Table of Contents

Introduction & Schedule ............................................................................................................................... 1

The Africa Global Mental Health Institute ................................................................................................ 6
Dr. Chester Middlebrook Pierce ............................................................................................................... 7
Acknowledgements & Dedications ........................................................................................................... 8
Speakers & Panelists ..................................................................................................................................... 9
Panel Summaries......................................................................................................................................... 35
1. The Intersection of Policy and Research ............................................................................................. 35
2. Service Delivery Models ...................................................................................................................... 40
3. Service Access Challenges ................................................................................................................... 46
4. Training & Education: Bridging Gaps in Capacity ................................................................................ 51
5. Training & Education: Collaborations in the 21sr Century ................................................................. 56
6. Examples of Global Research Collaboration ....................................................................................... 60
7. Research Capacity Building: Next Steps & Lessons Learned ............................................................... 65
Bibliography ................................................................................................................................................ 70

Introduction & Schedule

The 2016 African Diaspora Conference on Global Mental Health follows the first African
Diaspora Conference held in 2002 in Boston, MA, USA, organized by Dr. Chester M. Pierce.
The first conference gathered forty psychiatrists of African-descent to analyze, discuss, and
develop an agenda to address the role of psychiatry and psychiatrists in healing the mental
health problems of people of African-descent in Africa and throughout the world.
In this booklet, the reader will find bios from conference speakers and excerpts from each
presentation within the conferences panels. These excerpts cannot (and are not intended) to
substitute for the brilliant analysis and remarkable eloquence that characterized all of the
conference presentations, but are included here as a brief introduction to the issues and ideas
discussed, and as an enticement to the reader to delve into the collective experience and
wisdom of the psychiatrists of African descent who participated in this conference.

[1]
Schedule

When What Who

7h00 - 8h00 Breakfast

8h00 - 8h15 Welcome/Introduction Speakers:
Bonga Chiliza
Mashadi Motlana
Michelle Durham

8h15 - 9h00 Background Speakers:

Chester M. Pierce & 1st African Diaspora Conference Gregory Fricchione
2nd African Diaspora Conference & AGMHI David Henderson
9h00 - 10h45 Keynotes Speakers:
Introduction Eliot Sorel
Keynote Speeches David Satcher
Q/A & Comments Teddy B. Taylor
Atalay Alem

10h45 - 11h15 Break

11h15 13h00 Panel 1: The Intersection of Health Policy and Research Presenters:
Co-Chairs: David Ndetei, Solomon Rataemane, Eliot Sorel Eliot Sorel
Rahn Bailey
Evidence Based Medicine to Policy - What works? (Jimmy
David Ndetei
Volmink)
Jimmy Volmink
Translating Scientific Evidence into Global Health Policy: Making Bongani Mayosi
Mental Health Count for Individuals And Populations Health
(Eliot Sorel & Rahn Bailey)
Innovative approach to integrate research, policy statements, and
implementations (David Ndetei)
Translating research into policy: the case of rheumatic heart
disease (Bongani Mayosi)
13h00 14h00 Lunch

[2]
 When What Who

14h00 - 15h30 Panel 2: Service Delivery Models Presenters:

Co-Chairs: Mashadi Motlana, Greg Fricchione Godfrey Zari Rukundo
Dawit Wondimagegn
African Academic Psychiatry Departments and their Role in
Tedla Giorgis
Services Delivery (Dawit Wondimagegn)
Gordon Donnir
The Modern African Psychiatric Hospital Setting (Godfrey Atalay Alem
Zari Rukundo)
On the Intricacy of Developing, Institutionalizing and
Implementing Mental Health Strategies at the National Level
(Tedla Giorgis)
Role of Stigma in Reducing Access and Service Delivery (Gordon
Donnir)
Exemplary North South Collaboration and Local Capacity
Development for Mental Health Services in LAMICS
(Atalay Alem)
15h30 - 16h00 Break
16h00 - 17h15 Panel 3: Service Access Challenges Presenters:
Co-Chairs: Mashadi Motlana, Greg Fricchione Funeka Sokudela
Solomon Teferra
Access to Forensic Mental Health Services in Africa: Double-
Solomon Rataemane
Jeopardy and Human Rights Shifts in Post-Colonial Societies
Mashadi Motlana
Kubi-Kuhle (Funeka .Sokudela)
William Lawson
Current State of Mental Health Service in Ethiopia with Emphasis
on Integration Efforts (Solomon Teferra)
Improving Outpatient Access for Patients with Substance Use
Disorders (Solomon Rataemane)
Unequal Access to Medical Care Compared to Mental Healthcare
in the Private Sector (Mashadi Motlana)
"Building a better mousetrap: Why People of African Ancestry
Do Not Benefit" (William Lawson)

