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GMH Newsletter Featured Topics – July/August 2022

UW Consortium for Global Mental Health Spotlight

We had the opportunity to speak with Dr. Helen Jack, a new GMH junior faculty member, about her current work and plans for the future.  While Helen has recently joined the faculty, she has a long history of global mental health research activity.

Can you tell our readers a little about what brought you to Global Mental Health?

I started doing global mental health research as an undergraduate at Yale, when I conducted senior thesis research in psychiatric hospitals in Ghana, studying recruitment and retention of mental health workers. I started working in Zimbabwe when I connected with Dr. Khameer Kidia, a Zimbabwean researcher, while studying at Oxford and we began doing research together in Zimbabwe, a collaboration and friendship that continues to this day!

I chose to become a primary care physician, in part, because of my commitment to expanding access to mental health and substance use treatment – much of that treatment can be delivered in primary care, and we need primary care voices to be part of making that change.

I finished residency in Internal Medicine at University of Washington a little more than a year ago, and I now split my time between research and primary care practice. My research focuses on mental health systems strengthening and capacity building, primarily in Zimbabwe, and on substance use treatment in the United States, with a focus on peer-delivered interventions. My clinical practice is general adult primary care in a state prison in rural eastern Washington where I am also involved in a number of quality improvement initiatives.

Can you tell us a little about your global mental health research? Who are you working with and how did the project get started?

One of the projects I’m currently working on is with a group at University of Maryland that is implementing brief psychological interventions for people with substance use disorders that are delivered by peers, people who have lived experience with substance use and recovery. They are rolling out these peer-delivered therapies in Baltimore, Maryland and Cape Town, South Africa, as two separate projects, and they did a series of qualitative interviews with patients who received the therapy in each site. While there has been a fair amount of theoretical work on the importance of mutual capacity building, we have identified no prior studies that lay out frameworks or methods for this mutual learning. I am leading a study to combine the qualitative datasets from each site into a single set of qualitative interviews and analyze them jointly bot to learn more common elements and challenges of peer support and to begin to develop a set of methods for mutual capacity building.

Mutual capacity building” is the idea that people in high-income countries and people in low and middle-income countries can support each other to solve a common problem, such as lack of access to behavioral health services. This contrasts with development aid, which typically goes from high-income countries to low and middle-income countries, and with reverse innovation, which involves implementing ideas from low and middle-income countries in higher resource context, but which can parallel extractive and colonialist transfers of resources. I’m working with a team from University of Maryland to develop methods for doing research and implementation that are more grounded in mutual capacity building.

Prior to starting this project, I had collaborated closely with the PI of the University of Maryland lab, Dr. Jessica Magidson, PhD to do some conceptual work on mutual capacity building. We were interested in this because we both do both global mental health and US-based research and found that the two were increasingly informing each other. After she collected this data, we thought it would be a great opportunity to try to delve further into these concepts.

What do you see as the potential impact of your project? 

I hope that we can highlight some lessons learned for people who are implementing peer-delivered interventions to improve both clinical efficacy and implementation. I also hope that our methods will give other researchers a tool for doing similar joint analyses and provide a concrete way for researchers to engage in mutual, bidirectional learning.

What is the current status of this project? 

We have completed analyzing the joint dataset and just submitted our first manuscript outlining the method and some of our findings.

In closing, can you share a bit about other projects and what you’re planning for the next couple of months?

I am eager to start doing more research in a criminal justice setting, informed by both my clinical work and my prior global and US-based research. Later this year, I am excited to begin a research project looking at access to pre-exposure prophylaxis (PrEP) for HIV in patients releasing from prison in Washington State who have mental health or substance use disorders. This is funded by a supplement grant to UW BIRCH and I am co-leading it with Dr. Susan Graham.

 Global Mental Health News

  • Mental health topics were well represented at the International AIDS Conference in Montreal (AIDS 2022). UWCGMH presented collaborative research findings:
    • The e-poster, “Cumulative depression is associated with risk of all-cause mortality among adults living with HIV in Kenya, Tanzania, Uganda, and Nigeria”, was co-authored by Drs. Christopher Kemp (Johns Hopkins and UW), Jennifer Velloza (UCSF and UW), Pamela Collins (UW), and Ms. Tessa Concepcion (UW) with colleagues from the African Cohort Study (AFRICOS).  The analysis demonstrated the harmful effects of cumulative exposure to depressive symptoms over time. Abstracts will be available to the public on the International AIDS Society website in October.
    • Dr. Pamela Collins participated in the pre-conference hosted by the NCD Alliance that focused on integrating NCD care (including care for mental health conditions) into HIV care and treatment.
  • Virtually no screening and treatment for mental health disorders in many HIV clinics across the worldDr. Angela Parcesepe shared this troubling finding at AIDS 2022.  Despite this lack of services, there were some bright spots noted from the 2016/2017 survey to the 2020 survey shared at the Conference.  For example, there was a 31% (2016) and 24% (2017) increase in reported PTSD screening in clinics that did not previously offer these services.  Read the aidsmap article and the Conference abstract to learn more.
  • Creating safe spaces for youth, by youth. Young people in Nepal are working to develop mental health support systems for their peers.  UNICEF highlights the work of 17-year old Sumitra and others in this inspiring article.

West Coast Global Mental Health Spotlight

The King County Library System (KCLS) leads the way in community support services with Peers in Libraries partnership. KCLS has partnered with Peer Kent to implement a program to provide support and services to people living with HIV/AIDS and people who are impacted by mental health issues. Peer Service Specialists are people who have lived experience of these issues and have undergone training to provide a safe space for participants to open up about their struggles.

The American Library Association notes that “People experiencing poverty or homelessness constitute a significant portion of users in many libraries today and this population provides libraries with an important opportunity to change lives.”  With it’s unique program, KCLS may be on the forefront of a new model for providing these vital services as the need for them grows.

Global Mental Health Opportunities

Southeast Asian Mental Health Conference

Early career researchers from Vietnam, Cambodia, Burma, and Thailand will have the opportunity to network and learn from each other under this year’s them of Adversity and Resilience.  This two-day conference will take place from September 10 – 11, 2022.  You’re invited to register here.

NIMH and NIDA announce RFA to Expand Collaborative Implementation Science to Address Social and Structural Determinants of Health and Improve HIV Outcomes

This RFA is intended to strengthen the evidence base for interventions to address social and structural determinants of health with the ultimate goal of reducing these barriers in order to improve HIV outcomes.

Applications are due November 19, 2022.  Learn more here.

The NIMH Center for Global Health Research Webinar Series continues!

Find the monthly event calendar here.  The next webinar (date TBD, September) will be on Establishing and Independent Career in Global Mental Health Research.  Check the calendar later this month for the dates.