000, we have worked with locally-based service providers to adapt, develop and evaluate the impact of mental health treatments provided through task-sharing models.  We have completed impact evaluations, including more than 10 randomized controlled trials, of different evidence-based psychotherapies and of interventions for which the evidence is lacking or emerging.  As part of this research, we have developed and tested a transdiagnostic treatment model, the Common Elements Treatment Approach (CETA), which provides a single intervention approach that allows providers to treat a range of common mental disorders, including depression, anxiety and trauma-related symptoms that occur independently and frequently together. 

In addition to researching the direct impact of mental health treatments on the burden of common mental health problems, we have conducted intervention research to explore the impact of mental health treatments on a range of other outcomes, including violence reduction, HIV-related risk behaviors, experience of stigma, child neurocognitive outcomes, and substance use behaviors. We have also investigated the impact of economic programming on mental health outcomes. 

 

Services, Dissemination and Implementation (D&I Research)

Our research has now moved beyond the determination of whether mental health treatments can successfully reduce the burden of common mental health problems to investigating how to establish and sustain these types of interventions in community settings. Currently we are conducting implementation and scale up research how to address barriers to mental health services sustainability found at the organization, provider, and user levels. These barriers can include lack of space, lack of support or understanding of the selected intervention, identification of providers who having competing demands on their time, problems with motivating and retaining providers and staff, insufficient outreach, and limited financial resources to sustain a new program. Understanding there is no “one size fits all” to the needs of organizations, we are researching how to use different approaches to meet the different needs. 

 

Instrumentation and Measurement

A fundamental need in global mental health research is to have reliable, valid and useful measurement tools. We have spent much of the last decade developing and using qualitative and quantitative methods to develop and validate instruments that assess the presence and severity of common mental health problems, including depression, anxiety, posttraumatic stress, and function impairment. We have used these methods to develop and validate brief depression measures, substance use assessments and measures of HIV-risk behavior and violence exposure. More recently, we have applied these methods to developing useful measures for assessing and monitoring service-related implementation factors

 

Emerging Areas

As our research team grows, our areas of research also expand. Currently, we are initiating intervention and prevention research for substance use problems as well as reducing the burden of interpersonal and gender-based violence. We continue to work with diverse, vulnerable populations, with new collaborations including with a focus on Native American populations. In addition, we are expanding our work on multi-dimensional intervention models that include empowerment, economic, and stigma-reduction components.