A Network for Studying Psychological Resilience in Low and Middle-Income Countries (NESP)

Lead Research Organisation: University of Edinburgh

Abstract

Vulnerability to or resilience to the commonest mental health disorders (depression, anxiety, drug and alcohol misuse) is related to the combination of genetic susceptibility, early life factors and an individual's current environment. Studies, over
95% of which have been confined to high income countries (HICs), have confirmed the importance of genes, development and adult environment. However, very little is known of these factors in low and middle-income countries (LMICs), where the burden of such common mental health disorders is even more substantial than in HICs.
Here we propose a powerful network of global leaders to analyse the key factors in three contrasting LMIC settings in three regions of the world, Nepal, Malawi and Costa Rica. This will enable us systematically to determine the processes leading to vulnerability or resilience to common disorders of mental health and exploit this knowledge, enabled by globally-leading
data sciences and within-country expertise, to develop specific approaches to reinforce resilience and support prevention, diagnosis and treatment.
Our approach is highly multidisciplinary, combining genetic, clinical and social sciences expertise to provide a comprehensive view of an individual's genetics, development and environment. We will combine this expertise with worldleading informatics capacity to create a network for the study of psychological resilience across diverse environments and
economies.

Technical Summary

Vulnerability or resilience to common mental health disorders is related to the combination and interaction of genetic susceptibility, early life factors and an individual's current environment. Over 95% of studies addressing these factors have been confined to High income countries (HICs) however, very little is known of these factors in low and middle-income countries (LMIC), where the burden of such common mental health disorders is even more substantial.
Here we propose to develop a network of global leaders to analyse the key factors in three contrasting LMIC settings. This will enable us systematically to determine the processes leading to vulnerability or resilience to common disorders of mental health and exploit this knowledge, enabled by leading data sciences and in-country expertise, to develop specific approaches to reinforce resilience and support prevention, diagnosis and treatment. Our approach is highly multidisciplinary, combining genetic, clinical and social sciences expertise to provide a comprehensive view of an individual's genetics, development and environment. We will combine this expertise with world-leading informatics capacity to create a network for the study of psychological resilience across diverse environments and economies.
The long term aims of this pump-priming grant are to conduct high quality multidisciplinary research into the epidemiology and aetiology of resilience and mental disorders with our partners - extending awareness of risk factors, knowledge of illness and preventative protective systems. We also seek to build a linked community in each country with local leadership
to lead a mental health research programme over the coming decades and establish connections between these three different regions (each with their different economic, social, and cultural systems). This will help position our partner countries as centres of mental health research within regional and wider international networks.

Publications

10 25 50

 
Description CAHSS SFC ODA Global Challenges Internal Fund
Amount £10,000 (GBP)
Funding ID 01MacBeth CAHSS SFC ODA Global Challenges Internal Fund 
Organisation University of Edinburgh 
Sector Academic/University
Country United Kingdom
Start 03/2019 
End 10/2019
 
Description Centre for Biomedicine, Self and Society - Extension
Amount £844,510 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2023 
End 04/2024
 
Description Exploiting genomic approaches to identify the environmental basis of depression
Amount £2,530,384 (GBP)
Funding ID 220857/Z/20/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2021 
End 05/2026
 
Description Generation Malawi: A study of family, maternal and childhood mental health
Amount £3,736,689 (GBP)
Funding ID MR/S035818/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 08/2019 
End 01/2024
 
Description One Health Models of Disease: Science, Ethics and Society
Amount £5,328,962 (GBP)
Funding ID 218471/Z/19/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2020 
End 09/2028
 
Description Transforming Primary Care in Scotland and China to meet the needs of an ageing population - are health inequalities being tackled?
Amount £832,923 (GBP)
Funding ID ES/T014164/1 
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 08/2020 
End 08/2023
 
Description Chhahari Nepal Center for Mental Health & Counseling collaboration 
Organisation Chhahari Nepal for Mental Health
Country Nepal 
Sector Charity/Non Profit 
PI Contribution We have formed a close collaboration with 2 NGOs in Kathmandu: Chhahari Nepal for Mental Health (CNMH) and Center for Mental Health & Counseling -Nepal (CMC-Nepal). Both provide support services for individuals with mental health problems in the region and are very supported of research, particularly in the social sciences. We have provided expertise and knowledge regarding the characteristics, and causes of mental health disorders
Collaborator Contribution Tribhuvan University of Nepal, Chhahari Nepal for Mental Health (CNMH) and Center for Mental Health & Counseling -Nepal (CMC-Nepal) have provided facilities, senior staff members and local expertise regarding the epidemiology, treatment and community management of mental health disorders
Impact We have planned a series of studies and public engagement activities that are underway. Some of these were deliverables identified in our application
Start Year 2018
 
