Social Change, Armed Conflict, and Mental Health Disorders and Service Use

Project Details

Investigators: William G. Axinn, PI, Dirgha J. Ghimire, Co-I, Stephanie A. Chardoul, Co-I.

Description: The goal of this research and training program is to create research capacity needed to launch a new program concerning mental health disorders and service use in Nepal, a society that is in the midst of dramatic social change with a recent history of armed conflict and a recognized paucity of mental health services. The research component of the planned program has three specific aims: 1) build on existing World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) measures to create new, high quality, culturally appropriate measures of prevalence of and variation in mental health disorders in Nepal; 2) administer the measures of prevalence and variation in mental health disorders and service use on the Chitwan Valley Family Study (CVFS) general population sample and link those measures directly to the existing CVFS measurement of community and family change and variation; and 3) link a detailed record of violent events in the Chitwan valley to the existing CVFS data and newly collected measures of mental health outcomes to investigate the associations among social change, violence, and mental health disorders. The training component of the planned program also has three aims: 1) train Nepali scholars and research staff in translation, refinement, and validation of key mental health measures used in the World Mental Health Survey Initiative and to implement the standardized CIDI instrument; 2) create a strong coalition of mental health professionals and social researchers within Nepal, prepared to collaborate with the objective of improving information flow about prevalence of mental health disorders and service needs; and 3) train members of this coalition in the administration of the CIDI instrument in the general population and analyses of CIDI data to identify service needs and barriers to service use. We took advantage of existing research infrastructure and expertise from a number of institutions and individuals to accomplish these goals. With exceptionally high levels of enthusiasm and participation from both Nepalese scholars and collaborators, and the University of Michigan researchers with substantial technical support from Harvard University, this study has made significant progress. Below we summarize the accomplishments.

Coverage: Nepal.

Sponsor: University of Michigan, GHRT Initiative. R56 HD08528. $40,000. 2013-2016.