Building a Global Mental Health Research Workforce: Perspectives from the National Institute of Mental Health.

Evaluation of the National Institute for Health and Care Research’s (NIHR) Global Health Research (GHR) Portfolio - Inception Report

Will RDoC hasten the decline of America's global leadership role in mental health?

Equity in Global Health Research.

Global pandemic perspectives: public health, mental health, and lessons for the future

Developing and implementing collaborative research in global mental health: the NIMH Hubs

Psychiatric disorders are among the leading cause of disability worldwide, yet fewer than 25 % of affected individuals are estimated to have access to treatment. In many low-income settings, it is estimated that less than 10 % of affected individuals are able to access basic mental health care and, even when they do, it is often below minimum ethical and clinical standards [1]. The discipline of global mental health is dedicated to reducing mental health disparities within and between countries by preventing mental disorders and improving access to psychiatric treatment, particularly in low-resource settings [2]. The study of cross-cultural mental health dates back to the late 1800s, when European psychiatrists and anthropologists began to identify and document locally specific mental diseases in their colonies [3]. Transcultural psychiatry branched into two research traditions: “relativists,” who were focused on characterizing culture-bound syndromes, and “universalists,” who sought to identify universality across cultures in the manifestation of mental disorders [2]. Both research traditions emerged from a colonial paradigm, wherein Western researchers studied the non-Western “other.” Whereas relativists relied primarily on qualitative and ethnographic methods [4], universalists employed epidemiological methods to estimate the cross-cultural prevalence of mental disorders, as defined by Western criteria. Cross-cultural mental health research has evolved significantly from its colonial roots to what is now a global partnership model emphasizing interdependency, bi-directional knowledge generation and transfer, and shared ownership (see Fig. 1). Though the relativist and universalist perspectives still exist, most global mental health researchers have gravitated towards an integrationist perspective, recognizing both broad universality in mental disorders across cultures as well as meaningful cross-cultural variation. Global mental health research now requires an interdisciplinary approach to bridge multiple perspectives and address complex questions related to cultural adaptation, effectiveness, dissemination, and implementation. It is grounded in the social justice and human rights perspective that all people have the right to health and mental health [5], with an emphasis on creating sustainable interventions to reduce mental health disparities. This paradigm shift has many implications for the training of the next generation of global mental health researchers, including both identifying and developing critical new skill sets to propel the field forward. Fig. 1 History and evolution of global mental health research and training

Global mental health: policy, progress, and prospects

The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project presents innovative ways of investigating mental illness based on behavioral and neurobiological measures of dimensional processes. Although cultural psychiatrists have critiqued RDoC's implications and limitations for its under-developed focus on context and experience, RDoC presents opportunities for synergies with global mental health. It can capture aspects of clinical or sub-clinical behavior which are less dependent upon Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and perhaps better elucidate the role of culture in disease expression and resilience. Aim/Results: This article uses the example of migration to describe several starting points for new research: (1) providing components for building an investigable conceptual framework to understand individual's mental health, resilience and adjustment to migration challenges or social adversities in low- and middle-income countries (LMICs) and (2) identifying measurable factors which determine resilience or vulnerability, to guide development and evaluation of targeted prevention, treatment and recovery strategies for mental health in LMICs. In such ways, RDoC frameworks could help put the new cutting edge neurobiological dimensional scientific advances in a position to contribute to addressing mental health problems amid social adversities in LMICs. However, this would require a much-expanded commitment by both RDoC and global mental health researchers to address contextual and experiential dimensions.

By 2030, the global Muslim population is expected to reach 2.2 billion people. The representations of Islam and Muslims in the media and academic literature may unconsciously impact how clinicians perceive and approach their Muslim patients. Our study focuses on the emerging Muslim mental health (MMH) literature using bibliometric analysis, specifically social network analysis of word co-occurrence and co-authorship networks of academic publications, to describe how the content of MMH discourse is evolving. We conducted an Ovid search (including Medline and PsycInfo databases) to identify articles written in English from 2000 to 2015 that had the terms 'Islam' and/or 'Muslim' in the abstract as well as research conducted in Muslim-majority countries and among Muslim minorities in the rest of the world. Of the 2652 articles on MMH, the majority (65.6%) focused on describing psychopathology; the minority (11.2%) focused on issues around stigma, religiosity, spirituality, identity, or acculturation. Among the top 15 most frequent terms in abstracts were 'post-traumatic stress disorder', 'violence', 'fear', 'trauma', and 'war'. Social network analysis showed there was little collaborative work across regions. The challenges of producing MMH research are similar to the challenges faced across global mental health research. Much of the MMH research reflects regional challenges such as the impact of conflict and violence on mental health. Continued efforts to develop global mental health researchers through cross-cultural exchanges, academic journals' dedicated sections and programs for global mental health recruitment, and online training are needed to address the gap in research and collaborations.

