Ethiopia:

Epidemiological and Socio-cultural Landscape of Schizophrenia in Rural Ethiopia (2014 - Present)
Butajira, Ethiopia has found the prevalence of schizophrenia to be 5:1 where males have a higher risk of schizophrenia compared to women. The reason behind this high gender differential in this setting still remains unclear. The goals of the project are to understand community members' cultural explanatory models of schizophrenia in Butajira, to improve cultural and gender sensitivity to aid in identifying new patients with schizophrenia, and to conduct an incidence study.

A Placebo-controlled Trial of Folate with B12 in Patients with Schizophrenia with Residual Symptoms in Ethiopia (2012 - Present)

This study is a randomized sequential parallel design for double-blind phase fixed dose, four-month trial of folate plus B12 as add-on therapy in 200 Ethiopian patients with schizophrenia with stable residual positive or negative symptoms. 

T32 Sites in Addis Ababa and Butajira (2012 - Present)
The University of Addis Ababa and its research offices in Addis Ababa and Butajira serve as two sites for the Division’s T32 Global Psychiatric Clinical Research Training Program.  The University’s Department of Psychiatry offers fellows the ability to research urban and rural mental health issues, psychotic disorders, HIV-mental health, and mood disorders.

Building Capacity for Mid-Level Mental Health Professionals in Rural Ethiopia (2008 - Present)
Faculty from the Division has assisted with curriculum development and on-site training for a master’s degree in community mental health at Jimma University.

Making Strides in Women’s Mental Health Care Delivery in Rural Ethiopia (2006 - 2008)
This study examined psychiatric charts for more than 225 women seen at Jimma University Specialized Hospital between 2006 and 2008 and found a wide range of medical documentation for the patients.  One of the findings was that no charts recorded medication status, detailed substance abuse history, or a history of violence.

Ghana:
Psychiatric Training for Medical Students (2010 - Present)
Since 2010, MGH faculty and residents have assisted in teaching medical students at the University of Cape Coast, School of Medical Sciences in Ghana.  The annual course has involved teaching fourth-year medical students basic diagnoses in psychiatry and fifth-year medical students psychiatric interviewing skills at the Ankaful Psychiatric Hospital as well as didactics that are more clinically oriented.

 

Liberia:
Liberia Center of Excellence (2012 - Present)
This is a collaboration between MGH and the University of Liberia (UL) to (1) provide skills-transfer between MGH and colleagues in Liberia; (2) update the psychiatry and neurology curriculum at A.M. Dogliotti College of Medicine at UL; (3) develop a three-year psychology doctoral program; (4) develop a two-year master of social work program; (5) develop a three-year psychiatry training program; and (6) collaborate on research.

Hopes and Dreams of Youth in Post-Conflict Liberia (2012)
The purpose of this pilot research qualitative investigation was to gain an insider’s understanding of how Liberian children have experienced past events and current circumstances and what barriers they face in their daily lives. This study examines the relationship between the loss of a parent and children’s sense of identity and development of future goals in children ages 13-18.

Traditional Medicine in Liberia (2012)
This qualitative investigation aimed to determine the understanding that Liberians have about mental illness, explore the treatment options available given the lack of formal psychiatric care, and to explore the methods and techniques used by traditional healers who deliver this treatment.

The Role of Substance Use and High Risk Behaviors of Public School Students in Monrovia (2012)
This pilot research qualitative investigation examined the present behaviors and beliefs of public school students regarding substance use and sexual behaviors in Monrovia, Liberia.

Assessing Mental Health and Psychosocial Status in Post-Conflict Liberia (2012)
This pilot research qualitative investigation aimed to develop a culturally-grounded measurement tool to assess psychological well-being and distress among adults in post-conflict Liberia.

Mental Health Needs Assessment of Liberian Children, Adolescents, and Young Adults (2009)
This was a qualitative and quantitative needs assessment with 170+ key informants in post-conflict Liberia.  The study sought to identify major mental health and psychological issues that affected young people and interventions or programs that would help.  The Liberian Ministry of Health and Social Welfare used the results to help develop the country’s first post-conflict National Mental Health Policy.

 

Somaliland:
Capacity Building for Neurology and Psychiatry (2014 - Present)
The Division of Global Psychiatry is working in collaboration with the University of Hargeisa Medical and Nursing Schools, Somaliland Ministry of Health, and the Hargeisa City Council to plan an integrated neurology and psychiatry residency program at the University of Hargeisa. This innovative curriculum focuses on illnesses of the brain rather than segmenting disorders into the two fields of neurology and psychiatry in an attempt to build clinical capacity to address the country’s needs regarding mental illness. The team is also developing an electronic collection system for clinical data at Hargeisa Neurology Hospital. They will use this technology for care quality improvement and as a starting point for mental health research infrastructure in Somaliland.

