title: Closing the mental health gap in low-income settings by building research capacity: perspectives from Mozambique.
abstract: BACKGROUND
  Neuropsychiatric disorders are the leading cause of disability worldwide, accounting for 22.7% of all years lived with disability. Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, although nonallopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need mental health treatment and those who have access to it include stigma and lack of awareness, limited material and human resources, and insufficient research capacity. We argue that investment in dissemination and implementation research is critical to face these barriers. Dissemination and implementation research can improve mental health care in low-income settings by facilitating the adaptation of effective treatment interventions to new settings, particularly when adapting specialist-led interventions developed in high-resource countries to settings with few, if any, mental health professionals. Emerging evidence from other low-income settings suggests that lay providers can be trained to detect mental disorders and deliver basic psychotherapeutic and psychopharmacological interventions when supervised by an expert.
  
  
  OBJECTIVE
  We describe a new North-South and South-South research partnership between Universidade Eduardo Mondlane (Mozambique), Columbia University (United States), Vanderbilt University (United States), and Universidade Federal de São Paulo (Brazil), to build research capacity in Mozambique and other Portuguese-speaking African countries.
  
  
  CONCLUSIONS
  Mozambique has both the political commitment and available resources for mental health, but inadequate research capacity and workforce limits the country's ability to assess local needs, adapt and test interventions, and identify implementation strategies that can be used to effectively bring evidence-based mental health interventions to scale within the public sector. Global training and research partnerships are critical to building capacity, promoting bilateral learning between and among low- and high-income settings, ultimately reducing the mental health treatment gap worldwide.
authors: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY. Electronic address: acs2124@columbia.edu.
authors: Annika C
authors: AC
authors: Sweetland
authors: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY.
authors: Maria A
authors: MA
authors: Oquendo
authors: Universidade Eduardo Mondlane, Maputo, Mozambique.
authors: Mohsin
authors: M
authors: Sidat
authors: Ministry of Health, Mental Health Department, Maputo, Mozambique.
authors: Palmira F
authors: PF
authors: Santos
authors: Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
authors: Sten H
authors: SH
authors: Vermund
authors: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY.
authors: Cristiane S
authors: CS
authors: Duarte
authors: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY.
authors: Melissa
authors: M
authors: Arbuckle
authors: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY.
authors: Milton L
authors: ML
authors: Wainberg
mesh_terms: D057191:Capacity Building; D003906:Developing Countries; D014943:Global Health; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007391:International Cooperation; D001523:Mental Disorders / Q000628:therapy*; D008602:Mental Healing; D008605:Mental Health Services; D009073:Mozambique; D016730:Program Development
keywords: Mozambique; PALOP; global mental health; research partnerships