Webinar: Mental Health Implementation Research in Action
Our recent webinar focused on mental health implementation research. It was a partnership between The Lancet Psychiatry, The Being Initiative, United for Global Mental Health, and the Global Mental Health Action Network.
Panellists:
Jihad Bnimoussa: Psychologist and CEO, InspireCorp and Being Initiative Youth Advisor
Prof Beth McGinty, The Lancet Psychiatry Commission on Implementation Research: Co-Lead Editor, Professor of Population Health Sciences at Weill Cornell Medical College
Prof Matthew Eisenberg, The Lancet Psychiatry Commission on Implementation Research: Co-Lead Editor, Associate Professor in Health Policy and Management at Johns Hopkins University Bloomberg School of Public Health
Sahil Chopra, Portfolio Manager, Grand Challenges Canada
Prof Milton Wainberg, Professor of Clinical Psychiatry (in Sociomedical Sciences), Columbia University
Malvikha Manoj, Health Systems and Policy Practitioner, UNICEF
Replay the session
Session notes:
The Lancet Psychiatry Commission: transforming mental health implementation research
Effective mental health promotion, prevention, and treatment approaches exist but are not widely delivered at-scale to large groups or populations. Most people who could benefit from evidence-based mental health interventions - defined broadly to encompass policies, programmes, and individual-level practices or services - do not receive them. The growing field of implementation research, which seeks to understand what, why, and how interventions work (or do not work) in real-world settings, aims to identify approaches to overcome barriers to scaling. Although some progress has been made, implementation research can fall short of this goal. Often, research produces both interventions and implementation strategies (e.g., financing, facilitation, training to improve mental health literacy or reduce stigma) that are difficult to deliver at scale owing to misalignment with the political, cultural, policy, system, community, provider, and individual realities of real-world settings. This Commission considered strategies for transforming how we conduct research to produce more actionable evidence to narrow the mental health implementation gap. Its recommendations include:
Replace the research-to-implementation pathway with an integrated approach.
Embed equity in mental health intervention and implementation research.
Approach the implementation gap with a complexity science lens.
Expand the use of non-experimental approaches to establish causality.
Use a transdisciplinary approach to generate actionable knowledge to close the mental health implementation gap.
You can access the full text of the Commission on The Lancet website.
The Being Initiative
Being is a global mental health initiative which envisions a world where young people feel well and thrive. The programme funds and supports research, innovation, and ecosystem mobilisation. It is focused on mental health prevention and promotion, and – in many ways – serves to close the mental health implementation gap.
The Initiative’s goal is to understand the local mental health needs of young people, gaps and capacities within systems and evidence base in the 13 priority countries. The 13 countries are; Romania, Tanzania, Colombia, Ecuador, Ghana, Senegal, India, Morocco, Egypt, Indonesia, Pakistan, Sierra Leone and Vietnam.
Based on its major findings so far, the Initiative’s top actionable recommendations include:
Foster enhanced intersectoral collaboration and coordination among governmental ministries to streamline efforts.
Advocate for prioritising youth mental health issues within policy agendas and governmental action plans.
Increase resources towards mental health research to support evidence-based policy and programming.
Prioritise mental health prevention and promotion initiatives alongside treatment strategies.
Embed mental health care and services within primary healthcare, cross-cutting programs, and educational institutions.
Combat pervasive stigma surrounding mental health to foster greater mental health literacy and support for help-seeking behaviours.
Implement monitoring and evaluation to assess the effectiveness of existing mental health policies and interventions.
You can follow the activities of the Being Initiative on their website.
The responses
Prof Milton Wainberg from Columbia University highlighted that the funding needed to move to the direction of the recommendations has been very limited, and the actual global burden of mental illness has not really shifted since 1990 despite advances in science. The key challenge will be to bring research-to-practice at scale with equity, sustainment and sustainability of effects. He urged for a re-thinking of implementation research using a global health perspective with needed emphasis on equity and on overcoming macro-level barriers, whilst proportionate funding to mental health services and to implementation research will need to increase to a recommended minimum of 10%. The Comment he co-authored about the Commission can be read on The Lancet Psychiatry website.
Malvikha Manoj highlighted UNICEF’s transformative journey to advance programmatic and policy action for mental health and psychosocial wellbeing. The work has now shifted beyond short-term emergency work, using data and research to fill the gaps in services and programmes. UNICEF will be embedding more implementation research to gain better insights on what interventions work for whom, why and how, as well as to assess ways to optimise reach, impact, inclusivity and scale. From the Commission and initiatives like Being, there is a clear roadmap on how to close the know-do gap in global mental health, towards taking a socio-ecological model to improve children and young people’s psychosocial wellbeing.
Key takeaways:
The key “take-home” messages from the panellists included:
Mental health implementation is incredibly needed, and we need to break down the silos and work together at a global level.
It is hard to break down the traditional pipeline of research, but we are optimistic we can achieve integration (research into action) because there are so many people that are keen to join the journey.
There is strength and expertise in Low- and Middle- Income Countries that should be nurtured.
If we really want to work on mental health equity, the work needs to be led in communities.
Mental health needs a minimum of 10% of the funding (everywhere where there’s funding).
Implementation research is of particular importance in the current poly-crisis of issues affecting young people as it also changes practice and action on the ground.
