Generation Malawi: A study of family, maternal and childhood mental health
Lead Research Organisation:
University of Edinburgh
Department Name: Centre for Clinical Brain Sciences
Abstract
A lack of research training, resources, infrastructure and data in Low- and Middle-Income Countries (LMIC) greatly limits their ability to conduct studies of common mental health conditions. Nowhere is this more true than in Africa generally and in Malawi specifically, where sparse mental health care alone limits not only clinical research capacity, but also the ability to attract inward investment. In a partnership between UK and Malawian institutions, we propose to directly address this challenge by building clinical research capacity through the coordinated appointment of new researchers and research assistants, a programme of education and dissemination, and the development of a population mental health dataset focussed on an area of great unmet need - the mental heath of mothers and their children.
After a period of piloting our research assessments and obtaining the necessary approvals, we will recruit 5000 mothers prior to delivery of their child from antenatal clinics in Lilongwe and Karonga districts, selected to represent urban and rural populations respectively. We will assess the mental health of mothers before and after birth, and the mental health of their spouses and other family members with a view to identifying the major risk factors for mental health disorders and mitigating variables that promote resilience. We will then examine the impact of maternal and, where possible, paternal mental health on the neurodevelopment of their offspring.
In addition to creating new and highly valuable data, we will also create the bioresources needed for future genetics and 'omics based research. We believe this is essential to prevent the current imbalance in genetic research favouring rich countries of predominantly European ancestries leading to greater entrenchment of global health inequalities.
As part of the proposed work, we will develop internationally competitive research capacity and datasets in Malawi, augment standard of care treatment, develop research training and the availability of affordable and effective interventions for depression and other common mental disorders, such as the "Friendship Bench" intervention. Our research will be multidisciplinary, involving experts from psychiatry, clinical psychology, nursing, reproductive and child health, and social sciences in both UK and Malawi. Throughout the project, we will carefully monitor our progress and impact on the participants and their communities.
The project, if funded, will lead to a step change in mental health research capacity in Malawi, paving the way for new inward investment and the development of evidence based interventions and policies.
After a period of piloting our research assessments and obtaining the necessary approvals, we will recruit 5000 mothers prior to delivery of their child from antenatal clinics in Lilongwe and Karonga districts, selected to represent urban and rural populations respectively. We will assess the mental health of mothers before and after birth, and the mental health of their spouses and other family members with a view to identifying the major risk factors for mental health disorders and mitigating variables that promote resilience. We will then examine the impact of maternal and, where possible, paternal mental health on the neurodevelopment of their offspring.
In addition to creating new and highly valuable data, we will also create the bioresources needed for future genetics and 'omics based research. We believe this is essential to prevent the current imbalance in genetic research favouring rich countries of predominantly European ancestries leading to greater entrenchment of global health inequalities.
As part of the proposed work, we will develop internationally competitive research capacity and datasets in Malawi, augment standard of care treatment, develop research training and the availability of affordable and effective interventions for depression and other common mental disorders, such as the "Friendship Bench" intervention. Our research will be multidisciplinary, involving experts from psychiatry, clinical psychology, nursing, reproductive and child health, and social sciences in both UK and Malawi. Throughout the project, we will carefully monitor our progress and impact on the participants and their communities.
The project, if funded, will lead to a step change in mental health research capacity in Malawi, paving the way for new inward investment and the development of evidence based interventions and policies.
Technical Summary
A lack of research training, clinical capacity, resources, infrastructure and data in Malawi, greatly limits its ability to attract inward investment and conduct mental health research and healthcare improvements. We propose to directly address this challenge by building clinical research capacity through the coordinated appointment of new researchers and research assistants, a programme of education and dissemination and the development of a population mental health dataset focussed on an area of great unmet need - the mental heath of mothers and their children. We will recruit 5000 mothers prior to delivery of their child from antenatal clinics in Lilongwe and Karonga districts, selected to represent urban and rural populations respectively. We will assess the mental health of mothers before and after birth, and the mental health of their spouses and other family members with a view to identifying the major risk factors for mental health disorders and mitigating variables that promote resilience. We will then examine the impact of maternal and, where possible, paternal mental health on the neurodevelopment of their offspring. We will create a new and highly valuable dataset and bioresource for future genetics and 'omics based research.
Planned Impact
Generation Malawi will deliver HEALTH, ECONOMIC and SOCIAL IMPACTS by engaging country stakeholders - women, families, academic groups, healthcare providers, policy makers and governments. We will build data resources, research and healthcare capacity and sustainability through our links to charitable organisations and research funders, philanthropy, private investment and national governments.
