Mainstreaming Global Mental Health: A Praxis Nexus Approach

Worldwide, one billion people have a mental health disorder, placing these among the leading causes of ill-health and disability. Moreover, poor mental health disproportionately affects people in Low and Middle Income Countries (LMIC) where there exists also a huge mental health workforce gap. Arguably, mental health is a right and tackling poor mental health is also a means of facilitating sustainable socio-economic development. Global Mental Health aligns with Sustainable Development Goal 3: 'Good Health and Well-Being,' specifically 3.4: 'By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.'

Our ambition is to trigger a step-change in how the research community thinks about where, how and by whom mental health in LMICs can be impacted to benefit people experiencing poor mental health. Specifically, we believe there is untapped potential for global researchers to impact mental health whilst delivering their core (non-mental health) project aims, and that this can be done without significant resource implications. Therefore, to accelerate global action on mental health our long-term aim is to produce a Global Mental Health Impact Framework with potential for use in all research in developing countries. Our first stage project will establish a foundation and pathway towards this long-term aim by creating a beta version of the Impact Framework, based on arts and humanities methodologies first, ready for future testing and development across a broad range of GCRF projects in a second stage application. At this second stage, we will also develop an implementation plan to support funders, researchers and LMIC partners to understand and use the Framework.

The Challenge Cluster brings together 16 GCRF projects funded by the AHRC, ESRC and MRC, a University of Leeds (UoL) AHRC-GCRF Network Plus, and UoL AHRC-led GCRF Hub totalling over £6.5 million and collaborator from outside the academy who has worked on non-GCRF ODA-oriented projects. A huge advantage of the Cluster is that it builds on the activities and resources of Praxis: Arts and Humanities for Global Development: an AHRC-led GCRF Hub at the UoL. We will develop our own Praxis Nexus approach to bring together what has been found and engage with researchers, practitioners, and policy-makers to accelerate impact on a cross-national scale commensurate with the significance of the GCRF programme.

Measurable, realistic, achievable objectives for the first-stage 12-month project are to:-
1. Complete a scoping review of (i) material practices and (ii) implicit and explicit mental health activities in non-mental health focused GCRF projects funded to date;
2. Complete a report outlining the basis for a Global Mental Health Impact Framework around collaborative material practices;
3. Develop and strengthen equitable international academic, policy and practitioner partnerships and build capacity in LMIC and the UK; and,
4. Use this work to assist in developing the agenda and programmes of research to be undertaken in the second stage application.

In relation to potential applications and benefits we will:
1. Raise the awareness of UK and LMIC funders, researchers and organisations that they may be missing 'low hanging fruit' opportunities to impact mental health in their portfolios and projects;
2. Provide them with a basic understanding of how Global Mental Health challenges can be conceptualised and identified in non-mental health focused projects; and
3. Explain ways that diverse projects could achieve mental health impact at micro, meso and macro levels as part of their routine activities without overstretching project expertise or resources; and,
4. Stimulate LMIC organisations and government departments to think about how they might integrate mental health impact across their diverse agendas and projects.

Evidence synthesis, shared learning and consultation cross-cuts all project activities in order to build learning alliances to strengthen Global Mental Health research and our collective potential for impact. We anticipate the following people and organisations will benefit from this research in the following ways.

People in LMIC with poor mental health, their families and communities
Our aim is to accelerate action on mental health by producing a Global Mental Health Impact Framework with potential for use in all research in developing countries. The potential impact is massive given that poor mental health is among the leading causes of ill-health and disability worldwide. The Framework will explain how diverse projects working in troubled regions of the world can achieve mental health impact as part of their routine activities.

Cluster-associated LMIC partners, collaborators, and networks
-We will collaborate with our Partner Organisations (PO): MIND India, the National Institute of Mental Health and Neurosciences (NIMHANS, Bangalore) and the Center for Public Mental Health, University of Gadjah Mada (Indonesia). A key contact from each will sit on our Steering Group (SG) and POs will co-host our 3 2-day Challenge Cluster Workshops. Invitations to Workshops will be extended to other existing GCRF Cluster-associated LMIC partners and collaborators to facilitate shared learning and new connections.
-At the 4 overseas Praxis Nexus Events we will share the ambition for the Framework, explore how non-mental health global projects might be supported to realise impacts on mental health, learn about potential barriers and solutions to Framework development, use and up-scaling, and identify potential second stage collaborators, particularly early career researchers (ECR) and partners in LMICs.

Researchers in LMIC and UK
-To build LMIC researcher capacity and equitable partnerships, we will: work with at least 4 LMIC partners to co-author the main open-access paper; work with at least 6 LMIC partners/CoIs to prepare the second stage application; engage in equitable partnership with LMIC POs in the SG and Cluster Workshops; and digital materials will be disseminated through Cluster projects websites, social media, and networks.
-We will provide mentoring opportunities for 3 UK ECR to develop their competencies to engage in Global Mental Health research and to establish connections with LMIC networks and partners. Mentored ECRs will: 'meet' the SG partners; attend overseas Praxis Nexus Events; be invited to all Cluster events; co-organise and host the Cluster Praxis Learning Event; and blog about their skill and knowledge development as ECR in Global Mental Health.
-An additional 6 UK ECR will be subsidised to attend the Praxis Learning Event, selected on potential and passion to engage in Global Mental Health research. They will be offered development opportunities at the event, including securing their own mentor.
-The Praxis Learning Event will also build the capacity of UK researchers involved in ODA-oriented projects through discussion of the emergent Framework and how it might be deployed to produce tangible outcomes for Global Mental Health in diverse projects in LMICs.
-A scoping review of material practices and mental health activities in non-mental health focused GCRF projects funded to date will enhance researcher knowledge of the potential of these methodologies for mental health research and impact in LMICs.
-A preliminary version of the Framework will be reported via an open access, peer reviewed publication, as well as summaries on Cluster projects websites, of immediate benefit to researchers in the UK and LMICs.

Funders
We will discuss the Framework with the GCRF to plan a manageable programme of consultation across portfolio leads. This will ensure the Framework and plans for stage two application are aligned with GCRF strategic objectives, increasing potential for impact.