Global Mental Health Research Fellowship: Interventions That Make a Difference

描述(由申请人提供)：在15岁及以上的人中，精神障碍是导致全球残疾年数最多的十大因素中的三个。这一贡献在低收入和中等收入国家更为明显。在LMIC中，75%以上的精神障碍患者在严重残疾的情况下得不到治疗，而且在提供治疗的地方，很少是以循证做法为基础的，侵犯人权的情况仍然经常发生。2007年，《柳叶刀》全球精神卫生系列报告得出结论：“应该为研究提供资金，以开发和评估非精神卫生专业人员可以提供的干预措施(任务转移)，并评估卫生系统如何在所有常规护理环境中扩大此类干预措施。”在美国，全球健康研究已成为NIH的五个优先事项之一，全球精神健康研究现在是NIMH的明确优先事项。尽管最近呼吁将行动和承认作为高度优先事项，但专注于LMICs中精神障碍的国际研究合作有限。此外，国立卫生研究院在GMH临床研究方面的正式研究生培训计划也不可用。这项拟议的计划将与巴西、尼日利亚和中亚国家合作，为下一代转基因科学家提供培训，并将有两个重点。第一个是以部署为重点的干预研究，这样研究员将学会制定针对资源匮乏地区部署的干预措施。在社区协作下，将对研究员进行适应培训，并对直接涉及识别、评估、预防和治疗的行之有效的干预措施进行实地测试。第二个重点是干预措施的传播、实施和服务研究，研究人员学习如何将心理健康预防、评估和治疗干预措施转化为在特定的LMIC环境中使用。全球精神卫生(GMH)研究培训计划将包括八个部分：(1)指导；(2)临床研究设计、统计、专题、拨款编写方面的教学课程；(3)GMH的专门培训；(4)参与研究，包括设计、执行和分析研究以及提交科学论文、综述和建议；(5)通过设计和实施自己的试点项目，在任务转移和其他促进获得机会的策略方面的实践研究经验；(6)负责任地进行研究的指导；(7)在科学会议上陈述；以及(8)与哥伦比亚大学教师、我们的全球合作伙伴和该领域的杰出研究人员进行交流。该计划将利用哥伦比亚大学和国际网站现有的计划和设施，提供丰富的学习环境，使研究员沉浸在专注于促进当地和世界范围内心理健康的科学努力的环境中。令人遗憾的是，由于美国服务不足的人口很多，该培训计划还将向年轻研究人员传授必要的技能，以实施研究方案，从而缩小美国的精神卫生保健提供缺口。

DESCRIPTION (provided by applicant): Mental disorders comprise three of the top 10 contributors to years lived with disability globally among those aged 15 years and over. The contribution is more pronounced in low- and middle-income countries (LMICs). 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 still occur frequently. In 2007, the Lancet Global Mental Health Series concluded that "funding should be given to research that develops and assesses interventions that can be delivered by people who are not mental health professionals (task-shifting), and that assesses how health systems can scale up such interventions across all routine-care settings." In the US, global health research has become one of five NIH priorities and global mental health research is now an explicit NIMH priority. Despite recent calls for action and recognition as a high priority, international research collaborations focused on mental disorders in LMICs is limited. Further, formal NIH postgraduate training programs in GMH clinical research are not available. In partnership with Brazil, Nigeria and countries in Central Asia, this proposed program will provide training to the next generation of GMH scientists and will have a two-fold focus. The first is deployment-focused interventions research, such that fellows will learn to develop interventions geared towards deployment in resource poor areas. With community collaboration, fellows will be trained on adaptation and field-testing of tried and true interventions that directly address recognition, assessment, prevention and treatment. The second focus is intervention dissemination, implementation and services research, with fellows learning to examine how mental health prevention, assessment and treatment interventions can be translated for utilization in specific LMIC settings. The Global Mental Health (GMH) Research Training program will include eight components: (1) mentorship; (2) didactic courses in clinical research design, statistics, special topics, grant writing; (3) specialized training in GMH; (4) participation in research, including design, execution and analysis of studies and submission of scientific papers, reviews and proposals; (5) hands-on research experience in task-shifting and other access- enhancing strategies through design and implementation of their own pilot projects; (6) instruction in the responsible conduct of research; (7) presentation at scientific meetings; and (8) interchange with Columbia faculty, our Global partners, and distinguished researchers in the field. This program will leverage existing programs and facilities at Columbia University and international sites to provide a rich learning environment so that fellows are steeped in a milieu focused on the scientific endeavor of promoting mental health locally and worldwide. Because underserved populations are sadly abundant in the US, this training program will also teach young investigators the necessary skills to implement research protocols that can lead to the closing of the mental health care delivery gap in this country as well.