Description Chhahari Nepal Center for Mental Health & Counseling collaboration 
Organisation Tribhuvan University of Nepal
Department Institute of Medicine
Country Nepal 
Sector Academic/University 
PI Contribution We have formed a close collaboration with 2 NGOs in Kathmandu: Chhahari Nepal for Mental Health (CNMH) and Center for Mental Health & Counseling -Nepal (CMC-Nepal). Both provide support services for individuals with mental health problems in the region and are very supported of research, particularly in the social sciences. We have provided expertise and knowledge regarding the characteristics, and causes of mental health disorders
Collaborator Contribution Tribhuvan University of Nepal, Chhahari Nepal for Mental Health (CNMH) and Center for Mental Health & Counseling -Nepal (CMC-Nepal) have provided facilities, senior staff members and local expertise regarding the epidemiology, treatment and community management of mental health disorders
Impact We have planned a series of studies and public engagement activities that are underway. Some of these were deliverables identified in our application
Start Year 2018
 
Description Collaboration with UNC research partners and facilities in Malawi 
Organisation University of North Carolina at Chapel Hill
Department UNC School of Medicine
Country United States 
Sector Academic/University 
PI Contribution We have provided expertise and intellectual input into mapping out separate and common areas of interest in Maternal Mental Health and planning future research studies and capacity building in the region
Collaborator Contribution UNC colleagues have provided expertise and intellectual input into mapping out separate and common areas of interest in Maternal Mental Health and planning future research studies and capacity building in the region
Impact We have partnered with Dr Melezer Brody on her development of studies of postpartum depression using the PPD-ACT application We have developed work within the Psychiatric Genomics Consortium around the genomics of postpartum depression We are involved with UNC on the first GWAS meta-analyses of postpartum depression (Melzer-Brody) and depression in diverse ancestries (Sullivan, Lewis, Kuchenbaker)
Start Year 2018
 
Description Development of the African Alliance for Maternal Mental Health 
Organisation University of Malawi
Department College of Medicine
Country Malawi 
Sector Academic/University 
PI Contribution We have provided practical expertise and intellectual input to the development of a pan-African allocate and network on Maternal Mental Health. We have supported key activities and the network launch.
Collaborator Contribution College of Medicine at the University of Malawi have provided practical expertise and intellectual input, as well as web-hosting and administrative support
Impact Outcomes have included the development of meetings with key partners in Sub-Saharan Africa that provide care to mothers who suffer from postpartum depression and related disorders. This has catalysed a new funding application for a project, Generation Malawi, currently under review
Start Year 2018
 
Description Being Human Festival event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact 'Bedtime Stories for the Brain', Being Human Festival, Scottish Storytelling Centre, Edinburgh, 21st Nov 2019. (co-organiser and speaker).
Year(s) Of Engagement Activity 2019
 
Description Consolation on mental health research in Nepal and Northern India 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We have conducted 3 public events, involving the general public, local students, practitioners and policymakers than has also included local politicians and policymakers (e.g. Nepalese Government). This has raised the profile of research in Nepal, particularly around Kathmandu) and in Northern India.
Year(s) Of Engagement Activity 2018
 
Description Instagram public engagement event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Schools
Results and Impact 'Social and Ethical Aspects of Biobanks', Instagram public engagement event, U. Edinburgh 25th-26th Feb 2020 (co-organiser).
Year(s) Of Engagement Activity 2021
 
Description Launch of African Alliance for Maternal Mental Health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact We launched the African Alliance for Maternal Mental Health at 2 events in Lilongwe and Blantyre in 2018
Year(s) Of Engagement Activity 2018
URL http://aammh.org
 
Description Schools engagement even on ELSI 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact 'Reflections on Science, Ethics and Society', 'Meet the Researcher' sessions, Scotland Science Insights Online, 29th July 2020 (speaker).
Year(s) Of Engagement Activity 2020
 
Description Visit to Costa Rica to establish local collaborations 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact We hosted a workshop in San Jose to discuss areas of common interest across our Network for Studying Psychological Resilience in Low-middle income countries, planned future applications and activities, including KE activities around the creation of patient videos to support information exchange about research in psychiatric genomics
Year(s) Of Engagement Activity 2018