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Abstract

A local insurgency has displaced many people in the northern Mozambican province of Cabo Delgado. The authors’ global team (comprising members from Brazil, Mozambique, South Africa, and the United States) has been scaling up mental health services across the neighboring province of Nampula, Mozambique, now host to >200,000 displaced people. The authors describe how mental health services can be expanded by leveraging digital technology and task-shifting (i.e., having nonspecialists deliver mental health care) to address the mental health needs of displaced people. These methods can serve as a model for other researchers and clinicians aiming to address mental health needs arising from humanitarian disasters in low-resource settings.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 98 - 101
PubMed: 37461818

History

Received: 10 September 2021
Revision received: 31 March 2023
Revision received: 25 May 2023
Accepted: 30 May 2023
Published online: 18 July 2023
Published in print: January 01, 2024

Keywords

  1. Public health
  2. Armed conflict
  3. Internally displaced people
  4. Nonpsychiatric professionals
  5. Sub-Saharan Africa
  6. Mental health systems

Authors

Details

Jennifer J. Mootz, Ph.D. [email protected]
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Catherine Chantre, M.Sc.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Kathleen Sikkema, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
M. Claire Greene, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Kathryn L. Lovero, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Lidia Gouveia, M.D., Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Palmira Santos, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Antonio Suleman, M.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Andrea Simone Comé, B.S.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Paulino Feliciano, B.A.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
José Miguel Uribe-Restrepo, M.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Annika C. Sweetland, Dr.P.H.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Rachel C. Shelton, Dr.P.H.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Jeremy Kane, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Milena Mello, M.A.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Wilza Fumo, M.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Yazmin Cadena-Camargo, M.D., Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Myrna Weissman, Ph.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).
Milton L. Wainberg, M.D.
Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo).

Notes

Send correspondence to Dr. Mootz ([email protected]). Pamela Y. Collins, M.D., M.P.H., Matías Irarrázaval, M.D., M.P.H., Helen E. Jack, M.D., and Lola Kola, Ph.D., are editors of this column.

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This research was supported by NIMH (grants K23 MH-122661, U19 MH-113203, and T32 MH-096724), Fogarty International Center and NIMH (grant D43 TW-009675), and the National Institute on Alcohol Abuse and Alcoholism (grant R01 AA-025947).The views in this column are those of the authors and not necessarily those of NIH or the U.S. government.

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