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Spatial Data Analysis Of Mental Health Service Uptake, Adherence And Outcomes In Four Low- And Middle-Income Country Districts Of The Programme For Improving Mental Health Care (PRIME)

Principal supervisor: Dr Mary De Silva (LSHTM)

Co-supervisors: Dr Maurizio Gibin (Bbk), Dr Sujit Rathod (LSHTM)

More than 13% of the global burden of disease is due to neuropsychiatric disorders, and almost three quarters of this burden lies in low- and middle-income countries (LMICs) with few resources for mental health care. In order to optimise allocation of scarce resources and improve mental health outcomes, it is important to be able to compare the factors affecting help-seeking behaviour, screening patterns, service uptake, treatment adherence and mental health outcomes across geographical areas and at as fine a spatial scale as possible.

This project will analyse spatial and interview data collected by the Programme for Improving Mental Health Care (PRIME) consortium to investigate how geographical factors affect mental health service uptake, adherence and outcomes relative to other possible influences in two countries in South Asia (India and Nepal) and two in sub-Saharan Africa (South Africa and Uganda).

PRIME is a DFID funded project generating evidence on the implementation and scale up of integrated packages of care for depression, alcohol use disorders, psychosis and epilepsy in primary care in five low and middle income countries: Ethiopia, India, Nepal, South Africa and Uganda (see http://www.prime.uct.ac.za/ and (Lund et al., 2012)).

The country teams have developed mental health care plans for the integration of mental health services into primary health care. These plans are now being implemented and evaluated in one district in each country. This includes a community based survey to evaluate changes in access to services, and cohorts of patients followed up for 12 months to assess changes in outcomes as a result of treatment. Data for these interviews were collected on mobile phones, capturing the GPS location of the individuals’ home.

The findings from this research will have important policy implications through identifying the optimal location for community-based mental health services in order to maximise service uptake, adherence and outcomes. They will also explain how spatial and non-spatial factors interact to affect mental health outcomes, helping to inform the location of future service development and to identify additional supporting services required in order for the integration of mental health care into primary and maternal health care to be successful.

Candidate requirements

We invite applications from outstanding and highly motivated students. Applicants must hold an MSc or other Masters degree in a relevant discipline (global mental health, epidemiology, health geography, public health or other relevant discipline).

The studentship is open to Home/EU students as the studentship only covers fees at the Home/EU rate. It will be predominately based in London, with the possibilty of site visits to one or more of the PRIME countries if funding for fieldwork can be found.

Key references

  • http://www.prime.uct.ac.za/
  • Lund C, Tomlinson M, De Silva M, Fekadu A, Shidhaye R et al. (2012) PRIME: A Programme to Reduce the Treatment Gap for Mental Disorders in Five Low- and Middle-Income Countries. PLoS Medicine, 9(12): e1001359.
  • Rytkönen, MJP (2004). Not All Maps Are Equal: GIS and Spatial Analysis in Epidemiology. International Journal of Circumpolar Health, 63(1): 9-24.

Further details about the project may be obtained from:

Principal supervisor: Dr Mary De Silva, mary.desilva@lshtm.ac.uk, http://www.lshtm.ac.uk/aboutus/people/desilva.mary

Co-supervisors: Dr Maurizio Gibin, m.gibin@bbk.ac.uk, http://www.bbk.ac.uk/geds/our-staff/full-time-academic-staff/gibin
Dr Sujit Rathod, sujit.rathod@lshtm.ac.uk http://www.lshtm.ac.uk/aboutus/people/rathod.sujit

Further information about PhDs at LSHTM is available from:

http://www.lshtm.ac.uk/study/research/eph_mphilphd.html

Application forms and details about how to apply are available from:

LSHTM uses an online application system, please see: http://www.lshtm.ac.uk/study/research/eph_mphilphd.html

Please contact Dr Mary De Silva, mary.desilva@lshtm.ac.uk with project queries; or scholarships@lshtm.ac.uk for queries related to the submission of the application.

Please use the standard LSHTM application system to apply for this studentship and state clearly under the funding section that you are applying for this particular studentship. Since you are applying for an existing project you don't need to include a research proposal, so please instead upload a personal statement outlining your interest in this field and your motivation to study for a PhD.

If your fee status will not be assessed as Home/EU please provide an explanation on how you plan to fund the difference between the Home/EU fee rate and the Overseas fee rate.

Closing date for applications is Monday 13 April at 10am