PALOP Mental Health Implementation Research Training

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With 29 million people and only 18 psychiatrists (trained abroad) and 125 clinical psychologists, none of whom had a PhD prior to this D43, Mozambique faces enormous mental health (MH) care challenges. To address the country’s large MH treatment and research gaps, through a North- South-South collaboration between the US, Brazil and Mozambique, our PALOPmhIS-1 (Países Africanos de Língua Oficial Portuguesa –Portuguese-speaking African countries– MH implementation science; 2014-2019) D43 program has provided individually mentored hands-on research and didactic training to four senior mentors from other medical fields and 11 trainees, the majority of whom are women. We have had an enviable ‘return-on-investment’ in only five years surpassing our targets: a) Research capacity building: nine fellows and two others are in the final stages of obtaining their PhDs and Masters in Brazil, respectively (15 publications in international journals); b) Research funding: fellows have become valuable investigators, and as a team, we have garnered over $8.5 million in NIH-funded research; c) Implementation science (IS): in a multiplier effect, fellows oversaw the training of 25 trainers, who in turn are training 300 primary care providers and 900 community health workers in evidence-based practices (EBPs) targeting common mental disorders (Interpersonal Counseling), substance use disorders (Motivational Interviewing), severe disorders (Psychiatric Medications), and suicidal risk (Safety Planning), as part of two NIH-funded studies scaling-up comprehensive MH (NIMH) and substance use (NIAAA) care integrated into primary care using mobile health technology; and, d) Policy impact: our team, which includes Ministry of Health personnel, is leading the integration of electronic medical records for clinical and research purposes, previously functioning as separate disease-silos. We also initiated training activities for other PALOP countries. In response to evolving needs and opportunities, PALOPmhIS-2 will (Objective 1) recruit and support long- term (4 years) doctoral training of eight Fellows integrating a novel concentration in MH IS within a Public Health PhD program in Mozambique; (Objective 2) offer past PALOPmhIS D43 graduates (N=11) and other Mozambican Mid-Level Faculty (N=50) medium-term training on new scientific content: MH IS sustainability (Fogarty International Center Strategic Plan Goal 3), e- Health (Goal 2), health informatics, EMR, large datasets, multimorbidities; and (Objective 3) train five graduates in research leadership towards independence and local program sustainability. We will extend training to other local and regional partners (Goal 1); pursue further research funding opportunities, and continue to train the local workforce while scaling up the use of e-Health EBIs.