HEALTH IMPACT
Healthcare providers, policy makers and governments will benefit from new knowledge on the scale and correlates of poor maternal and family mental health and how this influences the developing infant. We will engage with healthcare providers and researchers through local communications with clinician networks including the African Alliance on Maternal Mental Health (AAMMH), the African Mental Health Research Initiative (AMARI) and through existing training links between the Universities of Edinburgh, Cape Town and Malawi, and through the Malawi-Scotland partnership (https://www.scotland-malawipartnership.org). We will engage with existing national media and radio, local knowledge brokers and our existing network of community contacts including churches, school festivals, and art/drama for health activities. Government and policy maker engagement will be achieved through targeted meetings and workshops and inclusion of policy leaders in our Advisory group. Health academic impacts will be disseminated through open access publications, video clips on university websites, and through our many education routes. We have world class expertise in Edinburgh in data collection, analysis, archiving and data sharing, complying with regulations in privacy and data protection.
ECONOMIC IMPACT
The availability of an internationally competitive training environment in Malawi, incoming investment for mental heath research capacity building, new dataset and bioresources of DNA and relevant samples will ensure that the research is sustainable and attracts further inward investment. The resources created will be valuable for UKRI, Wellcome Trust and other charitable and philanthropic funders in both mental, neonatal and physical health. Philanthropic funders, such as the Bill and Melinda Gates foundation, are also keenly interested in maternal mental health as a risk factor for infant mortality and morbidity but without the investment proposed in our application, it is uncertain that mental health research in Malawi would be sufficiently competitive to attract the investments required to sustain its future stability and development.
SOCIAL IMPACT
We anticipate that our proposal, healthcare and public involvement will further disseminate the value of scientific research in mental health and reduce stigma. The information obtained from our planned research programme will enable the correlates and causes of risk and resilience of mental disorders to be identified in a local context. This will have wide ranging positive effects on healthcare and social policy as governments in Malawi and elsewhere in the region access the new knowledge provided.
HEALTH IMPACT
Healthcare providers, policy makers and governments will benefit from new knowledge on the scale and correlates of poor maternal and family mental health and how this influences the developing infant. We will engage with healthcare providers and researchers through local communications with clinician networks including the African Alliance on Maternal Mental Health (AAMMH), the African Mental Health Research Initiative (AMARI) and through existing training links between the Universities of Edinburgh, Cape Town and Malawi, and through the Malawi-Scotland partnership (https://www.scotland-malawipartnership.org). We will engage with existing national media and radio, local knowledge brokers and our existing network of community contacts including churches, school festivals, and art/drama for health activities. Government and policy maker engagement will be achieved through targeted meetings and workshops and inclusion of policy leaders in our Advisory group. Health academic impacts will be disseminated through open access publications, video clips on university websites, and through our many education routes. We have world class expertise in Edinburgh in data collection, analysis, archiving and data sharing, complying with regulations in privacy and data protection.
ECONOMIC IMPACT
The availability of an internationally competitive training environment in Malawi, incoming investment for mental heath research capacity building, new dataset and bioresources of DNA and relevant samples will ensure that the research is sustainable and attracts further inward investment. The resources created will be valuable for UKRI, Wellcome Trust and other charitable and philanthropic funders in both mental, neonatal and physical health. Philanthropic funders, such as the Bill and Melinda Gates foundation, are also keenly interested in maternal mental health as a risk factor for infant mortality and morbidity but without the investment proposed in our application, it is uncertain that mental health research in Malawi would be sufficiently competitive to attract the investments required to sustain its future stability and development.
SOCIAL IMPACT
We anticipate that our proposal, healthcare and public involvement will further disseminate the value of scientific research in mental health and reduce stigma. The information obtained from our planned research programme will enable the correlates and causes of risk and resilience of mental disorders to be identified in a local context. This will have wide ranging positive effects on healthcare and social policy as governments in Malawi and elsewhere in the region access the new knowledge provided.
Organisations
- University of Edinburgh (Lead Research Organisation)
- St John of God Mzuzu, Malawi (Collaboration)
- African Academy of Sciences (Collaboration)
- Wellcome Trust (Collaboration)
- Bill & Melinda Gates Foundation (Collaboration)
- Maternal Mental Health Scotland (Collaboration)
- National Institutes of Health (NIH) (Collaboration)
- Medical Research Council (MRC) (Collaboration)
Publications
Hoeyer K
(2019)
Datafication and accountability in public health: Introduction to a special issue.
in Social studies of science
Levis B
(2019)
Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta-analysis.
in International journal of methods in psychiatric research
Erikainen S
(2019)
Patienthood and participation in the digital era.
in Digital health
Pickersgill M
(2019)
Biomedicine, self and society: An agenda for collaboration and engagement
in Wellcome Open Research
Pickersgill M
(2019)
Challenging social structures and changing research cultures.
in Lancet (London, England)
Thombs BD
(2020)
Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis.
