title: Strengthening mental health systems in low- and middle-income countries: the Emerald programme.
abstract: There is a large treatment gap for mental health care in low- and middle-income countries (LMICs), with the majority of people with mental, neurological, and substance use (MNS) disorders receiving no or inadequate care. Health system factors are known to play a crucial role in determining the coverage and effectiveness of health service interventions, but the study of mental health systems in LMICs has been neglected. The 'Emerging mental health systems in LMICs' (Emerald) programme aims to improve outcomes of people with MNS disorders in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda) by generating evidence and capacity to enhance health system performance in delivering mental health care. A mixed-methods approach is being applied to generate evidence on: adequate, fair, and sustainable resourcing for mental health (health system inputs); integrated provision of mental health services (health system processes); and improved coverage and goal attainment in mental health (health system outputs). Emerald has a strong focus on capacity-building of researchers, policymakers, and planners, and on increasing service user and caregiver involvement to support mental health systems strengthening. Emerald also addresses stigma and discrimination as one of the key barriers for access to and successful delivery of mental health services.
authors: King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. maya.semrau@kcl.ac.uk.
authors: Maya
authors: M
authors: Semrau
authors: King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. sara.evans-lacko@kcl.ac.uk.
authors: Sara
authors: S
authors: Evans-Lacko
authors: Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, 6th Floor, College of Health Sciences Building, Tikur Anbessa Hospital, PO 9086, Addis Ababa, Ethiopia. atalay.alem@gmail.com.
authors: Atalay
authors: A
authors: Alem
authors: Department of Psychiatry, Universidad Autonoma de Madrid, IIS-IP, CIBER, Calle Arzobispo Morcillo 4, 28029, Madrid, Spain. joseluis.ayuso@uam.es.
authors: Jose Luis
authors: JL
authors: Ayuso-Mateos
authors: Department of Mental Health and Substance Abuse, World Health Organization, Avenue Appia 20, 1211, Geneva 27, Switzerland. chisholmd@who.int.
authors: Dan
authors: D
authors: Chisholm
authors: Department of Psychiatry, College of Medicine, University of Ibadan, University College Hospital, Oritamefa, PMB 5116, Ibadan, Nigeria. oye_gureje@yahoo.com.
authors: Oye
authors: O
authors: Gureje
authors: King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. charlotte.hanlon@kcl.ac.uk.|Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, 6th Floor, College of Health Sciences Building, Tikur Anbessa Hospital, PO 9086, Addis Ababa, Ethiopia. charlotte.hanlon@kcl.ac.uk.
authors: Charlotte
authors: C
authors: Hanlon
authors: King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. mark.jordans@hntpo.org.|Department of Research and Development, HealthNet TPO, Lizzy Ansinghstraat 163, 1072 RG, Amsterdam, Netherlands. mark.jordans@hntpo.org.
authors: Mark
authors: M
authors: Jordans
authors: Butabika National Referral and Teaching Mental Hospital, PO Box 7017, Kampala, Uganda. fredkigozi@yahoo.com.
authors: Fred
authors: F
authors: Kigozi
authors: King's College London, Faculty of Life Sciences and Medicine, Academic Rheumatology, Clinical Trials Group, Weston Education Centre, 10, Cutcombe Rd., London, SE5 9RJ, UK. heidi.lempp@kcl.ac.uk.
authors: Heidi
authors: H
authors: Lempp
authors: Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, Cape Town, South Africa. crick.lund@uct.ac.za.
authors: Crick
authors: C
authors: Lund
authors: School of Applied Human Sciences, University of KwaZulu-Natal, Mazisi Kunene Avenue, 4001, Durban, South Africa. peterseni@ukzn.ac.za.
authors: Inge
authors: I
authors: Petersen
authors: Center for Chronic Conditions and Injuries, Public Health Foundation of India, Plot No. 47, Sector 44, Institutional Area Gurgaon, Delhi, NCR, 122002, India. rahul.shidhaye@phfi.org.
authors: Rahul
authors: R
authors: Shidhaye
authors: King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK. graham.thornicroft@kcl.ac.uk.
authors: Graham
authors: G
authors: Thornicroft
mesh_terms: D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration; D003906:Developing Countries; D005002:Ethiopia; D006801:Humans; D007182:Income; D007194:India; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration; D009390:Nepal; D009549:Nigeria; D011203:Poverty; D013019:South Africa; D014454:Uganda