PALOP Mental Health Implementation Research Training

描述（申请人提供）：PALOP （Paises Africanos de Lingua official portuesa）心理健康（MH）实施研究培训计划。在全球范围内，精神障碍仍然是造成15岁以上人群残疾年数的十大原因之一。在莫桑比克等低收入和中等收入国家更是如此；低收入和中等收入国家中75%以上的精神障碍患者尽管有严重残疾，但没有得到治疗，即使提供治疗，也很少基于循证做法，而且经常发生侵犯人权的行为。《柳叶刀》全球妇幼保健系列（2007年）得出的结论是，“应该为开发和评估干预措施的研究提供资金，这些干预措施可以由非妇幼保健专业人员（任务转移）提供，并且……评估卫生系统如何在所有常规保健环境中扩大此类干预措施。”遗憾的是，关注中低收入国家MH的国际研究合作是有限的，而且在任何中低收入国家中还没有Fogarty或NIH的MH实施研究培训项目。我们与爱德华多蒙德兰大学（UEM）合作，并与圣保罗联邦大学（UNIFESP）和范德比尔特全球卫生研究所（VIGH）结成联盟，在莫桑比克提出了一个南北和南南合作的方案，该方案将以为期两年的奖学金培训下一代PALOP MH实施科学家。该项目将有两个重点：A)以部署为重点的干预研究：通过社区合作，研究员将学习适应和实地测试久经考验的真正干预措施，以解决获取、有效评估、有效预防和治疗问题；B)干预措施的传播、实施和服务研究：研究如何在莫桑比克新扩大的保健护理系统内扩大护理。莫桑比克是一个理想的环境，因为我们的合作伙伴联合国卫生组织与卫生部（也是合作者）共同制定了新的医院护理战略计划，而且最近实施了一项创新的精神病学技术人员培训方案，以提供非专科护理。该计划的组成部分将是：1)指导；2)研究设计、统计和拨款写作方面的教学；3)干预研究培训；4）

DESCRIPTION (provided by applicant): PALOP (Paises Africanos de Lingua Oficial Portuguesa) Mental Health (MH) Implementation Research Training Program. Globally, mental disorders remain 3 of the top 10 contributors to years lived with disability among those over age 15. This is even more so in low- and middle-income countries (LMICs) such as Mozambique; over 75% of those with mental disorders in LMICs receive no care despite substantial disability, and where treatment is provided, it is rarely based on evidence-based practices and human rights violations occur frequently. The Lancet Global MH Series (2007) concluded that "funding should be given to research that develops and assesses interventions that can be delivered by people who are not MH professionals (task- shifting), and... assesses how health systems can scale up such interventions across all routine-care settings." Sadly, international research collaborations focused on MH in LMICs are limited and no Fogarty or NIH training programs in MH implementation research are yet available in any LMICs. Partnering with Universidade Eduardo Mondlane (UEM) and in alliance with Universidade Federal de Sao Paulo (UNIFESP) and the Vanderbilt Institute for Global Health (VIGH), we propose a program in Mozambique with a North-South and South-South collaboration that will train the next generation of PALOP MH implementation scientists in a 2- year fellowship. The program will have two foci: A) Deployment-focused interventions research: With community collaboration, fellows will learn adaptation and field-testing of tried and true interventions that address access, valid assessment, effective prevention and treatment; and B) Intervention dissemination, implementation and services research: Examining how care can be scaled-up within Mozambique's newly expanding system of MH care. Mozambique is an ideal setting given its new strategic plan for MH care developed by our partner UEM with the Ministry of Health (also collaborators) and the recent implementation of an innovative training program for psychiatric technicians to deliver non-specialist care. The program's components will be: 1) mentorship; 2) didactics in research design, statistics, and grant writing; 3) interventions research training; 4) participation in design, execution and analysis of research and submission of scientific papers/proposals; 5) hands-on research experience in task-shifting, stepped-care and access-enhancing strategies through design/implementation of pilot projects; 6) instruction in responsible conduct of research; 7) presentation at scientific meetings; and 8) interchange with New York State Psychiatric (NYSPI)/Columbia University and UNIFESP faculty and distinguished researchers in the field. Mozambique can be a model to other PALOP and sub-Saharan African countries as well as other low-resource settings, including the US. This program will leverage 8 existing fellowships at NYSPI, including a T32 Global MH implementation fellowship, and scholarships from UNIFESP to cultivate a rich learning environment that will immerse fellows in a milieu focused on fostering MH locally, regionally, and globally.