The following abstract was presented at the Implementation Science and Global Health satellite meeting on March 17, 2010 at Bethesda, Maryland.
Byron Good, PhD
Professor of Medical Anthropology
Director of Programs in Global Mental Health
Department of Social Medicine
Harvard Medical School
The past decade has seen remarkable changes in the mental health system of China. Although overall investment in mental health care is still small relative to other areas of medical services, national and provincial investment in the development of new mental health services programs is dramatically changing the organization and quality of services for persons with mental illnesses. Investment in model mental health programs by the central government of China has created critical opportunities to evaluate innovative programs, provide empirical evidence for determining which should be implemented on a wider basis, and advocate for new policies and investment in mental health services. Former trainees and national training partners of the Harvard Medical School (HMS) ICOHRTA program have emerged as the leaders in mental health implementation research in recent years.
The HMS ICOHRTA program focuses on training fellows to develop innovative responses to difficult mental health problems in China, and to undertake research relevant to all stages of implementation research. Fellows are taught a model that includes empirical needs assessments, the development and evaluation of innovative pilot interventions, the assessment of the potential for pilot interventions to be brought to scale, the translation of needs assessments and pilot interventions into mental health policy, and evaluation of the effectiveness of programs as policies are implemented on a large scale. The Harvard program has focused on capacity-building in two of China’s most important institutions of mental health training and research – the Shanghai Mental Health Center, and the Peking University Institute for Mental Health. These two institutions have been deeply involved in implementation research associated with many of the most important services development programs, several of which will be briefly described.
- Former trainees of the Harvard program, led by a team in Beijing, have directed the ‘686 Program,’ the largest mental health services reform program in the world, aimed at providing integrated hospital and community care for persons with psychotic illness. A total of 60 demonstration areas have built in rural and urban districts in 30 provinces, covering a population of 43 million.
- The Great Sichuan Earthquake of May 2008 killed over 70,000 persons and left millions homeless. More than half (7 of 13) of the national China Expert Team for Psychosocial Response were former trainees of the Harvard program, and they and other trainees of the program have been deeply involved in carrying out and evaluating mental health services and psychosocial training activities in the region.
- A mental health policy research team at Shanghai Mental Health Center has emerged as the most important group providing empirical data relevant to the development and implementation of national and municipal mental health legislation, with particular focus on
controversial legal and ethical issues associated with patient care.
- Teams in both Shanghai and Beijing are deeply involved in developing and evaluating programs to meet the Chinese government’s recent commitment to providing mental health promotion and early intervention services, with special focus on vulnerable populations – children and adolescents, women, the elderly – and on industrial laborers.
Updated May 2010