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Global Mental Health

Dissemination and Scale Up

In the last decade an expanding scientific evidence base continues to demonstrate that at least some mental health treatments are acceptable and can be effective across cultures and contexts. This has led to interest in how to disseminate these interventions in ways that are sustainable and accessible while retaining quality and impact.

In the USA concerns regarding the slow pace at which research results in program changes (17 years on average, according to one estimate) has led to an active new field of program research called Dissemination and Implementation (D&I) Research. In recent years researchers in this field have become interested in applying US-based methods and lessons to health programming in other countries. JHU Global MH faculty have also taken on this challenge, combining findings from domestic D&I research with experience in the fields of Operations Research, Quality Assurance, and Program Planning that have been developed for physical health programs in low and middle-income countries since the 1980s.

Drawing on these resources our faculty have developed an approach to global D&I mental health research that explores multiple domains: adoption, acceptability, appropriateness, uptake/access, leadership, sustainability and cost effectiveness. Aspects of these issues are explored across 4 types of stakeholders: clients/population, providers, local administration, and higher management/policy.  Instruments reflecting these approaches have been created and have undergone testing, revision, and adaptation in Iraq, Burma, and Zambia. The latest versions of these instruments are available on this website. As we continue to accumulate experience and data we will update these instruments, including producing versions for different environments and populations as indicated.

We have also developed a series of activities and assessments to facilitate better program planning and implementation for organizations just beginning to include mental health into their services. The intent is not only to enhance short term success but also promote long term integration and sustainability. These materials were developed to assist provider organizations in Myanmar to implement CETA programming under a NIMH-funded scale up project