18h15 Shuttle Departs for Dinner from Century City

19h00 Dinner at Africa Cafe

[3]
 When What Who

7h00 - 8h00 Breakfast

8h00 - 8h15 Recap of Thursday Speakers:
Bonga Chiliza
Mashadi Motlana
Michelle Durham
8h15 - 9h15 Panel 4: Training & Education: Bridging Gaps in Capacity Presenters:
Chair: Altha Stewart & Zukiswa Zingela Samuel Okpaku
Altha Stewart
What Models of Education and Training for Psychiatrists in Africa
Nancy Carter
(Samuel Okpaku)
Gordon Donnir
Adverse Childhood Experiences: A Global Health Problem (Altha Olayinka Omigbodun
Stewart)
Family Engagement across Cultures: Healing Family Trauma
through Story (Nancy Carter)
Training and Education in Psychiatry in Ghana
(Gordon Donnir)
Building Child and Adolescent Mental Health Capacity in
Sub Saharan Africa (Olayinka Omigbodun)
9h15 - 10h15 Panel 5: Training & Education: Collaborations in the Presenters:
21st Century Zukiswa Zingela
Chair: Altha Stewart & Zukiswa Zingela Gregory Fricchione
Training Psychiatrists in Under-Resourced Areas: Challenges and Eliot Sorel
Opportunities (Zukiswa Zingela) Lori Chibnik

Global Mental Health Education (Gregory Fricchione)

TOTAL Health: Integrating primary care, mental health, and public
health (Eliot Sorel)
Building a Better Training Program: A Mixed Methodology
Approach (Lori Chibnik)

10h15 - 10h45 Break

[4]
 When What Who

10h45 - 11h45 Panel 6: Examples of Global Research Collaboration Presenters:

Co-Chairs: Dan Stein, Bonga Chiliza, David C. Henderson David Henderson
Dan Stein
David Henderson
Roy Kallivayalil
African College of Neuropsychopharmacology: Laying a Pamela Collins
Foundation (Dan Stein) Soraya Seedat
A Multi-Centric Depression Screening Study in Primary Care
Setting From India (Roy Kallivayalil)
Addressing Global Mental Health Challenges through
Collaborative Research and Training (Pamela Collins)
Collaborative Networks: Harnessing Research Training (Soraya
Seedat)
11h45 - 12h45 Panel 7: Research Capacity Building: Next Steps & Lessons Presenters:
Learned William Lawson
Co-Chairs: Dan Stein, Bonga Chiliza, David C. Henderson Bonga Chiliza
Karestan Koenen
Genetics and Psychiatry in the United States: Lessons Learned
Christina Borba
(William Lawson)
Rolling the Dice: A Young African Researcher Plays Snakes and
Ladders (Bonga Chiliza)
Neuropsychiatric genetics in Africa: Waste not or want not?
(Karestan Koenen)
Christina Borba
12h45 - 13h45 Lunch
13h45 - 14h45 Debate (Participants)
Politics & Global Mental Health
14h45 - 17h00 Forum Panel of Section
10 Minute Summary Statements Leaders
Large Group Discussion
17h00 - 17h30 Break
17h30 - 18h30 Outcomes (Speakers)
AGMHI: Structure & Mission
African Mental Health Book & Future Objectives
18h30 - 19h00 Closing Speakers:
Bonga Chiliza
Mashadi Motlana
Michelle Durham

19h00 WPA Reception

[5]
Conference Overview

The Africa Global Mental Health Institute

The intended outcome of this innovative conference is to
develop the Africa Global Mental Health Institute
(AGMHI). The mission of the AGMHI is to address the
contemporary challenges of mental health disorders and
their comorbid conditions through four key components:
policy, services, education, and research. These four key
components will communicate with each other and be
integrated into a cohesive whole with a focus on global
mental health and their comorbid conditions, with the aim
of narrowing and eventually closing the mental health gap
between Africa and the rest of the world.
We aim to align this initiative with the goals worldwide disease burden of mental illness
of the World Health Organization (WHO) from multiple perspectives. By facilitating
and World Bank. Many of our collaborators these collaborations in policy, services,
on the AGMHI, including Drs. Eliot Sorel, education, and research, we will help to
David Henderson, Gabriel Ivbijaro, Victoria decrease the strong stigma of mental illness
Mutiso, and David Ndetei actively worldwide, thus helping to improve other
contributed to the WHO/World Bank health, social, and economic outcomes.
Meeting entitled Out of the Shadows:
Each component of the AGMHI will be co-
Making Mental Health a Global Priority, on
led by African and American collaborators
April 13 and 14, 2016.
with expertise in that particular area. Given
We are firmly committed to achieving the that the African Diaspora Global Mental
goals of the WHO Mental Health Action Health Conference will be held in Cape
Plan for 2013-2020, and the four cross- Town, South Africa, each component will
cutting tracks of the AGMHI strongly align also be co-chaired by a South African expert
with the principles and approaches outlined in that area. These co-chairs will give
in the action plan, particularly the lectures at the conference and provide
importance of a multisectoral life course high-level guidance in the development of
approach, and the need to develop the conference and AGMHI. Finally, Dr.
evidence-based practices for mental illness. David Satcher will provide the keynote
address and set the stage for the meeting
Bringing together professionals from
and development of the Africa Global
various countries and professional
Mental Health Institute.
backgrounds will help address the urgent

