Funding: The Economic and Social Research Council (R4HC-MENA), UK
Teachers College IRB Protocol #18-015
Building on a pilot capacity building project funded by the International Medical Corps (IMC) in 2016, the GMH Lab received a Transition-to-Scale grant from Canada Grand Challenges (GCC) to train a second cadre of mental health professionals in primary health-care centers, NGOs, and community-based organizations in March 2017. With funds awarded by Grand Challenges Canada (GCC) Transition-to-Scale Grant, an acceptability and scalability study in Lebanon has been in progress since then, to systematically build capacity in IPT delivery in primary and tertiary care settings, using a training-of-trainers (TOT) model. This project will continue and extend the work supported by the GCC grant in Lebanon and in the UK.
Funding: The United Nations High Council for Refugees (UNHCR)
Teachers College IRB Protocol #19-043
In partnership with UNHCR and its mental health and psychosocial support team, this project is aimed to study the acceptability, feasibility and preliminary effectiveness of interpersonal psychotherapy (IPT) for distressed adult Rohingya refugees settled in refugee camps in Cox’s Bazar District in Bangladesh. Specific aims of the project are: 1) Adaptation of IPT to the Rohingya refugee context informed by qualitative, formative research with mental health provider-trainees and patients to inform acceptability and ecological validity (cultural-fit) for this population; 2) Train a cadre of Bangladeshi mental health care providers from the UNHCR, BRAC and other partner agencies to become competent IPT therapists; 3) Evaluate provider-level competence of IPT adoption and practice in mental health care by the trainee-providers; and 4) Evaluate patient-level outcomes (symptom reduction, improvement in functioning and wellbeing) over time.
Funding: The Medical Research Council (MRC), UK
This pilot, feasibility study seeks to understand how a group interpersonal psychotherapy (IPT-G) intervention can be made relevant, feasible and acceptable for adolescents with depression and anxiety in rural Nepal. The study will be conducted within rural regions, where adolescents are at high risk of mental disorders and have limited access to mental health services. This would be achieved in five stages: 1) a preliminary qualitative study to understand adolescents' experiences of depression and anxiety, help-seeking and barriers to intervention will be carried out; 2) The WHO IPT group intervention manual will be translated to Nepali; 3) A cadre of mental health specialists will be trained in IPT for adolescents; 4) an intervention adaptation workshop and community advisory board to provide feedback on the revised manual will be developed; and 5) IPT-G will be piloted in the community and in schools (with monitoring of adherence, quality and costs, and optimal treatment duration). Ultimately, this study will generate essential information on adolescent mental health intervention in LMICs and will enable developing a protocol for a randomized controlled trial to evaluate the effectiveness and cost value of an IPT intervention in Nepal as the future step.
Teachers College IRB Protocol #19-483
The International Food Policy Research Institute (IFPRI) is conducting an impact evaluation of the Strengthen PSNP4 Institutions and Resilience (SPIR) Development Food Security Activity (DFSA) project in Ethiopia from 2018-2021, including a substudy on maternal depression in collaboration with the GMH Lab at TC. The evaluation is designed as a cluster randomized controlled trial (RCT) that compares the impact of different combinations of livelihood and nutrition components of the project on measures of household wellbeing, food security, child and maternal nutritional status and related outcomes. The maternal depression substudy screens women with children under age 3 years for depression and treats these women found to be depressed in the intensive nutrition treatment arms via interpersonal therapy in groups (IPT-G). The study will measure the impact of IPT-G, along with related intensive nutrition interventions, on depression and will assess whether changes in rates of maternal depression contribute to improved health and nutrition outcomes for their children and reduced intimate partner violence.
Funding: Starbucks Coffee Corporation
Despite the growing number of student veterans, only half of the total population is estimated to graduate (Million Records Project, 2014; VA Campus Toolkit Handout, 2014). Evidence suggests that student veterans have a significantly higher prevalence of psychological distress in comparison to their non-veteran college peers (Fortney et al., 2016). Regardless of the need for treatment and support, student veterans still experience barriers to seeking and accessing mental health care through formal Department of Veterans Affairs (VA) systems as well as Veteran Service Organizations (VSOs). The team, in collaboration with the Veterans Integration to Academic Leadership (VITAL) Program, adapted Interpersonal Counseling (IPC) for student veterans in a three-session format. In 2019, a pilot was conducted to explore the feasibility of utilizing short-term IPC as a potential non-stigmatizing engagement and treatment strategy for student veterans in distress. Preliminary findings suggest that this brief intervention is a promising short-term symptom reduction strategy for this population and increased the likelihood of future engagement with mental health services. The team is currently expanding the project to gather more information about student veterans' experiences of mental health services and to evaluate the intervention in a randomized control trial.
