This is one of the five hubs awarded by US-NIMH to increase research capacity that can create better strategies to reduce the mental illness treatment gap in resource-poor settings. The three main driving principles for this proposal are:
A) to build capacity with a focus on strengthening within-region efforts so that sustainability and autonomy can be rapidly achieved.
B) to go beyond the traditional boundaries of mental health and develop strategic partnerships with other disciplines and health-research groups, and
C) to fully integrate effective mental health treatment into existing primary care and community health systems.
In order to achieve this aim we established a regional hub to carry out relevant mental health research and training to increase research capacity in the region. The core centre is based at the University of São Paulo (USP) with another major sub-center based in Peru (Universidad Peruana Cayetano Heredia) and three satellite centers in Ecuador, Guatemala and Colombia. This network is supported by strong academic centers in the fields of interest in the US and Europe. Two main activities constitute the foundation of our proposal:
1) a research component with two core research projects focusing on assessing the effectiveness of a mobile phone intervention assisted by an nurse assistant for the treatment of depression among individuals with chronic physical diseases identified in general medical settings in Brazil and Peru. One of the major barriers to the treatment of mental disorders is the sheer lack of trained specialized human resources. This intervention will address this problem by shifting tasks to this automated mobile phone intervention, thereby taking advantage of the huge penetration of mobile phones in the region.
2) To build increased mental health research capacity in the region through a research training program delivered by a network involving the University of São Paulo in Brazil, the Latin American network for the Global Alliance for Chronic Disease, University of Washington and the London School of Hygiene and Tropical Medicine. The strategy will include: 1) greater prominence to South-South collaboration; 2) focus on a multiplying strategy starting with the strengthening of a solid research hub and gradual expansion to other sub-centers in a large mutually supportive research network; and 3) more efficient methods of delivering training with improved accessibility. The capacity building component prioritizes training in research methodologies that can generate sound evidence on the best strategies to reduce this gap, allowing ‘hands-on’ training for researchers. In both components due importance is given to issues related to scaling up and policy making, including the creation of a highly qualified advisory board and consultation with a range of stakeholders throughout the life of the project.