in Canadian journal of psychiatry. Revue canadienne de psychiatrie
Rose N
(2020)
The social underpinnings of mental distress in the time of COVID-19 - time for urgent action.
in Wellcome open research
Ahrens J
(2020)
Implementing an mhGAP-based training and supervision package to improve healthcare workers' competencies and access to mental health care in Malawi.
in International journal of mental health systems
Beange I
(2020)
Using a knowledge exchange event to assess study participants' attitudes to research in a rapidly evolving research context.
in Wellcome open research
Cloatre E
(2020)
Research Handbook on the Sociology of Law
Hillary RF
(2020)
Epigenetic measures of ageing predict the prevalence and incidence of leading causes of death and disease burden.
in Clinical epigenetics
Pickersgill M
(2020)
Pandemic Sociology.
in Engaging science, technology, and society
Ng'oma M
(2020)
Perinatal mental health around the world: priorities for research and service development in Africa.
in BJPsych international
Iftekhar EN
(2021)
A look into the future of the COVID-19 pandemic in Europe: an expert consultation.
in The Lancet regional health. Europe
Bhandari PM
(2021)
Data-driven methods distort optimal cutoffs and accuracy estimates of depression screening tools: a simulation study using individual participant data.
in Journal of clinical epidemiology
Manda-Taylor L
(2021)
Developing Biopsychosocial Research on Maternal Mental Health in Malawi: Community Perspectives and Concerns.
in Ethics & human research
Pickersgill M
(2021)
The Cambridge Handbook of Health Research Regulation
Greene M
(2021)
The epidemiology of psychiatric disorders in Africa: a scoping review
in The Lancet Psychiatry
Lyubenova A
(2021)
Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis.
in International journal of methods in psychiatric research
Harel D
(2021)
Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS-Dep-5.
in Acta psychiatrica Scandinavica
Pickersgill M
(2021)
Expertise from the humanities and social sciences is essential for governmental responses to COVID-19.
in Journal of global health
Giannakopoulou O
(2021)
The Genetic Architecture of Depression in Individuals of East Asian Ancestry: A Genome-Wide Association Study.
in JAMA psychiatry
Barbu MC
(2021)
Epigenetic prediction of major depressive disorder.
in Molecular psychiatry
Farkas C
(2021)
Predictors of emotional problems in 5-year-old children: an international comparison between two cohorts in Chile and Scotland
in Current Psychology
Clarke TK
(2021)
Genetic and shared couple environmental contributions to smoking and alcohol use in the UK population.
in Molecular psychiatry
Priesemann V
(2021)
Towards a European strategy to address the COVID-19 pandemic
in The Lancet
Harden J
(2021)
Children's understanding of epilepsy: A qualitative study.
in Epilepsy & behavior : E&B
Mainga T
(2022)
Qualitative study of patient experiences of mental distress during TB investigation and treatment in Zambia.
in BMC psychology
Pickersgill M
(2022)
Pandemic preparedness means policy makers need to work with social scientists.
in Lancet (London, England)
Ng'oma M
(2022)
Exploring the cultural appropriateness of a psychosocial intervention, the Thinking Healthy Programme-Peer delivered (THPP), for perinatal depression in Lilongwe, Malawi.
in Malawi medical journal : the journal of Medical Association of Malawi
Golds L
(2022)
What factors influence dyadic synchrony? A systematic review of the literature on predictors of mother-infant dyadic processes of shared behavior and affect.
in Infant mental health journal
Herbert D
(2022)
The mental health impact of perinatal loss: A systematic review and meta-analysis.
in Journal of affective disorders
Broer, T.
(2022)
Temporal imaginaries in accounts of parenting practices: negotiations of time, advice, and expertise
in Catalyst: Feminism, Theory, Technoscience
Garcia Iglesias J
(2022)
Is monkeypox an STI? The societal aspects and healthcare implications of a key question
in Wellcome Open Research
Grotzinger AD
(2022)
Genetic architecture of 11 major psychiatric disorders at biobehavioral, functional genomic and molecular genetic levels of analysis.
in Nature genetics
Mainga T
(2022)
Conceptualization, detection, and management of psychological distress and mental health conditions among people with tuberculosis in Zambia: a qualitative study with stakeholders' and TB health workers.
in International journal of mental health systems
Barnett A
(2022)
Evaluating the Brain Disease Model of Addiction
Barbu MC
(2022)
Epigenome-wide association study of global cortical volumes in generation Scotland: Scottish family health study.
in Epigenetics
Wierenga LM
(2022)
Greater male than female variability in regional brain structure across the lifespan.
in Human brain mapping
Howard DM
(2022)
Methylome-wide association study of early life stressors and adult mental health.