 

South Africa:

Hybrid Effectiveness-Implementation Trial for ART Adherence and Substance Use in HIV Care in South Africa (2016 – Present)
This is a 5-year award funded by the National Institute on Drug Abuse (NIDA).  The research grant aims to develop and evaluate a lay counselor-delivered intervention for substance use and HIV medication adherence in primary HIV care in Cape Town, South Africa.

T32 sites in Cape Town and Stellenbosch (2012 - Present)
Two universities in South Africa, the University of Cape Town and Stellenbosch University, serve as international sites for the Division’s fellows in the T32 Global Psychiatric Clinical Research Training Program.  Research covers key clinical problems that are relevant in the South African context, including behavioral and neuropsychiatric aspects of HIV/AIDS, substance use disorders, adolescent risk-taking behavior, posttraumatic stress disorder, and mental health policy and services.

Uganda:
T32 site in Mbarara (2012 - Present)
Mbarara University of Science and Technology (MUST) in Mbarara, Uganda is one of the international sites for the Division’s T32 Global Psychiatric Clinical Research Training Program.  The MUST Department of Psychiatry has conducted research on suicide, HIV and mental health, traditional medicine, addiction psychiatry, mood disorders, psychosis, and quality of care.

 

 

China:

Shanghai Mental Health Observership (2009 - 2013)
This program provided senior investigators from Shanghai Mental Health Center in China an opportunity to participate in research mentorship and training in the MGH Schizophrenia Clinical and Research Program.

 

Malaysia:
Mahadevan Traveling Observership (2009-2011)
The Mahadevan Traveling Fellowship offered one observership per year to an early-career Malaysian physician with a background or interest in mental health with the MGH Department of Psychiatry. The goal of the observership was to provide the trainee with knowledge and strategies that could be applied to enhance psychiatry training and contemporary practice in Malaysia. The program enabled an MGH resident and junior faculty member to travel to Malaysia for a similar experience.

Barbados

T32 site in Barbados (2015 - Present)
Barbados is one of the international sites for the Division’s T32 Global Psychiatric Clinical Research Training Program.  The studies being conducted there have followed the impact of breastfeeding and postpartum depression on mental health in youth and the long term effects of early childhood malnutrition on the prevalence of cognitive, behavioral, and health problems lasting into adulthood and into subsequent generations.

Breastfeeding and Postpartum Depression Lead to Adverse Mental Health in Childhood and Adolescence (1986 – Present)
We have documented psychosocial factors associated with reduced breast-feeding during the first six months of life in the mothers of 226 infants born at the Queen Elizabeth Hospital, Barbados in 1986. Breastfeeding has a beneficial impact on infant growth and development. However, subclinical depression in the postpartum period is also associated with reduced levels of breast-feeding and, as a result, adverse infant outcomes. These include delayed physical growth, impaired social development and difficult temperament. 

The Legacy of Childhood Malnutrition:  Lifespan and Transgenerational Effects on Mental Health (1973 – Present)
The Barbados Nutrition Study, a unique 40+ year longitudinal study, has followed the behavioral and health outcomes over the lifespan of individuals with histories of infant malnutrition and a matched control group who were classmates of the original sample.  We are currently studying the transgenerational effects of childhood malnutrition in the G2 offspring, focusing on potential epigenetic mechanisms that may explain continuing adverse effects into the next generation.

Translational Studies in Animal Models of Prenatal and Intergenerational Malnutrition on Brain and Behavior (1968 – Present)
This research is identifying important mechanisms, including epigenetic changes that may explain the long-term and possible intergenerational deficits caused by early nutritional deficits.  One of our early observations in the Barbados Nutrition Study was the four-fold increase in attention deficits among children who were exposed to malnutrition as infants. Because our human studies have shown that early childhood malnutrition results in increased attention deficits throughout the life span, our animal models have been specifically developed to address this behavior.  Therefore, we are exploring the neural basis of impulsivity and attention deficits in a rat model of prenatal protein malnutrition, using state-of-the-art multidisciplinary approaches.

Netherlands:
Mental Health Research Capacity Building (2014 - Present)
This is a collaboration with the Athena Institute at VU University in Amsterdam to mentor master’s and doctoral candidates pursuing careers in mental health research.

Norway:
Early Onset Dementia: Awareness Work and Raising the Bar for Standardized Care for Patients with Young Onset Neurodegenerative Disease (2012 - Present)
In collaboration with the National Aging Council and Oslo Memory Disorders Clinics, this study is a comparative analysis of patients with Early Onset Alzheimer’s disease in Norway and Boston, USA. 

 

Kuwait:
Hadi Videoconsultation Project (2013 - Present)
This is a videoconsultation project between Massachusetts General Hospital and Hadi Hospital in Kuwait City where services are provided using a physician-to-physician consultation model.