[6]
 Dr. Chester Middlebrook Pierce

As black psychiatrists, we have the opportunity to help our

people better negotiate the future.
The African Diaspora Conference and the resulting Africa
Global Mental Health Institute are dedicated to the late
Chester M. Pierce, M.D., Professor Emeritus of Education
and Psychiatry at Harvard University; a psychiatrist,
researcher, scholar, mentor, friend, and gentleman
extraordinaire, who has planted this powerful seed in
fertile ground and nurtured it into creation.
In 2002, Dr. Chester M. Pierce organized the first African
Diaspora Conference, with the vision of uniting
psychiatrists throughout the diaspora to address pressing
mental health concerns for people of African descent. Of
all those involved in the 2002 conference, Dr. Pierce was
perhaps the most influential in his vision, drive, and
dedication to developing a plan of action, through which
African and African-descent psychiatrists may better
facilitate health and wellbeing in global communities.
Dr. Pierce is widely renowned for his unprecedented career in the field of global mental health.
He was Emeritus Professor of Psychiatry at Harvard Medical School and Emeritus Professor of
Education at the Harvard College of Arts and Sciences, notably serving as the first African
American full professor at Massachusetts General Hospital. In 1969, he was appointed chair of
the Ad Hoc Committee of the Black Psychiatrists of America, after he championed efforts to
widen opportunities for black psychiatrists in leadership positions. Dr. Pierce is possibly best
known for his groundbreaking research on the effects of racism, having first proposed the
concept of racial micro-aggressions in 1970. This work had a profound influence on the field
of psychiatry, and ultimately contributed to his reception of the American Psychiatric
Associations Human Rights Award in 2015. A man of many accomplishments, Dr. Pierce rose to
become president of the American Board of Psychiatry and Neurology, the American
Orthopsychiatric Association, and Black Psychiatrists of America, as well as chairperson of the
Child Development Associate consortium.
Dr. Pierce passed away in September of 2016 at the age of 89 years old. He is remembered as a
humble, kind, and visionary scholar, whose contributions to the field of psychiatry continue to
inspire generations of physicians. The Africa Global Mental Health Institute is proud to bear his
name, and hopes to accomplish the vision Dr. Pierce has laid out in his lifetime of service.
[7]
 Acknowledgements & Dedications

On behalf of the African Diaspora Conference on African Global Mental Health, we would like to
thank the following individuals and institutions for their dedication to this conference, without
whom these proceedings would not be possible:

Addis Ababa University

The Africa Mental Health Foundation
Boston Medical Center
Boston University
The Chester M. Pierce, MD Division of Global Psychiatry
George Washington University
Massachusetts General Hospital
University of KwaZulu-Natal
University of Nairobi
Stellenbosch University

These proceedings are dedicated to people of African-descent in Africa and throughout the
African Diaspora, our families, friends, colleagues and patients. We, as a group and as
individuals, understand the truth and wisdom of the African proverb; I am because we are, and
because we are, I am.
These proceedings are dedicated to all of the traditional healers, physicians and psychiatrists of
African-descent, past and present, who have preceded us and continue to guide us; We
acknowledge that; If we have seen farther, it is because we are standing on the shoulders of
giants.
These proceedings are dedicated to the children and adolescents of African-descent throughout
Africa and the African Diaspora, who look to our generation of elders for guidance and wisdom
in these difficult times, May the ancestors be proud and may our children speak well of us.
And finally, these proceedings are dedicated to the late Chester M. Pierce, MD, whose vision
and wisdom continue to guide our strides in the field of global mental health. May our efforts
be worthy of your vision and may the results resound throughout the millennia.