in Human molecular genetics
Czypionka T
(2022)
The benefits, costs and feasibility of a low incidence COVID-19 strategy.
in The Lancet regional health. Europe
Ndambo M
(2023)
Maternal mental health research in Malawi: Community and healthcare provider perspectives on acceptability and ethicality
in SSM - Mental Health
Garcia Iglesias J
(2023)
Is mpox an STI? The societal aspects and healthcare implications of a key question
in Wellcome Open Research
| Description | Community sensitization 1. We engaged the residence of Chilumba, Karonga at both an individual and community level on all aspects of the study. 2. Engagement with relevant stakeholders; DHO/ chiefs etc in Lilongwe to establish urban cohort in Area 25 Liongwe. Cohort establishment & current Status 1. Continuous training of field workers and clinical team in both rural and urban sites on standard operating procedures for study activities including: - Recruitment and eligibility assessment procedures - Consent procedures - Data collection 2. Continuously assessing (and modifying as needed) the workflow of field and clinical procedures 3. Cross-checking and amending translation of items 4. Rural recruitment of birth cohort - Recruitment commenced 24th January 2022 - Recruitment As @ 24th Jan 2023 (Week 47): 1363 screened. 1040 index 323 spouses. 811 have been enrolled in the study. 521 Index, 290 spouses. 256 women have attended 3rd Trimester. 290 deliveries Total number of babies that have been seen Week 1 - 151 Week 6 - 38 Week 16 - 31 5. Rural birth cohort follow-up - Currently following up 6. Urban Recruitment of birth cohort - Recruitment commenced on 8th November 2022 - Recruitment As @ 24th Jan 2023 (Week 9): 1167 women have attended ANC; 131 from the DSS;76 women recruited 22 spouses. 2 women for third trimester and 1 delivery The delivery training was done and 61 nurses were trained. We should be able to collect samples for GM from here on 7. Systems Strengthening: Mental Health Clinics Established Mental Health Clinic in rural Karonga and Urban Lilongwe Area. Participants are being referred to the clinic via the Healthy Lives Malawi-Generation Malawi and nested studies 1. Chilumba Mental Health Clinic 182 Participants (105 Females, 77 Males) 142 have been discharged, 23 lost to follow-up, 4 refusals Lilongwe Mental Health Clinic 45 Participants, 13 are still in session, 12 on follow-up 13 referrals from Malawi Ministry of Health 8. Biorepository 1. Established a biorepository working group to oversee all the samples collected throughout the study 2. Developed standard operating procedures for sample collection and handling 3. Collected and stored samples from participants recruited in the study. 4. Governance: Established Cohort Management (CMG) to provide operational oversight of the implementation of the resource established by the HLM/GM Principal Investigators with the aim of ensure delivery of the aims and objectives of the programme and planning |
| Exploitation Route | The datasets and linked bioreporsity are already being used by others to submit their own grant applications for funding. The infromation is being used by national government in Malawi to infrom policy. All datasets are made available to researchers, on application. Most recently, the Generation Malawi resource, linked expertise and capacity has been included as a component of an application to MRC for a Centre of Research Excellence (CoRE) in Mental Health. |
| Sectors | Environment,Healthcare,Pharmaceuticals and Medical Biotechnology |
| Description | We have engaged with healthcare providers in Karonga and Lilongwe and begun the processes leading up to the formative work and piloting of study questionnaires. We have involved local opinion leaders, decision makers and others. It will be possible to expand on the scope of this impact in future returns. Unfortunately, however, progress of our research and the flow of new findings has been severely hampered by Covid-19. Nevertheless, we have now begun to recruit mothers for the bio banking parts of the study and we have enlarged recruitment to fathers and other family members. |
| First Year Of Impact | 2022 |
| Sector | Healthcare,Government, Democracy and Justice |
| Impact Types | Societal,Policy & public services |
| Description | Activities in support of Malawi response to Covid-19 2020/21 - Malawi Mental Health response discussion forum |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Description | Activities in support of Malawi response to Covid-19 2020/21 - The Malawi Quick Guide to Mental Health |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | Evaluation through a survey of 20 health care providers in Malawi showed improvements from baseline in knowledge and confidence, and perception of improved patient care. This evaluation is being written up a QI publication. |
| URL | http://www.smmhep.org.uk/sites/default/files/eMalawi%20Quick%20Guide%20to%20Mental%20Health%20v1%20%... |
| Description | (CoMorMent) - Predicting comorbid cardiovascular disease in individuals with mental disorder by decoding disease mechanisms |
| Amount | € 5,998,613 (EUR) |
| Funding ID | 847776 |
| Organisation | European Commission |
| Sector | Public |
| Country | European Union (EU) |
| Start | 01/2020 |
| End | 12/2023 |
| Description | A longitudinal population survey of the impact of the COVID-19 pandemic on mental health and associated health and socio-economic outcomes, in urban and rural Malawi. |
| Amount | £106,147 (GBP) |
| Organisation | Government of Scotland |
