PROVIDING SUSTAINABLE
MENTAL AND NEUROLOGICAL
HEALTH CARE IN GHANA AND KENYA
WORKSHOP SUMMARY
Sheena Posey Norris, Erin Hammers Forstag, and
Bruce M. Altevogt, Rapporteurs
Forum on Neuroscience and
Nervous System Disorders
Board on Health Sciences Policy
Board on Global Health
Institute of Medicine
THE NATIONAL ACADEMIES PRESS
Washington, DC
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by the Alzheimer’s Association; Brain Canada Foundation; Contract No. HHSN26300026 [Under Master Base # DHHS10001292] with the U.S. Department of Health and Human Services’ Food and Drug Administration and National Institutes of Health through the National Center for Complementary and Integrative Health, National Eye Institute, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke, National Institute on Aging, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and NIH Blueprint for Neuroscience Research; Contract No. VA240-14-C-0057 with the U.S. Department of Veterans Affairs; Eli Lilly and Company; Foundation for the National Institutes of Health; the Gatsby Charitable Foundation; GlaxoSmithKline, Inc.; Johnson & Johnson Pharmaceutical Research and Development, LLC; Lundbeck Research USA; Merck Research Laboratories; The Michael J. Fox Foundation for Parkinson’s Research; the National Multiple Sclerosis Society; Contract No. BCS-1064270 with the National Science Foundation; One Mind for Research; Orion Bionetworks; Pfizer Inc.; Pharmaceutical Product Development, LLC; Sanofi; the Society for Neuroscience; Takeda Pharmaceutical Company Limited; and Wellcome Trust. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-37764-5
International Standard Book Number-10: 0-309-37764-1
DOI: 10.17226/21793
Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2016 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Providing sustainable mental and neurological health care in Ghana and Kenya: Workshop summary. Washington, DC: The National Academies Press.
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PLANNING COMMITTEE ON PROVIDING SUSTAINABLE
MENTAL HEALTH CARE IN GHANA AND KENYA: A
WORKSHOP SERIES1
STEVEN HYMAN (Co-Chair), The Broad Institute of Massachusetts Institute of Technology and Harvard University
VIKRAM PATEL (Co-Chair), London School of Hygiene and Tropical Medicine
LUKOYE ATWOLI, Moi University School of Medicine
CAROL BERNSTEIN, New York University School of Medicine
FRANÇOIS BOMPART, Sanofi
TARUN DUA, World Health Organization
FIONA DUNBAR, Janssen Pharmaceuticals, Inc.
JULIAN EATON, CBM International
DAVID KIIMA, Ministry of Health, Kenya
ALAN LESHNER, American Association for the Advancement of Science (Emeritus)
CRICK LUND, University of Cape Town
ANA-CLAIRE MEYER, Yale School of Medicine
DAVID MICHELSON, Merck Research Laboratories
DAVID NDETEI, Africa Mental Health Foundation; University of Nairobi
ANGELA OFORI-ATTA, University of Ghana School of Medicine and Dentistry
SAMMY OHENE, University of Ghana School of Medicine and Dentistry
AKWASI OSEI, Ghana Health Service
ATUL PANDE, Tal Medical
BEVERLY PRINGLE, National Institute of Mental Health
PETER BADIMAK YARO, BasicNeeds Ghana
IOM Staff
BRUCE M. ALTEVOGT, Project Director (until April 2015)
SHEENA M. POSEY NORRIS, Associate Program Officer
ANNALYN M. WELP, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
_______________________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
FORUM ON NEUROSCIENCE AND NERVOUS
SYSTEM DISORDERS1
STEVEN HYMAN (Chair), The Broad Institute of Massachusetts Institute of Technology and Harvard University
STORY LANDIS (Vice Chair), Former Director, National Institute of Neurological Disorders and Stroke
SALVATORE ALESCI, Takeda Pharmaceuticals International, Inc. (until November 2015)
SUSAN AMARA, Society for Neuroscience
RITA BALICE-GORDON, Pfizer Global Research and Development (since September 2015)
KATJA BROSE, Cell Press
DANIEL BURCH, Pharmaceutical Product Development, LLC
SARAH CADDICK, Gatsby Charitable Foundation
ROSA CANET-AVILES, Foundation for the National Institutes of Health
MARIA CARRILLO, Alzheimer’s Association
C. THOMAS CASKEY, Baylor College of Medicine
KAREN CHANDROSS, Sanofi US
TIMOTHY COETZEE, National Multiple Sclerosis Society
FAY LOMAX COOK, National Science Foundation
BRUCE CUTHBERT, National Institute of Mental Health (since November 2015)
WILLIAM DUNN, Food and Drug Administration
EMMELINE EDWARDS, National Center for Complementary and Integrative Health
MARTHA FARAH, University of Pennsylvania