[8]
 Speakers & Panelists

Africa Asia
Atalay Alem Roy Kallivayalil
Bonga Chiliza
North America
Gordon Donnir
Rahn Bailey
Tedla Giorgis
Christina Borba
Bongani Mayosi
Nancy Carter
Mashadi Motlana
Pamela Collins
Victoria Mutiso
Lori Chibnik
David Ndetei
Michelle Durham
Olayinka Omigbodun
Gregory Fricchione
Solomon Rataemane
David Henderson
Soraya Seedat
Karestan Koenen
Funeka Sokudela
William Lawson
Dan Stein
Samuel Okpaku
Solomon Teferra
Altha Stewart
Jimmy Volmink
David Satcher
Dawit Wondimagegn
Eliot Sorel
Godfrey Zari Rukundo
Teddy B. Taylor
Zukiswa Zingela

[9]
 Atalay Alem, MD, PhD
Professor, Department of Psychiatry
College of Health Sciences
Addis Ababa University, Ethiopia
Phone: +251 112-139-744
Email: atalay.alem@gmail.com
Dr. Atalay Alem is a noted scholar and researcher in the field of psychiatry at Addis Ababa
University. His main research interests include epidemiology of mental disorders in rural, urban,
semi-nomadic and isolated islander communities, childhood disorders and child labor.
Dr. Alem has been a principal and co-investigator of the Butajira Mental Health Project which
has followed cohorts of patients with schizophrenia and bipolar disorders since 1998 to
describe the course and outcome of these disorders. Cases for the cohorts were identified by
screening over 68,000 adults from a predominantly rural population and it is one of the largest
community surveys in the world for major mental disorders. He has attracted over two million
USD in research grants from various international donors and has sponsored and co-supervised
10 completed PhDs in mental health. He has published over 120 scientific papers. He is now
engaged in mental health service development, mental health systems and clinical trial
projects.
Dr. Alem worked for the Ethiopian Ministry of Health as a psychiatrist for a number of years and
as a medical director of Amanuel Mental Hospital, the only psychiatric hospital in the country,
for six years before he joined Addis Ababa University as an Assistant Professor in 2000.
Currently, he is Professor of psychiatry at Addis Ababa University and consultant psychiatrist at
Amanuel Mental Hospital.

Bonga Chiliza, PhD, MBChB, FCPsych

Senior Lecturer, Department of Psychiatry
University of Stellenbosch
Senior Specialist Psychiatrist, Tygerberg Hospital
Stellenbosch, South Africa
Email: bonga@sun.ac.za

Dr. Chiliza is an investigator on a number of research studies within the Schizophrenia Research
Unit at Stellenbosch University, and also maintains teaching responsibilities with both
undergraduates and postgraduates at the University. He has worked to combat language and

[10]
cultural barriers to mental health care by using research, mentorship, and interpreter training
to establish a successful interpreter program in the Western Cape.
Dr. Chilizas additional research in psychiatry has focused on the efficacy of long acting
injectable antipsychotics in First Episode Schizophrenia patients. He has experience working in
clinical trials related to antipsychotic medication side effects. He has received numerous honors
and awards, including the Hamilton Naki Clinical Research Fellowship.

Gordon M. Donnir, BSc, MBChB, MGCPsych, Ex. MBA

Head & Director of Psychiatry Residency, Department of Psychiatry
Komfo Anokye Teaching Hospital, Kumasi
Adjunct Faculty, School of Medical Sciences
Kwame Nkrumah University of Science and Technology
Part-time Faculty
University of Cape Coast School of Medical Sciences
Email: gordon.donnir@gmail.com

Dr. Gordon M. Donnir is a General Psychiatrist & Head of Department for the Komfo Anokye
Teaching Hospitals Department of Psychiatry, the second largest tertiary & teaching facility in
Ghana. Since 2009, he has garnered experience in teaching medical students, nursing students,
graduate clinical pharmacy students, herbal (alternative) medicine practitioners and residents
in psychiatry in Ghana. His experience stretches further to include setting up, designing and
implementing a psychiatry residency program of the Ghana College of Physicians and Surgeons
and the second of only two sites for training psychiatrists in Ghana at the hospital department.
He is an adjunct faculty at his alma mater. He has taught alongside professors from Harvard
University, University of Alabama, the Maudsley in the UK, and institutions in Canada as visiting
faculty at the University of Cape Coast Medical School. Through this collaborative work he has
fostered collaborative training of residents in Ghana with institutions like Massachusetts
General Hospital Psychiatry Residency Program (Harvard University) and Boston University
Global Health Division, which began in August 2016.
His contribution to knowledge include co-authoring a book chapter Psychotherapy in
Indigenous Context: A Ghanaian Contribution Towards Provision of Culturally Competent Care
in the Handbook of Research on Theoretical Perspectives on Indigenous Knowledge Systems in
Developing Countries. He also authored a handbook for first-line middle level mental health
professionals solely for use at selected primary care facilities in Ghana handbook for primary
mental healthcare: a practical guide. He also serves as Co-PI and PI on a number of completed
and ongoing research projects in Ghana. He volunteers his time, skills and knowledge as a
consultant and facilitator in collaboration with mental health NGOs in running outreach clinics
and trainer of trainees programs throughout Ghana, in an effort to scale up the reach of mental
health service delivery.