| Department | Scottish Funding Council |
| Sector | Public |
| Country | United Kingdom |
| Start | 04/2020 |
| End | 07/2020 |
| Description | Building capacity in maternal mental health in Malawi: production of a clinical handbook |
| Amount | £38,500 (GBP) |
| Funding ID | University of Edinburgh UKRI ODA Impact and Development Grant 2022/2023 13329654 |
| Organisation | United Kingdom Research and Innovation |
| Sector | Public |
| Country | United Kingdom |
| Start | 10/2022 |
| End | 03/2023 |
| 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 | Depression Genetics in Africa (DepGenAfrica) |
| Amount | £2,002,780 (GBP) |
| Funding ID | 223165/Z/21/Z |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 05/2022 |
| End | 04/2027 |
| Description | Enhancement of Generation Malawi |
| Amount | £216,000 (GBP) |
| Organisation | United Kingdom Research and Innovation |
| Sector | Public |
| Country | United Kingdom |
| Start | 02/2022 |
| End | 03/2022 |
| 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 | Exploiting genomic approaches to identify the environmental basis of depression |
| Amount | £2,530,384 (GBP) |
| Funding ID | 220857 |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 01/2021 |
| End | 12/2025 |
| Description | MALAWIAN PROGRAM FOR MENTAL HEALTH RESEARCH TRAINING (WARMHEART) |
| Amount | $249,990 (USD) |
| Funding ID | D43TW011794 |
| Organisation | National Institutes of Health (NIH) |
| Department | Fogarty International Centre |
| Sector | Public |
| Country | United States |
| Start | 09/2020 |
| End | 05/2025 |
| Description | Multimorbidity in Africa - Increasing Understanding of the Patient Experience and Epidemiology (MAfricaEE) |
| Amount | £199,515 (GBP) |
| Funding ID | MR/T037849/1 |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 04/2020 |
| End | 09/2021 |
| Description | My depression, your depression - same name, different stories |
| Amount | £65,600 (GBP) |
| Funding ID | 217078/Z/19/Z. |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 03/2020 |
| End | 12/2020 |
| Description | Non-invasive biomarkers of stress in mothers, fathers and infants in urban and rural Malawi: a feasibility study |
| Amount | £95,989 (GBP) |
| Funding ID | MR/T038683/1 |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 03/2020 |
| End | 03/2021 |
| 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 | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) |
| Amount | £3,039,622 (GBP) |
| Funding ID | 223615/Z/21/Z |
| Organisation | Wellcome Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 01/2022 |
| End | 12/2026 |
| 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 | Malawi Scotland Maternal Mental Health Partnership - a THET funded collaboration between Maternal Mental Health Scotland (MMHS); St John of God Hospitaller Services, Malawi; University of Edinburgh; and College of Medicine, Malawi |
| Organisation | Maternal Mental Health Scotland |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | University of Edinburgh (Angus Macbeth and Robert Stewart) support the project through expertise in training material development and monitoring and evaluation methods. Stewart is also closely involved in organisational activities on the ground in Malawi. |
| Collaborator Contribution | Maternal Mental Health Scotland (MMHS) is a Scottish Charity, registered in 2014, whose members include health professionals and women with a lived experience of perinatal mental health problems. MMHS looks to improve the provision of perinatal mental health services; to educate the public and the medical profession; and to bring practitioners, patients, and families together. St John of God Hospitaller Services (SJOG) is a registered NGO that has been providing mental health services and education in Malawi since 1993. It established services in Mzuzu in the Northern Region, and has recently opened a 50-bedded mental health centre (with attached community services) in Lilongwe, Central Region. The SJOG College of Health Sciences trains psychiatric nurses and clinicians at degree level, as well as offering psychosocial counselling courses. Purpose of the partnership is to support the development of community based support activities led by women with lived experience in Malawi, as well as enhancing training of primary care health workers and staff in SJOG's facilities where women with severe mental disorders (e.g. postpartum psychosis) receive care. |
| Impact | £10000 seed funding from Tropical Health Education Trust (THET) Visit to Malawi from 09/11/19 till 19/11/19 - 3 members of Maternal Mental Health Scotland (MMHS) visit to hosts St John of God (SJOG) where a programme had been organised - this included meeting the management and clinical teams, a presentation on the MH services provided by SJOG, and a question and answer session to enable the MMHS team develop an understanding of the mental health landscape in Malawi and consider the context, and in particular perinatal mental health (PNMH) provision, planning sessions on what the partnership can support, education/teaching session with clinical teams, and initial meeting with women who had accessed perinatal mental health care through SJOG to establish links with MMHS Change Agents and consider support and development of a pathway going forward. • Basic initial training to core staff teams at SJOG and Zomba • Malawi team engaged a group of capable, enthusiastic and empowered women with lived experience of maternal mental health problems to start the process of establishing peer support and how this would best meet the needs of women who are treated at SJOG. These women attended a workshop and were fully interactive and engaged in this process supported by the SJOG team. 45 pregnant women accessed 2 maternal mental health talks delivered by SJOG clinical staff who had attended the training delivered by UK team |