Teachers College IRB protocol #19-190
Perinatal depression (PD), depression that occurs during pregnancy or in the year following delivery, is a common and debilitating mental health condition. In New York City, at least one in ten (or 10,000) women suffer from PD (CIMH fact sheet). In New York State, between 1995 and 2004 over 7,000 women were hospitalized for PD-related symptoms. To reduce this treatment gap, the Greater New York Hospital Association and the NYC Department of Health launched the Maternal Depression Learning Collaborative. Comprised of 30 hospitals, this initiative aims to develop a system for screening women for PD and triaging them to necessary services and treatments. In collaboration with the GMH Lab, the current study will pilot interpersonal psychotherapy (IPT) for treatment of PD and assess impact by tracking outcomes among providers and patients in primary care settings. In partnership with the NYCDoH, the study aims to assess the acceptability and feasibility of an IPT training program for New York City-based health providers who work with depressed mothers.
Funding: Well-Being Trust
There is a mature evidence base and growing examples supporting adoption of mental health skills and methods by non-professionals in a growing range of settings, a process often referred to as task-sharing or task-shifting. This process is the answer to the critical question of how to position mental health needs--whether for care or prevention/promotion-- more deeply in communities and upstream in impact. In order to make this approach the "new normal" attention needs to turn to the tools, templates, methods, that enable local actors to indeed lead and frame such efforts and their aims. We will develop a prototype planning tool for them to do so. Its focus will be environmental change-vulnerable communities and local groups working on those issues. We do so because 1) environmental justice and climate change will become increasingly
Funding: Canada Grand Challenges
Teachers College IRB protocol #17-192
Building on the previously completed “Capacity building and dissemination of Interpersonal Psychotherapy for Syrian displaced persons in Lebanon” project (see above for description), this project aimed to scale-up IPT for depression into primary care and other healthcare settings. The first phase of the project consisted of systematic capacity building in IPT following a training-of-trainers model: A new group of 37 mental health or health professionals working at primary health-care centers (PHCs), NGOs, and community-based organizations were recruited to be trained as IPT providers. This group was co-trained by a group of previously trained IPT providers who were selected to become IPT supervisors in Lebanon, under the supervision of US-based IPT master trainers. The second phase of the project was the integration of IPT within the primary health care setting using the IMPACT collaborative care management platform, developed by the Advancing Integrated Mental Health Solutions (AIMS) Center. Both phases involved collecting patient-level, provider-level, and supervisor-level qualitative and quantitative data to inform the implementation process for scale-up. Assessments were also conducted regarding the feasibility, and acceptability of the IPT implementation, the competency of the IPT providers and supervisors, and outcomes in patient well-being, functioning, and symptom scores.
Funding: The Eleanor Crook Foundation
Trials.gov #: NCT03573713
Teachers College IRB protocol #17-255
The GMH Lab in partnership with Food for the Hungry completed a 33-month project testing the integration of Interpersonal Psychotherapy for Groups (IPT-G) within Care Group projects and assessing whether the treatment of maternal depression with IPT-G improves the adoption of maternal behaviors that can reduce stunting in Kitgum District in Kitgum district, northern Uganda. Using a cluster randomized controlled trial design (N=1200), the study tested whether adding IPT-G for half of the women identified with depression improved the adoption of household health and nutrition behaviors known to improve child linear growth.
Funding: World Health Organization
This manual aims to provide tools to help non-specialists conduct Interpersonal Therapy in groups. The manual is broken down into various components that provide a non-denominational therapy approach to guide community health workers through the process of case identification, psychoeducation, general treatment techniques, and referral pathways.
Funding: International Medical Corps & the Lebanese Ministry of Public Health
The 1.1 million Syrians who fled to Lebanon—close to one fourth of the nation’s population—have been exposed to adversities before and during their escape to the extent that the Lebanese Ministry of Public Health released a Mental Health Action plan for persons affected by the Syrian crisis calling for coordinated and integrated mental health operations. This project was a collaboration between the GMH Lab, the Lebanese Ministry of Public Health, the International Medical Corps (IMC), other NGOs, and mental health departments of academic centers to conduct a systematic training-of-trainers in Interpersonal Psychotherapy (IPT) to build sustainable capacity in Lebanese mental health educators and providers of all relevant disciplines (psychologists, social workers, nurses, psychiatrists) on a national level. Implementation and dissemination of this training was also evaluated.
Funding: Wailian Overseas Consulting Group
Teachers College IRB protocol #16-399
This project explored the mental health needs and priorities of Chinese adolescents attending middle and high school in the U.S., and to adapt, evaluate, and disseminate Social Emotional Learning (SEL) strategies targeting the needs of this population. The GMH lab developed an engaging, destigmatizing, and culturally relevant framework to strengthen the adjustment of these adolescents and to promote their short and long-term resilience and success.