[11]
 Tedla W. Giorgis, Ph.D.
Mental Health Advisor
Ethiopian Ministry of Health
Addis Ababa, Ethiopia
Phone: +251 911-195-312
Email: giorgistw@aol.com

Dr. Tedla W. Giorgis is clinical psychologist with 38 years of international experience and is
currently a special advisor to the Minister of Health of Ethiopia. For over 25 years, Dr. Tedla
served as a Director of the Multicultural Services Division for the Mental Health Directorate of
the Government of the District of Columbia and was responsible for the delivery of mental
health services to the ethnic/linguistic and international communities residing in the District of
Columbia. Prior, Dr. Giorgis worked for the personnel department of the World Bank advising
on issues selection interview and hiring of international staff from developing countries
underrepresented in the Bank
Since 2009, Dr. Tedla has been serving as a senior advisor on international affairs and mental
health at the Office of the Minister of the Ministry of Health, Ethiopia. Previous engagements
of Dr. Giorgis include working on mental health, human resources, organizational development
and knowledge management issues with several international organizations such as the World
Bank, Center for Population and Development Activities, US Agency for International
Development, American International Health Alliance, UNICEF, University of Washington and
the World Health Organization. Dr.Giorgis has also an extensive international working
experience in several African, Asia, Middle East and Caribbean countries and has several
refereed publications in academic journals.

Bongani Mayosi, PhD

Professor of Medicine & Dean of the Faculty of Health Sciences
University of Cape Town
Chief Specialist, Groote Schuur Hospital
Cape Town, South Africa

Professor Bongani Mayosi was recently appointed Dean of the Faculty of Health Sciences at the
University of Cape Town, assuming the role in September of 2016. Professor Mayosi's work
focuses on heart diseases particularly prevalent in developing countries. He led a
groundbreaking series of multinational research studies into the management of pericarditis,
including an African trial of the use of steroids in treating tuberculous (TB) pericarditis. More

[12]
recently, Professor Mayosi led the first large-scale, multinational study of rheumatic heart
disease in the world (first phase).
Since 2010 Professor Mayosi has attracted more than R100 million in research grants. He has
developed valuable collaborations with academics in other countries (and especially across
Africa) in researching the management of TB pericarditis, prevention of rheumatic heart
disease, and genetics of heart disease. He has held numerous editorial responsibilities over the
last 15 years, and has published more than 250 papers in peer-reviewed journals.
Professor Mayosi has received many awards and honours during his distinguished career,
including inter alia: election to the Fellowship of the World Academy of Arts and Science (2013);
South African Medical Association/Bonitas Medical Fund Merit Award for Health Research
(2013); National Science and Technology Foundation BHP Billiton Award (2012); National
Research Foundation Award for Transforming the Science Cohort in South Africa (2011); and
the Order of Mapungubwe, Silver (2009)

Mashadi Motlana, MBChB, Mmed Psych, SAPsych

Director, Dr Nthato Motlana Foundation
Director, Psychiatry M Powered
Head of Communications & Chair, Anti-Stigma Division
South African Society of Psychiatrists
Honorary Consultant, Tara Hospital and University of the Witwatersrand
Johannesburg, South Africa
Email: drmashadi@gmail.com

Dr. Motlana is a specialist psychiatrist and businesswoman who combines her unique skill set as
a clinician and her entrepreneurial interests to innovate and impact the health of the South
African population, particularly in the corporate sector. Her holding company, Moshading
Capital, has interests in various sectors Lifestyle and Wellness Corporate Consulting, MBS
Consultancy, Zeal Health, and sourcing and procurement company Source to Site.
Dr. Motlana is a non-executive director of Sechaba Medical Solutions, Clinix Health Group,
Sekela Xabiso and recently joined Union Life. She is also a founding director of NPO Happy with
A Purpose and serves as Head of Communications and Chair of the anti-stigma division for the
South African Society of Psychiatrists. She is a member of E-Rotary Southern Africa and also
serves on the Tara Hospital Board. Dr. Motlana has previously served as the Clinical Head and
Executive Manager for Clinical Services at Tara Hospital. She was responsible for managing the
clinical and allied staff and containing the costs of providing quality specialized health care with
limited resources. She is currently an honorary consultant and lecturer at the University of the
Witwatersrand and runs the Eating Disorder Outpatient Clinic at Tara Hospital. She remains
involved in teaching and research. Prior to moving back to public service she ran a busy private
practice at Life Fourways Hospital and Life Riverfield Lodge from 2006 to 2011.