| Start Year | 2019 |
| Description | Malawi Scotland Maternal Mental Health Partnership - a THET funded collaboration between Maternal Mental Health Scotland (MMHS); St John of God Hospitaller Services, Malawi; University of Edinburgh; and College of Medicine, Malawi |
| Organisation | St John of God Mzuzu, Malawi |
| Country | Malawi |
| Sector | Hospitals |
| PI Contribution | University of Edinburgh (Angus Macbeth and Robert Stewart) support the project through expertise in training material development and monitoring and evaluation methods. Stewart is also closely involved in organisational activities on the ground in Malawi. |
| Collaborator Contribution | Maternal Mental Health Scotland (MMHS) is a Scottish Charity, registered in 2014, whose members include health professionals and women with a lived experience of perinatal mental health problems. MMHS looks to improve the provision of perinatal mental health services; to educate the public and the medical profession; and to bring practitioners, patients, and families together. St John of God Hospitaller Services (SJOG) is a registered NGO that has been providing mental health services and education in Malawi since 1993. It established services in Mzuzu in the Northern Region, and has recently opened a 50-bedded mental health centre (with attached community services) in Lilongwe, Central Region. The SJOG College of Health Sciences trains psychiatric nurses and clinicians at degree level, as well as offering psychosocial counselling courses. Purpose of the partnership is to support the development of community based support activities led by women with lived experience in Malawi, as well as enhancing training of primary care health workers and staff in SJOG's facilities where women with severe mental disorders (e.g. postpartum psychosis) receive care. |
| Impact | £10000 seed funding from Tropical Health Education Trust (THET) Visit to Malawi from 09/11/19 till 19/11/19 - 3 members of Maternal Mental Health Scotland (MMHS) visit to hosts St John of God (SJOG) where a programme had been organised - this included meeting the management and clinical teams, a presentation on the MH services provided by SJOG, and a question and answer session to enable the MMHS team develop an understanding of the mental health landscape in Malawi and consider the context, and in particular perinatal mental health (PNMH) provision, planning sessions on what the partnership can support, education/teaching session with clinical teams, and initial meeting with women who had accessed perinatal mental health care through SJOG to establish links with MMHS Change Agents and consider support and development of a pathway going forward. • Basic initial training to core staff teams at SJOG and Zomba • Malawi team engaged a group of capable, enthusiastic and empowered women with lived experience of maternal mental health problems to start the process of establishing peer support and how this would best meet the needs of women who are treated at SJOG. These women attended a workshop and were fully interactive and engaged in this process supported by the SJOG team. 45 pregnant women accessed 2 maternal mental health talks delivered by SJOG clinical staff who had attended the training delivered by UK team |
| Start Year | 2019 |
| Description | Planned creation of African Population Cohort Consortium 2020 |
| Organisation | African Academy of Sciences |
| Country | Kenya |
| Sector | Charity/Non Profit |
| PI Contribution | Through cohort work in Malawi and ANDLA network, invited to be part of Africa-wide consortium developing plans for region-wide initiative, supported by multiple funders and with multiple partners |
| Collaborator Contribution | Experience in cohort establishment and data harmomonisation |
| Impact | not yet |
| Start Year | 2020 |
| Description | Planned creation of African Population Cohort Consortium 2020 |
| Organisation | Bill and Melinda Gates Foundation |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | Through cohort work in Malawi and ANDLA network, invited to be part of Africa-wide consortium developing plans for region-wide initiative, supported by multiple funders and with multiple partners |
| Collaborator Contribution | Experience in cohort establishment and data harmomonisation |
| Impact | not yet |
| Start Year | 2020 |
| Description | Planned creation of African Population Cohort Consortium 2020 |
| Organisation | Medical Research Council (MRC) |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | Through cohort work in Malawi and ANDLA network, invited to be part of Africa-wide consortium developing plans for region-wide initiative, supported by multiple funders and with multiple partners |
| Collaborator Contribution | Experience in cohort establishment and data harmomonisation |
| Impact | not yet |
| Start Year | 2020 |
| Description | Planned creation of African Population Cohort Consortium 2020 |
| Organisation | National Institutes of Health (NIH) |
| Country | United States |
| Sector | Public |
| PI Contribution | Through cohort work in Malawi and ANDLA network, invited to be part of Africa-wide consortium developing plans for region-wide initiative, supported by multiple funders and with multiple partners |
