Global and Local Center for Mental Health Disparities
Christina P. C. Borba, PhD, MPH
Michelle Durham, MD, MPH
The Global and Local Center for Mental Health Disparities seeks to improve the mental health of our diverse global communities, both locally in the greater Boston area and internationally, through coordinated clinical, research, and training initiatives. The Global and Local Center emphasizes the importance of building the capacity of our in-country and in-community partners to provide quality mental health and psychiatric care, to investigate locally relevant topics through rigorous research methodologies, and to build the next generation of mental health professionals through education and training programs. We believe that working with a global mindset means working with an appreciation for the diverse ways in which local culture, customs, beliefs and traditions substantially impact how individuals view their health and mental health, as well as how culture influences health-seeking behaviors and beliefs about treatment. By engaging in collaborative, interdisciplinary, and bidirectional partnerships with local experts and community members, we are able to ensure that we foster work of local relevance to our community partners.
Globally, we are engaged in research, clinical, and training initiatives in more than 15 countries in Africa, Asia, South America and the Middle East, including Ethiopia, Liberia, Somaliland, Lebanon and Peru. Locally, our work is strongly influenced by BMC’s uniquely diverse patient population, of which 59% are from underserved populations and 31% do not speak English as a primary language. We hope to build a deeper understanding of many historically marginalized and understudied populations, both at home and abroad, in order to provide more effective and accessible care.
Examples of our current global work include:
- African Diaspora Conference 2016: In November 2016, the Global and Local Center coordinated the second African Diaspora Global Mental Health Conference in Cape Town, South Africa. This conference brought together mental health professionals to discuss the future of mental health care, research, and training in Africa and the diaspora. As a result of this conference, the African Global Mental Health Institute (AGMHI) was created, whose mission is to address the contemporary challenges of mental health disorders and their comorbid conditions through four key domains: research, education and training, service delivery, and policy.
- Global Psychiatry Clinical Research Training Program (T32): Through this fellowship, we develop the next generation of independent clinical scientists with the skills necessary to address the most pressing public mental health challenges in global contexts. Postdoctoral fellows are prepared to work collaboratively across disciplines and cultures in order to respond to the substantial burden of mental health related diseases in low- and middle-income countries and resource-limited areas. T32 international sites include:
- Ethiopia – Addis Ababa University (AAU), Dept. of Psychiatry
- Uganda – Mbarara University of Science and Technology (MUST), Dept. of Psychiatry
- South Africa – University of Cape Town (UCT), Dept. of Psychiatry and Mental Health, and Stellenbosch University, Depts. Of Psychology and Psychiatry
- Barbados – Barbados Nutrition Study Research Center
- Peru – Universidad Peruana Cayetano Heredia, School of Medicine
- Epidemiological and socio-cultural landscape of schizophrenia in rural Ethiopia: Researchers in rural Ethiopia have found the male-to-female prevalence of schizophrenia to be 5:1, which differs substantially from prevalence ratios of 1:1 found in developed countries where the bulk of such research originates. Through the current epidemiological, mixed-methods study, we seek to gain a better understanding of the potential causes or explanations for the gender difference in the prevalence of schizophrenia in rural Ethiopia.
- PTSD Intervention for People with Severe Mental Illness in Primary Care Settings in Low- and Middle-Income Countries: This NIH-funded research initiative is to assess the feasibility and efficacy of implementing the Brief Relaxation, Education And Trauma Healing (BREATHE) intervention for the treatment of PTSD in primary care clinic settings in rural Ethiopia.
- Liberia: Our researchers have been involved in collaborations with the University of Liberia and the Liberia Ministry of Health and Social Welfare (MOHSW) for over a decade. The partnership began as U.S. and Liberian researchers conducted a needs assessment of mental health issues in Liberia in order to inform the development of the country’s first National Mental Health Policy, which was enacted in 2009. In 2016, we facilitated and supported Liberia’s second psychiatrist, who has been instrumental in helping inpatients at the country’s only psychiatric hospital, many of whom had been institutionalized for months or even years, to be safely discharged and returned home to their loved ones.
- Somaliland Neurology and Psychiatry Residency Program: In collaboration with the University of Hargeisa in Somaliland and the Minister of Health of Somaliland, we have established the country’s first integrated neurology and psychiatry residency program. The first cohort of residents have been selected and began the residency in Spring 2017.
- Collaboration with the Lesotho-Boston Health Alliance (LeBoHA): LeBoHA was established over a decade ago and seeks to strengthen management, policy, planning and clinical capacity in the health sector of Lesotho. LeBoHA is led by Dr. Brian Jack, Chief of Family Medicine at the BU School of Medicine. Researchers in the Department of Psychiatry recently traveled to Lesotho with Dr. Jack and are pursuing a collaboration to integrate mental health care into primary care through the training of in-country nurses.
- Health and Mental Health Education and Awareness for Africans in Lowell (HEAAL) Project: The first phase of this project included a mixed-methods needs assessment conducted in collaboration with Christ Jubilee International Ministries, a nondenominational Christian church in Lowell, Massachusetts that serves a largely African immigrant and refugee congregation. We are now using the needs assessment findings to inform the development, implementation and evaluation of community-informed mental health interventions for this community in Lowell.
For more information about the Global and Local Center for Mental Health Disparities, please contact:
Christina P.C. Borba, PhD, MPH
Director of Research, Dept. of Psychiatry