[13]
Dr. Motlana graduated from the University of Witwatersrand in 1998 with an MBChB and
obtained an Mmed (Psych) with distinction in 2004 from the University of Pretoria. She is also a
Fellow of the College of Psychiatrists (College of Medicine S.A) 2004.

Victoria Mutiso, PhD, MPH

Director of Administration and Finance & Research Fellow
Africa Mental Health Foundation
P.O. BOX 48423-00100, Nairobi, Kenya
Phone: +254 2-2716315
Fax: +254 2-2716315
Email: vmutiso@amhf.or.ke

Dr. Victoria Mutiso is in charge of research at the Africa Mental Health Foundation (AMHF), in
addition to overseeing the overall administration of the Foundation. She has been the Principal
Investigator for two projects run by the Africa Mental Health Foundation on innovative
integration of mental health services in primary health care, using task-shifting to include both
formal and informal health care systems.
Dr. Mutiso has a strong interest in mental health-related research and emerging trends. She
holds additional research interests in child psychology, parent-child relationships, and
developmental issues. She is a co-author on a manual on psychological trauma, and has
contributed book chapters and published several articles in peer-reviewed journals. She has
been in charge of the various projects that AMHF has undertaken for the past 5 years.

David Musyimi Ndetei, MD, PhD

Founder & Director, Africa Mental Health Foundation
Professor, Department Of Psychiatry
University Of Nairobi
Nairobi Psychotherapy Services & Institute
Phone: +254 2-2716315
Fax: +254 2-2716315
Email: dmndetei@mentalhealthafrica.com

Dr. Ndetei has been Principal Investigator or Co-Investigator (Co-I) of nearly all published
clinical and community epidemiological studies on mental health in Kenya. He was Co-I of one
of the first multicenter studies in the world, which focused on the neuro-psychiatric aspects of
HIV/AIDS. His pioneering research on the relationship between intravenous drug use and
HIV/AIDS forms the basis of the Kenyan governments current policy on intravenous drug users.
He has worked extensively as an international mentor and collaborator to National Institute of
Mental Health (NIMH)/National Institutes of Health (NIH)-funded researchers. He has also
served as a member of peer review and advisory committees to the NIMH/NIH and Grand

[14]
Challenges Canada. Dr. Ndetei has published extensively in leading peer-reviewed journals, co-
authored and edited 5 books and compiled 21 monographs based on his work available for
public access at the University of Nairobi library.
In addition to his academic and AMHF responsibilities, Dr. Ndetei is Chair of the African Division
of the Royal College of Psychiatrists (UK) and the World Psychiatric Association (WPA) Zone 14
(East, Central and South Africa) representative. He has worked extensively with the World
Health Organization (WHO), the United Nations, the International Development Research
Centre (IDRC), Grand Challenges Canada and numerous universities across the globe. He was
trained in Kenya at the University of Nairobi and in the UK at the University of London and the
Institute of Psychiatry, Kings College London, at the Maudsley.

Olayinka Olusola (Banjo) Omigbodun, MBBS, MPH, Dip

Psych, FMCPsych, FWACP
Director, Centre for Child & Adolescent Mental Health (CCAMH)
Professor of Psychiatry, College of Medicine
University of Ibadan
Honorary Consultant Child & Adolescent Psychiatrist
University College Hospital, Ibadan, Nigeria
Email: yomigbodun@comui.edu.ng

Olayinka Omigbodun is Professor and Head of Psychiatry at the College of Medicine, University
of Ibadan and University College Hospital (UCH), Ibadan, Nigeria. She is the Pioneer Director of
the Universitys John D. and Catherine T. MacArthur Foundation Funded, Centre for Child and
Adolescent Mental Health (CCAMH, www.ccamh.ui.edu.ng), a multidisciplinary centre for
training, research and service in child and adolescent mental health. CCAMH enjoys the
richness and diversity of course leaders and tutors from seven faculties in the University and
from the continents of Africa, Asia, Europe and North America. She is Chief Examiner for the
Faculty of Psychiatry in the West African College of Physicians (WACP) and the Immediate Past-
President of the International Association for Child and Adolescent Psychiatry and Allied
Professions (IACAPAP; www.iacapap.org), the first African to hold this position in the 78 years
of this organisation.