| Collaborator Contribution | Experience in cohort establishment and data harmomonisation |
| Impact | not yet |
| Start Year | 2020 |
| Description | Planned creation of African Population Cohort Consortium 2020 |
| Organisation | Wellcome Trust |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | Through cohort work in Malawi and ANDLA network, invited to be part of Africa-wide consortium developing plans for region-wide initiative, supported by multiple funders and with multiple partners |
| Collaborator Contribution | Experience in cohort establishment and data harmomonisation |
| Impact | not yet |
| Start Year | 2020 |
| Description | '(De-)Medicalising Antisociality', 'Mental Health Labels: Should Feelings be Medicalised?', U. Edinburgh, 25th Nov 2020 (speaker). |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | '(De-)Medicalising Antisociality', 'Mental Health Labels: Should Feelings be Medicalised?', U. Edinburgh, 25th Nov 2020 (speaker). Online international panel discussion, sparking conversations about the role of psychiatry in everyday life and what it might look like in the future. |
| Year(s) Of Engagement Activity | 2020 |
| Description | 'COVID-19 shows how governments need to work more closely with experts in the social aspects of biomedicine' - blog |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | 1. Pickersgill, M. (2021) 'COVID-19 shows how governments need to work more closely with experts in the social aspects of biomedicine', Campaign for Social Science (Academy of Social Sciences), 19th May 2021, https://campaignforsocialscience.org.uk/news/covid-19-shows-how-governments-need-to-work-more-closely-with-experts-in-the-social-aspects-of-biomedicine/ |
| Year(s) Of Engagement Activity | 2021 |
| Description | 'Covid vaccine presents its own challenges' - letter to The Guardian |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Pickersgill, M. (2020) 'Covid vaccine presents its own challenges', letter to The Guardian, 3rd Dec 2020, https://tinyurl.com/3u42dnxj . |
| Year(s) Of Engagement Activity | 2020 |
| Description | 'Reflections on Science, Ethics and Society', 'Meet the Researcher' sessions, Scotland Science Insights Online, 29th July 2020 (speaker). |
| 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, 2020 and 2021 (speaker). Online open day for Scottish school pupils, sparking interest in social science |
| Year(s) Of Engagement Activity | 2020,2021 |
| Description | Authored article on 'To tackle Covid, politicians need to be radical' for The Herald, https://tinyurl.com/4rfdzu3j (25th Nov 2021). |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Authored article on 'To tackle Covid, politicians need to be radical' for The Herald, https://tinyurl.com/4rfdzu3j (25th Nov 2021). Sparked interest from MPs and MSPs |
| Year(s) Of Engagement Activity | 2021 |
| Description | Authored article on 'We must do more to make mental health our priority' for The Herald, https://tinyurl.com/2zrj69kk (25th March 2021). |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Authored article on 'We must do more to make mental health our priority' for The Herald, https://tinyurl.com/2zrj69kk (25th March 2021). Resulted in invitation to join Cross-Party Group on Mental Health (Scottish Parliament) |
| Year(s) Of Engagement Activity | 2021 |
| 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 | Coverage of Lancet Regional Health - Europe and The Lancet publications on COVID-19 discussed within a range of international media (e.g., MSN, Politico etc.), including features in various outlets (e.g., BBC Russia) (Aug-Sept 2021). |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Coverage of Lancet Regional Health - Europe and The Lancet publications on COVID-19 discussed within a range of international media (e.g., MSN, Politico etc.), including features in various outlets (e.g., BBC Russia) (Aug-Sept 2021). |
| Year(s) Of Engagement Activity | 2021 |
| Description | Engagement with Scottish Parliament MSPs |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | The event showcased the work of the Medical Research Council (MRC) in Scotland. It brought together researchers from across the country into one place to talk with MSPs and other sector stakeholders about their work, the impact it is having in Scotland, the UK and beyond. The event opened with speeches from Lewis Macdonald MSP (who hosted the event), Richard Lochhead MSP and Professor Fiona Watt, MRC Executive Chair. During the event MSPs, key government officials and other sector stakeholders were able to explore the different exhibition stalls, speak to researchers and learn about the impact of their work. At our stand, we engaged directly with many MSPs including the Minister for Mental Health and the Minister for Sport. We held productive conversations and follow-on meetings were arranged. The event provided an opportunity to increase understanding amongst MSPs of the MRC's strategic vision and the leading role it plays in improving human health, innovation and economic growth by seeing first-hand the research that is taking place and the researchers that make it happen. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://www.parliament.scot/visitandlearn/104642.aspx |
| 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 | Interview and quotes for Euronews on the social dimensions of vaccine mandates for COVID-19. |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Interview and quotes for Euronews on the social dimensions of vaccine mandates for COVID-19. Printed as: Alice Tidey, 'Is it counterproductive to make vaccines mandatory?', https://tinyurl.com/2p8jsef9 (12th Jan 2022). |
