A large Wagnerian grandmother. A great-aunt known as 'the Buchenwald chicken'. Shame and misery on the sports field. A club-footed father who disappeared to the golf course every weekend. How do these experiences lead to a career in psychology? Able-Bodied is a unique account of how being the son of a disabled man and the product of an eccentric family brought Leslie Swartz to a professional life working with disability issues. At the heart of this tale is a moving account of a complex, troubled, but loving father-son relationship, a relationship that spurred a lifetime of trying to understand and come to grips with what different bodies and different abilities mean for us all. With wit, compassion, frankness and irreverence, Swartz considers the challenges faced by families, academics, institutions and everyone trying to make a positive difference to society. Poignant and often hilarious, Able-Bodied is a tale of conflict, achievement, pain and triumph. It is a fascinating blend of personal narrative, anecdote and reflection on society, medicine and ethics.
For more information, or to attain a copy, please contact the author at: lswartz@sun.ac.za
PLOS Medicine Policy Forum
articles provide a platform for health policy makers from around the world to discuss the challenges and opportunities in improving health care to their constituencies.
Grand Challenges in Global Mental Health: Integration in Research, Policy, and Practice
Citation: Collins PY, Insel TR, Chockalingam A, Daar A, Maddox YT (2013) Grand Challenges in Global Mental Health: Integration in Research, Policy, and Practice. PLoS Med 10(4): e1001434. doi:10.1371/journal.pmed.1001434
Published: April 30, 2013
Summary Points
Mental illnesses frequently co-occur with peripartum conditions, HIV-related disease, and non-communicable diseases. Care for mental disorders should be integrated into primary care and other global health priority programs.
Integration of care for mental, neurological, and substance use (MNS) disorders should (1) occur through intersectoral collaboration and health system-wide approaches; (2) use evidence-based interventions; (3) be implemented with sensitivity to environmental influences; and (4) attend to prevention and treatment across the life course.
Integration of care for MNS disorders with care for other conditions can occur through assimilation of activities, policies, or organizational structures at local, national, and global levels.
Plans for health-related development targets post-2015 should consider the tremendous burden of disability associated with MNS disorders and co-morbid conditions.
This paper is the first in a series of five articles providing a global perspective on integrating mental health.
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: No funding sources were used for preparation of this manuscript.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: DALY, disability adjusted life year; GBD, global burden of disease; GCGMH, Grand Challenges in Global Mental Health; LMIC, low- and middle-income country; MNS, mental, neurological, and substance use; mhGAP, Mental Health Gap Action Programme; MDG, Millennium Development Goal; NCD, non-communicable disease; NIMH, National Institute of Mental Health; NGO, non-governmental organization; WHO, World Health Organization
Provenance: Not commissioned; externally peer reviewed.
Research misconduct is a global problem as research is a global activity. Wherever there is human activity there is misconduct. But we lack reliable data on the extent and distribution of research misconduct, and few countries have mounted a comprehensive response to misconduct that includes programmes of prevention, investigation, punishment, and correction. The United States, the Scandinavian countries, and Germany have formal programmes [1], but even a country like the United Kingdom that has a long research tradition and has for years been debating research misconduct has failed to mount an adequate response [2]. But what of low- and middle-income countries (LMICs), many of which are investing heavily in research? There are some high profile cases of misconduct from these countries, but little has been published on research misconduct in LMICs. This article provides what might best be described as an initial sketch of research misconduct in LMICs. (Research misconduct has a specific definition, in the United States [see below], but we, like many others, use the term broadly in this paper to cover every kind of misconduct—major or minor and intentional or not.)
Summary Points
All human activity is associated with misconduct, and as scientific research is a global activity, research misconduct is a global problem.
Studies conducted mostly in high-income countries suggest that 2%–14% of scientists may have fabricated or falsified data and that a third to three-quarters may be guilty of “questionable research practices.”
The few data available from low- and middle-income countries (LMICs) suggest that research misconduct is as common there as in high-income countries, and there have been high profile cases of misconduct from LMICs.
A comprehensive response to misconduct should include programmes of prevention, investigation, punishment, and correction, and arguably no country has a comprehensive response, although the US, the Scandinavian Countries, and Germany have formal programmes.
China has created an Office of Scientific Research Integrity Construction and begun a comprehensive response to research misconduct, but most LMICs have yet to mount a response.
Citation: Ana J, Koehlmoos T, Smith R, Yan LL (2013) Research Misconduct in Low- and Middle-Income Countries. PLoS Med 10(3): e1001315. doi:10.1371/journal.pmed.1001315
Published: March 26, 2013
Copyright: © 2013 Ana et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: No specific funding was received for writing this article.
Competing interests: RS was, as described in the article, much involved in the Singh case. He is also a trustee of the UK Research Integrity Office. All other authors have declared that no competing interests exist.
Abbreviations: LMIC, low- and middle-income country
Provenance: Commissioned; externally peer reviewed.
A new film, “Our Stories: Living and Coping with Schizophrenia” describes the CGMH Community care for people with schizophrenia in India (COPSI) project. Funded by the Wellcome Trust and led by CGMH co-director Vikram Patel and staff member Graham Thornicroft, COPSI is a randomized controlled trial comparing the clinical and cost effectiveness of facility based (usual) care and a collaborative community based care intervention for people with schizophrenia in three sites in India. The community intervention is developed by a team comprising the treating Psychiatrist, the Intervention Coordinator and lay community health workers and the majority of the service is delivered in home settings. A package of evidence based treatments has been selected for the community intervention that can be delivered by CHW’s with adequate training and close supervision.
The film provides a personal and moving account of people with schizophrenia who are taking part in this project.
Click here to view the film.
Global mental health intervention research and mass trauma
Open Access Journal of Clinical Trials 2013:5 61–69
Susan Meffert, Solvig Ekblad
The impact of mass trauma on mental health and the treatment of resulting disorders has been a major focus of global mental health work since the inauguration of the field. Descriptive studies in the 1990s provided convincing evidence of the importance of addressing global mental health needs in the aftermath of mass trauma. Nonetheless, despite calls to move ahead with interventional research, few studies have tested the effectiveness of the treatments for survivors of mass trauma. In this study, we use a translational science model to review the status of intervention research for adult survivors of mass trauma with the goal of identifying promising treatments, and presenting a logic model for using available data in a manner that is sensitive to community needs, and integrating with existing systems for capacity building.
The second installment in the Cochrane20 Video Series introduces a range of Cochrane contributors from low- and middle-income countries. This video focuses on the need for, achievements in, and challenges of producing, disseminating, and implementing systematic reviews in resource-challenged settings.
No Health Withoutt Mental Health: Lessons Unlearned
An article consisting of five cogent paragrpahs on MH and NCDs,
Bulletin of the World Health Organization, January 2013--91: 3-3A
List of 30 funding or grant organizations, from the very small funding initiatives to the big global donors, from conventional funding to innovative online fundraising and loans.
It is a challenge for all sectors in Global Mental Health to get or safeguard finance. Think of anti-stigma campaigns, advocacy agencies, rehabilitation/housing projects, mental health care facilities, educations and research.
This list is a attempt to help people and organizations in the field to 'see the wood for the trees'.
Comments and additions are welcome.
