International project to strengthen mental health systems

Glowing work: EMERALD partners at the kick-off meeting in London on 8 and 9 November. In front are (left to right) Nicole Vortruba, EMERALD Project Manager, Prof Graham Thornicroft, EMERALD principal investigator, Domenico Lalli, finance officer, European Commission. UCT partners are A/Prof Crick Lund (third row, centre), Prof Mark Tomlinson (Stellenbosch University and UCT, fourth row, far right) and Erica Breuer (back row, second from right).

The mental health care systems of six low- and middle-income countries are going to get a thorough going-over in a major international project.

The Alan J Flisher Centre for Public Mental Health at UCT is part of a large international consortium that has recently received a grant of €5,798,000 - over R66 million - to examine health systems for mental health care in six low and middle-income countries over the next five years. The consortium, called EMERALD or Emerging Mental Health Systems in Low- and Middle-Income countries, will be working in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.

EMERALD is led by Prof Graham Thornicroft of the Institute of Psychiatry, King's College London, and includes partner institutions in each country (including UCT), the University of Madrid, and the World Health Organisation.

The project aims to improve mental health outcomes in low- and middle-income countries by enhancing health system performance. Health system requirements include the costs, financing mechanisms, governance structures and information systems needed to provide mental health care, particularly for poor and vulnerable communities in these countries, explained the UCT co-investigator, Associate Professor Crick Lund.

"This is a very exciting new development which builds on our existing international networks of research and policy partnerships in Africa and south Asia," he added.

EMERALD includes capacity building and communications components, to build capacity to conduct and communicate research of this nature in the countries.

The Centre for Public Mental Health, based in the Department of Psychiatry and Mental Health at UCT, is now conducting research in collaboration with academic institutions, ministries of health and NGOs in eight low- and middle-income countries in Africa and south Asia. The centre leads two large international research consortia, including the PRogramme for Improving Mental Health Care (PRIME ), and the AFrica Focus on Intervention Research for Mental health (AFFIRM). The centre also houses the Perinatal Mental Health Project (PMHP), which provides key inputs regarding maternal mental health in both PRIME and AFFIRM.

The Alan J Flisher Centre for Public Mental Health (CPMH) is a joint initiative of the Department of Psychiatry and Mental Health at the University of Cape Town (UCT); and the Department of Psychology at Stellenbosch University (SU) in South Africa. The CPMH conducts high quality research on public mental health, and uses evidence for teaching, consultancy and advocacy to promote public mental health in Africa and Low and Middle-Income Countries (LMIC). Working in 8 African countries (Ethiopia, Ghana, Malawi, Nigeria, South Africa, Uganda, Zambia and Zimbabwe) and 2 Asian countries (India and Nepal), the CPMH is involved in 4 international research, policy and capacity-building programmes known as PRIME (PRogramme for Improving Mental health carE), AFFIRM (AFrica Focus on Intervention Research for Mental health), IMHERZ (IMproving Mental Health Education and Research capacity in Zimbabwe) and EMERALD (Emerging mental health systems in low and middle-income countries).