Confidence in Global Mental Health Research

Early adversity is known to be associated with later mental health in young people. However, the nature of the early adversities experienced by young people differs considerably across the world, and much research to date has focused on data from high income countries. Here we propose to develop a portfolio of projects across five partner countries spanning three major global regions, to address research questions of direct relevant to those countries and regions, and build research capacity in those countries to ensure that the projects and partnership we help to establish can be sustained beyond the lifetime of this award. The research questions identified include understanding the impact of early adversity on suicide and suicidal ideation, exploring the role of socioeconomic adversity of psychological and psychiatric outomes, and investigating the effects of HIV/AIDS on mental health in young people. We expect this list to grow as the project develops and partnerships are established. Ultimately, we hope to identify risk factors that we can then develop interventions to target, in order to reduce the global burden of mental illness

Early adversity is strongly associated with subsequent mental health, but for many adversities it remains unclear whether these associations are causal, which hampers the development of effective intervention. At the same time, the exact nature of the adversities experienced by young people varies considerably across countries and regions, and most research conducted to date has relied on data from high income countries. We propose a programme of seed funding and capacity building focused on partners in LMICs that will allow early- and mid-career researchers from the University of Bristol and our partner countries to develop research proposal to explore these questions in detail, focusing on issues of particular relevance to these partner countries and their wider regions. Bristol's internationally-recognised excellence in epidemiology and in particular causal inference (e.g., Mendelian randomization) will support these efforts, providing core training in relevant skills as well as bringing expertise in the establishment and implementation of large-scale cohort studies.

The work that will be supported by this proposal will lead to applications for funding to conduct research across the research questions described, and potentially to new questions that will emerge from the interactions between researchers across the partner countries and institutions. This work will retain a focus on understanding causal pathways from early adversity to subsequent mental health outcomes. By focusing on causal inference, we will identify risk factors that are promising candidates for intervention (rather than those that simply predict an outcome but that may not be on the causal pathway). Therefore, the potential impact of this work is considerable, as it has the potential to inform the development of both individual- and population-level interventions that will ultimately serve to reduce the global burden of mental illness, particularly in LMICs. The range of translational research groupings across the UoB (e.g., the NIHR Biomedical Research Centre, the NIHR School of Public Health Research) will support the flow of work from epidemiology and causal inference to intervention development, continuing and developing the partnerships that will be established during the lifetime of this proposal.