Research Partnerships for Scaling Up Mental Health Interventions in Low- and Middle-Income Countries
Recent policy shifts and growing evidence of the efficacy, cost-effectiveness, and successful delivery of mental health care in low- and middle-income countries (LMICs) have set the stage for larger-scale efforts to reduce the mental health treatment gap. Multiple randomized clinical trials involving numerous LMICs have shown the effectiveness of mental health interventions, including cognitive-behavioral, interpersonal, and cognitive processing therapies. The delivery of mental health services via task sharing (i.e., delivery of mental health services by non-specialist providers under the supervision of specialists) has been shown to be acceptable, feasible, and cost-effective in places where specialty mental health care is vastly under-resourced. However, few mental health innovations are yet widely implemented. In attempting to remedy this, the World Health Organization (WHO) and, increasingly, LMICs themselves, are promoting policies to expand mental health care. Taken together, mounting research evidence, awareness of need, and political resolve provide opportunities to study the scale up of mental health care and to foster evidence-based mental health policy and program development in low-resource settings globally.
The Scale-Up Hubs
NIMH established the Research Partnerships for Scaling Up Mental Health Interventions in Low- and Middle-Income Countries (aka, the Scale-Up Hubs) to conduct implementation research on LMIC efforts to expand the reach of evidence-based mental health interventions, and to build and sustain in-country capacity for conducting implementation research and using scientific evidence to develop mental health policies and programs. Each hub supports an implementation research study and provides research capacity-building opportunities. The hub teams are interdisciplinary, with interest and expertise in increasing the reach and effectiveness of mental health services; enhancing collaborative learning and development; and building relationships with governmental, non-governmental, and community-based stakeholders. As a group, the Scale-Up Hubs constitute a research network with growing capacity for answering research questions about going to scale with mental health interventions, sustaining high-quality mental health care in resource-limited settings, and fostering evidence-based mental health policies and programs.