Global Mental Health Research Fellowship: Interventions That Make a Difference

描述（由申请人提供）：在全球15岁及以上的残疾人中，精神障碍占残疾年数的前10位贡献者中的3位。这一贡献在低收入和中等收入国家更为明显。在中低收入国家，超过75%的精神障碍患者尽管严重残疾，但得不到任何护理，即使提供治疗，也很少是基于循证实践，侵犯人权的行为仍然经常发生。2007年，《柳叶刀》全球心理健康系列报告得出结论，“应资助开展和评估非心理健康专业人员（任务转移）可以提供的干预措施的研究，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，全球心理健康研究现在是NIH的一个明确的优先事项。尽管最近呼吁采取行动和承认作为一个高度优先事项，国际研究合作的重点是在中低收入国家的精神障碍是有限的。此外，在GMH临床研究的正式NIH研究生培训计划是不可用的。在与巴西，尼日利亚和中亚国家的伙伴关系，这一拟议的计划将提供培训，以下一代的GMH科学家，并将有一个双重的重点。第一个是以部署为重点的干预措施研究，这样研究员将学习制定针对资源贫乏地区部署的干预措施。在社区合作下，将对研究员进行培训，使他们了解如何调整和实地测试直接涉及识别、评估、预防和治疗的经过考验的真正干预措施。第二个重点是干预措施的传播，实施和服务研究，研究员学习研究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组成部分：（1）导师;（2）临床研究设计，统计，专题，拨款写作的教学课程;（3）GMH的专业培训;（4）参与研究，包括研究的设计，执行和分析以及提交科学论文，评论和建议;（5）通过设计和实施自己的试点项目，在任务转移和其他访问增强策略方面的实践研究经验;（6）在负责任的研究行为中的指导;（7）在科学会议上的演讲;以及（8）与哥伦比亚教师，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的现有计划和设施，提供丰富的学习环境，使研究员沉浸在专注于促进当地和全球心理健康的科学奋进的环境中。由于在美国，服务不足的人群非常多，因此该培训计划还将教授年轻的研究人员实施研究方案的必要技能，这些研究方案也可以导致在这个国家缩小精神卫生保健提供差距。

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.