| dc.description.abstract | Background: The publication of the 2007 Lancet Series set out the agenda for global mental health (GMH), calling for the scale-up of services to reduce the treatment gap, especially in low-middle-income countries (LMICs). Since then, there has been an increase in research programmes to address this agenda. These research programmes have different aims, including strengthening research capacity, testing, and developing interventions, or both. Yet there is limited research exploring whether these programmes can achieve their individual and GMH aims. The overall objective of this thesis was to evaluate a GMH research programme (GLOBE) delivered in three LMICs, Bosnia-Herzegovina, Colombia, and Uganda. Methods: Three studies were conducted to address the overall aim, the latter two forming an exploratory case study. They included: a systematic review of how GMH is understood in academic literature; a prospective longitudinal study involving interviews capturing the expectations and experience of members of GLOBE (n=38); a mixed methods evaluation of resource-oriented multi-family groups, delivered as part of the research programme, exploring feasibility, intervention fidelity, outcomes, and experiences. Findings: The findings demonstrate that GMH is understood beyond the local-global debate and that elements such as community engagement and collaborative research programmes emphasise local-global connectedness. Comparing the experiences of the participating researchers with their initial expectations identified three key findings: (i) relationships built on trust and respect were established but took time to develop, (ii) equity in the partnership can be achieved despite the obvious imbalances in partnerships between HICs and LMICs, and (iii) individual-level research capacity strengthening was achieved, yet institutional research capacity is needed to generate reliable career pathways for LMIC researchers. Evaluating the multi-family group intervention was feasible in the LMICs and yielded positive outcomes and experiences despite being an exploratory design. Conclusion: Overall, this evaluation provides encouraging findings that the experiences of participating researchers can meet their initial expectations. Yet the evaluation highlights limitations such as sustainable research capacity, and therefore setting more realistic aims for future GH programmes may be helpful. Positive improvements observed in the multi-family groups raises the question of whether larger trials are needed before wider implementation. | en_US |