1 Netherlands Society for Tropical Medicine and International Health (NVTG), Wageningen, The Netherlands 1 2 Institute for Medical Technology Assessment, ErasmusMC, Rotterdam, The Netherlands 3 Department of Public Health, University Medical Centre Nijmegen, Nijmegen, The Netherlands 4 ETC Crystal, Leusden, The Netherlands 5 Institute of Health Policy and Management, ErasmusMC, Rotterdam, The Netherlands

With approximately 254 million students enrolled in post-secondary education globally, this population represents a significant portion of young adults navigating a critical developmental period. Many of these students face unique academic, social, and financial challenges that can negatively impact their well-being. In response to the rising concerns of student mental health, the Global Student Mental Health Research Network was founded in 2021. Composed of students, staff and faculty from institutions around the world, the network aims to build collaborations, identify opportunities for research partnerships, and to share best practices in student mental health research. This commentary aims to highlight pathways for post-secondary students to take leadership roles in student mental health research, supporting the development of the next generation of researchers in this field. In June 2023, members of the Global Student Mental Health Research Network gathered in-person for a three-day conference. A primary goal of the conference was to develop recommendations to increase pathways for students to lead post-secondary mental health research. Using the World Café method, participants identified 15 recommendations, organized into four themes: Communication, Increasing Awareness, Supporting Professional Development, and Reducing Barriers. Recommendations emphasize establishing shared values among students, staff, and faculty, and the importance of institutional investment in resources and opportunities. These steps aim to cultivate emerging student researchers who will advance the field and contribute to addressing the pressing issue of post-secondary student mental health. With around 254 million people enrolled in post-secondary education around the world, students make up a large group of young adults going through an important stage of life. Many of them face challenges, like school stress and social pressures, that can lead to increased stress and lower well-being. In response to the growing concerns about student mental health, the Global Student Mental Health Research Network was founded in 2021. Composed of students, staff and faculty from institutions around the world, the network aims to facilitate research partnerships and develop best practices to support student mental health research. This commentary highlights ways to increase opportunities for students to take leadership roles in mental health research, helping to train the next generation of researchers in this field. In June 2023, members of the Global Student Mental Health Research Network met in-person for a three-day conference. One of the main goals was to create recommendations to help more students move into leadership roles in mental health research. These leadership roles, where students take the lead on research projects, offer valuable experience for skill development and to build future careers in the field. Using collaborative workshops, participants developed 15 recommendations grouped into four themes: Communication, Increasing Awareness, Supporting Professional Development, and Reducing Barriers. The recommendations highlight the need for students, staff, and faculty to work together to support the next generation of student mental health researchers. Ongoing support from institutions is essential to meet students’ mental health needs and build lasting progress in the field.

IntroductionGlobal mental health is a growing priority in health and development agendas. However, there is limited evidence on whether scientific research in mental health aligns with the health, societal, and developmental needs of different regions. The aim of this study was to analyze the associations between global mental health research and key indicators in science, health, mental health, and society across world regions.MethodsIt was conducted a longitudinal analysis of 386,671 peer-reviewed publications on mental health (1886–2024) using data from five databases. We linked annual publication counts with 60 indicators across four domains (Economy, Development and Education; Global Health; Inequality and Poverty; and Governance and Rights). Associations were evaluated using linear regression models and standardized β₁ coefficients, stratified by World Health Organization regions.ResultsSignificant regional differences were observed in both publication volume and coherence with contextual indicators. Africa and South-East Asia, despite lower publication rates (<5%), showed strong associations between research output and gross domestic product per capita (β = 0.125, 95% CI: 0.05–0.19, p < 0.01), average years of schooling (β = 526.05, 95% CI: 30.5–1021.5), and physician density (β = 1,289.6, 95% CI: 322.2–2,257.1). Conversely, the Americas and Europe, which accounted for >75% of publications, showed weaker or non-significant associations with mental health burden indicators such as disability-adjusted life years and suicide mortality.DiscussionThere is evidence of both alignment and misalignment between global mental health research and global needs. Scientific output does not consistently correspond to indicators of mental health burden or systemic needs.

Purpose of ReviewTosummarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice.Recent FindingsMental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts.SummaryThe field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.

16 - Ethical issues in global mental health

The global mental health (GMH) research agenda should include both culture-general and culture-specific perspectives to ensure ecological validity of findings. Despite its title, the current GMH research agenda appears to be using a monocultural model that is individualistic, illness-oriented, and focused on intrapsychic processes. Ironically, issues of culture are prominently absent in many discussions of global mental health. This paper highlights some issues and concerns considered key to conducting ecologically valid and socially responsible GMH research. The concerns are particularly directed at researchers from dominant cultures who are working in low-income countries. Central to these issues is the balance between etic and emic perspectives in assessment, diagnosis, and intervention, as well as language, engagement of stakeholders and their agendas, and evaluation of the benefit of interventions to the community. New terminology is proposed that identifies broad cultural groups, and recommendations provided for a research agenda to encourage both basic and applied research that mutually benefits all stakeholders in the GMH research endeavor.