[15]
 Solomon Tshimong Rataemane, MD
Department Head, Department of Psychiatry
Sefako Makgatho Health Sciences University
President, African Association of Psychiatrists and Allied Professions
Fellow, American Psychiatric Association
Secretary General, World Association of Psychosocial Rehabilitation
Chairperson, Ministerial Advisory Committee on Mental Health
Pretoria, South Africa
Email: srataema@gmail.com

Professor Solomon Rataemane has special interests in child psychiatry, mood disorders, and
addiction medicine. He has served as deputy chairperson and chairperson of the Central Drug
Authority of South Africa from 1995 to 2005. Professor Rataemane is a Board member of
International Council on Alcohol and Addictions (ICAA) and serves on the Health Committee of
the Health Professions Council of South Africa, assisting in physicians health management. In
2015 he was appointed to the Medical and Dental Board of the Health Professions Council of
South Africa (HPCSA) for a five year term with further re-appointment to the Health Committee
of this Council.
Professor Raraemane was appointed Deputy Chair of the Medical Research Council of South
Africa for the triennium 2007 2010, and also serves fourth term as member of the Colleges of
Psychiatry within the Colleges of Medicine of South Africa (CMSA). He has extensive community
involvement including participating in seminars on understanding and managing alcohol and
drug abuse (addiction medicine); childhood related problems; policy development in
Government and policy directives within the South Africa Society of Psychiatry. In 2015 he was
appointed as the Chairperson of the Ministerial Advisory Committee on Mental Health in South
Africa (five year term. He is the current Secretary General of the World Association for
Psychosocial Rehabilitation (WAPR). Prof Rataemane participates in the forums of APA
(American Psychiatric Association) and WPA (World Psychiatric Association).

Soraya Seedat, MBChB, MMed, FC Psych, PhDs

Professor & Executive Head, Department of Psychiatry
Stellenbosch University
South African Research Chair, Post-Traumatic Stress Disorder
National Research Foundation
Co-Director, Anxiety and Stress Disorders Research Unit
Medical Research Council
Email: sseedat@sun.ac.za

As research chair for the National Research Foundation, Dr. Soraya Seedat developed a
collaborative research and postgraduate training programme of excellence in PTSD, which

[16]
brings together basic and clinical neuroscience to further understand the etiology and
pathophysiology of this disorder. She is currently supervisor of four masters students, eight
doctoral students and three postdoctoral students. She has extensive research experience
assessing and treating anxiety disorders, with a special interest in clinical and translational work
in childhood and adult PTSD.
Dr. Seedat has received several awards, including a World Federation of the Society of
Biological Psychiatry fellowship, a Lundbeck Institute fellowship in psychiatry, a Medical
Research Council mid-career award, a research fellowship from the University of California, San
Diego, an Anxiety Disorders Association of America career development travel award, and the
Humboldt research award in memory of Neville Alexander.
Dr. Seedat has co-authored more than 220 peer-reviewed journal articles and book chapters.
She is editor-in-chief of the Journal of Child and Adolescent Mental Health and serves on the
editorial board of the African Journal of Psychiatry, PLoS One, and Aids Research and
Treatment. She is a National Research Foundation B2-rated scientist.

Funeka B. Sokudela, MBBCh, MMed Psych, Dip Health

Systems Management
Head of Clinical Unit
Interim Head of the Forensic Mental Health Unit
Senior Clinical Manager
Forensic Psychiatrist
Department of Psychiatry, University of Pretoria & Weskoppies Hospital
Email: funeka.sokudela@up.ac.za

Dr. Funeka Sokudelas current areas of function are as clinical manager, senior lecturer,
researcher, research supervisor and consultant forensic psychiatrist. She has served as a
consultant specialist for mental health outreach services at the Tshwane District's Pretoria
North Clinic, and serves as a consultant for both the Gauteng Provincial Mental Health
Directorate and the National Department of Healths Forensic Mental Health Directorate. She is
on the South African National Task Team for Forensic Mental Health.
Dr. Sokudela has a wide range of interests including forensic psychiatry, public and community
mental health, health systems management, mental health and Deafness, and mental health
awareness. She is also an avid advocate for diversity training and anti-stigma sensitization in
post-apartheid South Africa. She is a Fellow of the Albertina Sisulu Executive Leadership
Programme in Health (ASELPH) a flagship programme run by the universities of Pretoria, Fort
Hare and Harvard (Schools of Health Systems and Public Health). She is a member of the South
African Society of Psychiatrist (SASOP) and has served in its Northern subgroup's management
committee and as a national convener of the Forensic Psychiatry Special Interest Group. Dr.
Sokudela is passionate about improving access for all to health care services in general and to

[17]
mental health care services in particular, especially for marginalized and vulnerable
populations. She believes that "there is no health without mental health."