Lebanon:
Neurology and Psychiatry Capacity Building (2015 – Present)
This is a collaboration between the Departments of Neurology and Psychiatry at the American University in Beirut and the Department of Psychiatry at Massachusetts General Hospital.  The institutions have an agreement for MGH faculty to train faculty and staff in Beirut, by delivering lectures on behavioral neurology and neuropsychiatry, attending clinical case conferences, and rounding with physicians. 

Humanitarian Space and Wellbeing: Effectiveness of a Psychosocial Intervention for Host Communities and Syrian Refugees in Lebanon (2014 - Present)
This intervention targets host communities and Syrian refugees in the Mount Lebanon region.  Working with village municipalities, techniques from the Relaxation Response and Resiliency Program (3RP) are taught to groups on both sides to build resistance and defer tension by ways of mediation, problem solving, and collaborative community structural work.  The intervention also aims to build and empower an elder council to diffuse anger and negative emotions in the jobless youth population.

Building Capacity of Community Caregivers in Alzheimer’s Disease (2012)
In collaboration with the Ministry of Social Affairs of Lebanon, faculty and staff from The Division of Global Psychiatry administered a workshop on Alzheimer’s Disease (AD) best practices in six areas of the country to (1) heighten dementia and elderly health and wellbeing awareness; (2) improve AD knowledge and procedural skills of diverse professionals in the field; (3) inform region-specific and community-centered AD needs; and (4) provide public health outreach on AD and other dementias for stronger education, equal access, and excellence in care.

USA
Home Office (2009 - Present)
The Division of Global Psychiatry is located in Boston, MA at Massachusetts General Hospital (MGH).  Our core staff works out of 5 Longfellow Place, Suite 215.  From 2009-2016, the office was based at 25 Staniford Street in the Erich Lindemann Mental Health Center. 

Health Education and Awareness for Africans in Lowell (2014 - Present)
This pilot project between MGH and Christ Jubilee International Ministries in Lowell, MA seeks to increase the capacity of the church to address the physical and mental health needs of its congregation—predominantly African immigrants—by (1) identifying priority areas of focus through a needs assessment; (2) implementing activities that promote health and mental wellbeing; and (3) equipping church leaders and community members with the skills to act as resources for screening and referral to the community through intensive training and education.

Latino Americans’ Access to Psychiatric and Neurological Services: A Pilot Study (2010)
This mixed-methods study provided preliminary information on the individual preferences and non-medical factors that influence Latino Americans’ use of psychiatric and neurological services at Partners Healthcare System sites in Boston, MA. Participants reported placing greater importance on speaking the same language as their provider as opposed to having a provider of identical Latin American descent and gender. Despite low English proficiency, participants self-reported a comprehensive understanding of their illness, treatment, and the potential side effects of medication. Primary care physicians were the principal source that referred participants to neuropsychiatry for treatment of depression and anxiety.

 

Mexico:
ADHD Collaboration (2013 - Present)
This is a collaboration on Attention Deficit Hyperactivity Disorder (ADHD) with the Fundación Federico Hoth in Coyoacan, Mexico. This project aims to develop: (1) A teleconsulting project for the psychopharmalogical treatment of ADHD; (2) Exchange programs in medical training and research; (3) Joint workshops and conferences between the Foundation, hospitals in Mexico City, and MGH.

IMPACT: Building Leadership in Public Mental Health in North America (2004 - 2008)
The IMPACT project was a collaboration between MGH, Instituto Nacional de Psiquiatría Ramón de la Fuente in Mexico, Instituto Nacional de Neurología y Neurocirugía in Mexico, Dalhousie University in Canada, McMaster University in Canada, and Tufts/New England Medical Center in Boston.  Resident psychiatrists from the consortium institutions took part in a curriculum and spent time in each country to advance their knowledge of North American public health mental health systems, prepare them for leadership roles in psychiatry, and plan for care for a mixed society.

Brazil:

Sao Paulo Exchange Program (2014 - Present)
The Department of Psychiatry from the School of Medicine, University of São Paulo and the Department of Psychiatry, Massachusetts General Hospital have a cooperation agreement to encourage academic collaboration in clinical training, graduate and post-graduate medical education, and medical research. The agreement focuses on the areas of psychiatry, mental health, neurology, public health, and related disciplines.

 

Peru:
Making Strides Towards Better Mental Health Care in Peru: Results from a Primary Care Mental Health Training (2006 - 2007)
The goal of this program was to improve Peruvian primary care physicians’ skills and confidence in integrating mental health care into primary care practice.  A group of Peruvian physicians started by taking a two-week culturally sensitive psychiatry training course at the Harvard Program in Refugee Trauma where they extensively evaluated Peru’s primary care services. A study then examined the feasibility of training Peruvian primary care physicians in a culturally effective manner with sustainability over time.