| Year(s) Of Engagement Activity | 2022 |
| Description | Interview and quotes for Euronews on the social dimensions of vaccine mandates for COVID-19. |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Interview and quotes for Euronews on the social dimensions of vaccine mandates for COVID-19. Printed as: Alice Tidey, 'Is it counterproductive to make vaccines mandatory?', https://tinyurl.com/2p8jsef9 (12th Jan 2022). This resulted in further invitations and engagements. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Interview and quotes for La Tercera on the societal consequences of COVID-19. Printed as: Fernanda Rojas Alvarado, '"Nueva normalidad": La experiencia de Israel y Reino Unido, los líderes en vacunación', https://tinyurl.com/3uzrtr5d (30th April 2021). |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Interview and quotes for La Tercera on the societal consequences of COVID-19. Printed as: Fernanda Rojas Alvarado, '"Nueva normalidad": La experiencia de Israel y Reino Unido, los líderes en vacunación', https://tinyurl.com/3uzrtr5d (30th April 2021). |
| Year(s) Of Engagement Activity | 2021 |
| Description | Open University PolicyWISE Invitational series. Facilitator for Mental Illness ONline Seminar. |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Invited seminar on mental health to 20+ policy makers from across 4 nations of United Kingdom. Discussion session led to increase in awareness of mental health and it's relationship to social determinants of health, social care impacts and policy implications. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Path from the pandemic: take off the blinkers |
| Form Of Engagement Activity | A magazine, newsletter or online publication |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Pickersgill, M. (2022) 'Path from the pandemic: take off the blinkers', Research Professional, 20th March 2022, https://tinyurl.com/39bfn446. Highlighted the vital - yet neglected - role of social science in tackling pandemics. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://tinyurl.com/39bfn446 |
| Description | Perinatal, Infant & Intergenerational Mental Health: Pieces of the jigsaw |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Third sector organisations |
| Results and Impact | Invited to give keynote opening talk on perinatal mental health to Mellow Parenting/Homestart Worldwide online seminar. Feedback from event indicated increasing awareness of links between perinatal/infant mental health and broader child and family outcomes. Direct approach from Homestart Worldwide for collaboration. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.youtube.com/watch?v=lfp0e76NurM |
| 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 by Jeane Freeman, Cabinet Secretary for Health in Scotland |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Hosted by Professor Andrew McIntosh, the Cabinet Secretary met MRC researchers working on the MRC Mental Health Data Pathfinder award and the Generation Malawi project, both based at the University of Edinburgh. The Cabinet Secretary, was welcomed by Vice Principal, Professor Jonathan Seckl, and heard from researchers about how the Scottish Government can support researchers in the vital work they are doing, for example by improving access to data. Ms Freeman said: "These two projects being funded by the MRC are important. Improving mental health is a priority for the Scottish Government and research looking at the causes and consequences of mental health conditions, both in Scotland and abroad, is crucial." In genuine two-way dialogue, the cabinet secretary not only heard about the two projects but was also able to offer her advice and input to the researchers. She recommended several people that the researchers should contact, and these suggestions are being followed up. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://mhdss.ac.uk/news/19/08/9/visit-jeane-freeman-cabinet-secretary-health-scotland |
| Description | Visit from Dr Catherine Calderwood, Chief Medical Officer for Scotland |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Dr Catherine Calderwood, Chief Medical Officer for Scotland, visited Mental Health researchers at the University of Edinburgh in January to hear about the projects the team is working on in Scotland and Malawi. She was welcomed and accompanied on the visit by The Principal of the University of Edinburgh, Professor Peter Mathieson. The researchers were keen to impress upon Dr Calderwood the importance of Big Data Science to the future of mental health research. Dr Calderwood replied: "The time is now to talk about this. Everyone has Mental Health." High on the agenda at the meeting was the pending public consultation around the use of Guthrie Cards [newborn blood spots] for research. The researchers asked Dr Calderwood to lend her support towards further action which would allow this wealth of blood and DNA data to be used to improve healthcare for all. Dr Calderwood indicated a change in her view and a desire to expedite this consultation. Dr Calderwood also mentioned her upcoming visit to Malawi and a desire to visit our researchers who are based there. We will continue to liaise with her team to arrange this. |
| Year(s) Of Engagement Activity | 2019 |
| URL | https://mhdss.ac.uk/news/20/02/27/chief-medical-officer-scotland-visits-researchers |