The overarching goal of this study was to evaluate the effectiveness of IPT-G in increasing the uptake of positive child rearing, feeding, and hygiene behaviors in Malawi through an existing food program by Feed the Children. At the time, the reported point prevalence was approximately 20% for depression in pregnant or lactating mothers in the country, with a huge number of women getting services from food programs. Since depression decreases the uptake of services from these programs, it is critical to evaluate whether their effectiveness can be enhanced through treatment of depression in the affected mothers.
This study at Portsmouth, Virginia, adapted and tested the feasibility and acceptability of group IPT for depressed Navy spouses. The project was conducted in two phases: 1) focus groups with depressed spouses, service members, and clinicians to inform adaptation and 2) a small pilot study testing 8-week and 16-week versions of the treatment.
Funding: The International Medical Corps
The overarching goal of this study was to evaluate the comprehensive mental health service program of the International Medical Corps (IMC) against the standard of care for Syrian refugees in need of mental health services in Jordan. The first stage of this project aimed to improve existing mental health evaluation instruments in use by IMC and validate new ones to develop an assessment battery for use by IMC and other humanitarian organizations. The second stage was an evaluation of ongoing IMC mental health services and a feasibility study of a randomized controlled trial involving comparison of the IMC model to treatment as usual for Syrian refugees. Data for both phases were collected at the Za’atari refugee camp and urban settings in Jordan.
Funding: Advanced Consortium on Cooperation, Conflict and Complexity, Earth Institute & Dean's Grants, Teachers College, Columbia University
Teachers College IRB protocol #15-301
In collaboration with MINDS Foundation, this formative pilot study aimed to develop the baseline for building future stepped-care, effective and culturally relevant pathways for integrating mental health as a vital and accessible component to healthcare for sex workers in rural Gujarat State, India. This cross-sectional pilot study investigated the mental health needs, the current health care delivery routes and the barriers to mental health care for females engaged in home-based sex work in rural communities of Gujarat. Information on the knowledge, attitudes, needs and perspectives of mental health and illness among female sex workers was gathered to inform the feasibility of creating community-based mental health supports for the women. Focus group and in-depth interviews were conducted with female sex workers and health workers to assess 1) Psychosocial stressors; 2) Mental health needs and perceptions; 3) Subjective assessment of the impact of mental health problems; 4) Issues/barriers surrounding access to care; 5) Attitudes toward psychotherapy as a treatment for mental health disorders; 6) Usage of existing medical or wellness resources as well as assess the impact of psychiatric healthcare cost offset on the current medical costs; 7) Experiences with HIV/AIDS; 8) Experiences with indigenous and western medical health intervention options.
Funding: Grand Challenges Canada
Teachers College IRB protocol #19-085
The Global Mental Health Lab in partnership with health care organization Zanmi Lasante (ZL), Partners in Health (PIH) and other collaborators sought to reinforce Haiti’s mental health system infrastructure through IPT implementation. The GMH Lab contributed to this project by assisting with implementation of the 5x5 model, an intervention designed to improve and expand access to quality and systematic mental health services delivery and care in the Central Plateau and Lower Artibonite regions. Professionals were trained in a phased manner in four priority disorders: depression, epilepsy/seizures, psychosis/bipolar, and child and adolescent disorders. IPT was disseminated to depressed members of the Haitian population through training and supervision of CHWs and mental health professionals.
Funding: Grand Challenges Canada
The Global Mental Health Lab in collaboration with the Bogota Health Department, Colombia; Bristol University, England; and DEEP Center, University of Miami; conducted a mixed methods study to develop and test the feasibility and acceptability of an outreach, screening, and intervention program to address mental health and psychosocial support (MHPSS) for internally-displaced women (IDWs) residing in Bogota, Colombia.
Funding: International Affairs Global Investment Fund
The overarching aim of this project was to lay the foundation for the Abu Dhabi-based Columbia University, Teachers College Center of Excellence for Arab Women’s Mental Health. The proposed Center provides regional leadership in building training, research, and policy/advocacy capacity for the mental health needs of Arab women in the United Arab Emirates.
Funding: The Wellcome Trust
Depression and harmful drinking are major global health problems with high prevalence rates, high levels of disability and potentially fatal consequences through suicide, road traffic accidents or health complications such as liver cirrhosis. Psychological treatments have been shown to be effective in Western settings, but the vast majority of people in low-income countries do not have access to these treatments. The main reasons for this are a lack of skilled personnel for delivering treatments, and concerns regarding the acceptability of treatments developed in Western settings. Through the PREMIUM project, Dr. Vikram Patel addressed these challenges by developing and evaluating contextually appropriate psychological treatments for delivery by lay health workers in primary healthcare settings. Dr. Lena Verdeli served as an international advisor.