DANIEL GESCHWIND, University of California, Los Angeles
HANK GREELY, Stanford University
MAGALI HAAS, Cohen Veterans Bioscience
RAMONA HICKS, One Mind for Research
RICHARD HODES, National Institute on Aging
STUART HOFFMAN, U.S. Department of Veterans Affairs
THOMAS INSEL, National Institute of Mental Health (until October 2015)
PHILIP IREDALE, Pfizer Inc. (until August 2015)
_______________________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
MICHAEL IRIZARRY, Eli Lilly and Company
JOHN ISAAC, Wellcome Trust
INEZ JABALPURWALA, Brain Canada Foundation
FRANCES JENSEN, University of Pennsylvania School of Medicine
GEORGE KOOB, National Institute on Alcohol Abuse and Alcoholism
WALTER KOROSHETZ, National Institute of Neurological Disorders and Stroke
ALAN LESHNER, American Association for the Advancement of Science (Emeritus)
HUSSEINI MANJI, Johnson & Johnson Pharmaceutical Research and Development, LLC
DAVID MICHELSON, Merck Research Laboratories
JAMES OLDS, National Science Foundation
ATUL PANDE, Tal Medical
STEVEN PAUL, Voyager Therapeutics
EMILIANGELO RATTI, Takeda Pharmaceuticals International, Inc. (since December 2015)
TODD SHERER, The Michael J. Fox Foundation for Parkinson’s Research
DAVID SHURTLEFF, National Center for Complementary and Integrative Health
PAUL SIEVING, National Eye Institute
NORA VOLKOW, National Institute on Drug Abuse
STEVIN ZORN, Lundbeck Research USA
IOM Staff
BRUCE M. ALTEVOGT, Forum Co-Director (until April 2015)
CLARE STROUD, Forum Director
SHEENA M. POSEY NORRIS, Associate Program Officer
ANNALYN M. WELP, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
BOARD ON GLOBAL HEALTH1
THOMAS C. QUINN (Chair), National Institute of Allergy and Infectious Disease and Johns Hopkins University School of Medicine
JO IVEY BOUFFORD, New York Academy of Medicine
GARY DARMSTADT, Stanford School of Medicine
JACOB A. GAYLE, Medtronic Foundation
GLENDA E. GRAY, South African Medical Research Council
MARGARET A. HAMBURG, National Academy of Medicine
STEPHEN W. HARGARTEN, Medical College of Wisconsin
CLARION JOHNSON, ExxonMobil
ALAN LESHNER, American Association for the Advancement of Science (Emeritus)
GUY H. PALMER, Washington State University
ANNE C. PETERSEN, University of Michigan
DAVID VLAHOV, University of California, San Francisco, Schools of Nursing and Medicine
IOM Staff
PATRICK KELLEY, Board Director
_______________________
1Institute of Medicine boards do not review or approve individual reports and are not asked to endorse conclusions and recommendations. The responsibility for the content of the reports rests with the rapporteurs and the institution.
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
JOSEPH BEDIAKO ASARE, Ghana Mental Health Authority
MARCELLO CRUZ, Central University of Ecuador
RICHARD OTIENO MUGA, Great Lakes University Kisumu
INGE PETERSEN, University of Kwazulu-Natal
STEPHANIE SMITH, Harvard Medical School; Partners In Health
CATHERINE SYENGO MUTISYA, Mathari National Teaching & Referral Hospital
TEDLA WOLDE-GIORGIS, Ministry of Health, Ethiopia
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by HELLEN GELBAND, Center for Disease Dynamics, Economics & Policy. She was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review
Contents
Organization of the Workshop Series and Report
Challenges to Sustainable Mental and Neurological Health Care in SSA
Mental and Neurological Health Care in Kenya
Potential Demonstration Projects
Challenges and Opportunities to Sustainable Mental Health Care
Potential Demonstration Projects
Challenges and Opportunities to Sustainable Mental Health Care
Africa Mental Health Foundation: Community Partnerships
Direct Relief and Breast Care International: Collaboration
Fight Against Epilepsy: Stakeholder Engagement
Kenya Association for the Welfare of People with Epilepsy: Public Education
The Kintampo Project: Focus on Community-Based Care
Program for Improving Mental Health Care (PRIME): Buy-in, Buy-in, Buy-in
Project Fives Alive!: Scaling Up
Mental Health Care in Turkey: Policy Development
World Association for Social Psychiatry and Sanofi: Country-Specific Approaches
686 Project in China: Focus on General Practitioners
5 Perspectives on Potential Next Steps
Overarching Concepts Identified by Individual Participants
APPENDIXES
E Commissioned Paper: Providing Sustainable Mental Health Care in Kenya: A Demonstration Project
F Commissioned Paper: Providing Sustainable Mental Health Care in Ghana: A Demonstration Project