Dan Stein, PhD, FRCPC, MBChB, BSc (Med)

Professor and Chair, Department of Psychiatry & Mental Health
Head of Division, Psychopharmacology & Biological Psychiatry
University of Cape Town
Director, Medical Research Council Unit on Anxiety Disorders
Visiting Professor of Psychiatry, Mt. Sinai Medical School
Cape Town, South Africa
Email: dan.stein@uct.ac.za

Dr. Dan Stein is interested in the psychobiology and management of the anxiety, obsessive-
compulsive and related, and traumatic/stress disorders. He has mentored work in other areas
that are of particular relevance to South Africa and Africa, including neuro-HIV/AIDS and
substance use disorders. Dr. Stein's work ranges from basic neuroscience, through clinical
investigations and trials, and on to epidemiological and cross-cultural studies. He is enthusiastic
about the possibility of clinical practice and scientific research that integrates theoretical
concepts and empirical data across these different levels. Having worked for many years in
South Africa, he is also enthusiastic about establishing integrative approaches to services,
training, and research in the context of a low and-middle-income country.
Dr. Stein has authored or edited over 30 volumes, including Cognitive-Affective Neuroscience
of Mood and Anxiety Disorders, and The Philosophy of Psychopharmacology: Smart Pills,
Happy Pills, Pep Pills. He has also contributed to many articles and chapters. Dr. Stein's work
has been continuously funded by extramural grants for more than 20 years. He is a recipient of
CINPs Max Hamilton Memorial Award for his contribution to psychopharmacology, and of
CINP's Ethics and Psychopharmacology Award for his contribution to the philosophy of
psychopharmacology.

Solomon Teferra, MD, PhD

Associate Professor of Psychiatry, Department of Psychiatry
College of Health Sciences, Addis Ababa University
Visiting Scientist, Harvard T.H. Chan School of Public Health
Harvard University, Boston, U.S.A
Consultant Psychiatrist and Addiction Psychiatrist
Zewditu Memorial Hospital, Addis Ababa, Ethiopia
President, Ethiopian Psychiatric Association (EPA)
Email: solomon.teferra@gmail.com
Currently, Dr. Teferra aids in directing a PhD Program in Mental Health Epidemiology, a
program jointly run by the Department of Psychiatry and School of Public Health at Addis Ababa
[18]
University. He lectures mainly on topics related to Addiction Psychiatry to Psychiatry Residents,
Medical Students, Emergency Medicine Residents, and Anesthesia students. He also runs an
Addiction Treatment Program at Zewditu Memorial Hospital, and is a member of the Executive
Committee of African Association of Psychiatrists and Allied Professionals. Dr. Teferra has
published articles in the journals BMC Psychiatry, Schizophrenia Research, Transcultural
Psychiatry and World Psychiatry.
Dr. Teferras research interests are mainly on epidemiology of severe mental disorders,
including course and outcome of schizophrenia; clinical trials for treatment resistant
schizophrenia; epidemiology and clinical aspects of substance abuse, indigenous
psychostimulants such as khat, substance abuse and severe mental disorders; and culture and
mental health. He is currently the Principal Investigator (PI) on a clinical trial of folate and B12
in patients with schizophrenia in Addis Ababa, which is part of a collaboration between Addis
Ababa University and the Division of Global Psychiatry at Massachusetts General Hospital.

Jimmy Volmink, BSc, MBChB, DCH, FRCP, MPH, DPhil, MASSAf

Dean, Faculty of Medicine and Health Sciences
Stellenbosch University
Posbus 241, Cape Town, Kaapstad, 8000
Francie van Zijl Drive, Rylaan, Tygerberg, 7505
South Africa
Phone: +27 21 938 9200
Email: jvolmink@sun.ac.za
Dr. Volmink has extensive experience in teaching Evidence-based Medicine and is working with
clinicians and policy makers to promote the use of research in decision-making. He has held
various specialist research positions at, amongst others, the Centre for Epidemiological
Research and the SA Cochrane Centre, where he reached the top ranks of Chief Specialist
Scientist and Director. During his career, he has published over 90 scientific articles in
accredited journals and contributed to a number of books, book chapters, and other
publications. Prof Volmink is regularly invited to deliver addresses at national and international
congresses and conferences, with media experience in SA and the USA. He is currently
chairperson of the Western Cape Provincial Health Research Committee and project leader of a
Stellenbosch Universitys multi-Faculty Food Security project.

[19]
 Dawit Wondimagegn, MD
Associate Director, College of Health Sciences
Associate Professor, Department of Psychiatry
Addis Ababa University
Tikur Anbessa, Fl. 1, Office 7
College of Health Sciences
Phone: +251 911-250-826
Email: dawitwondi@yahoo.com

Dr. Dawit Wondimagegn Gebreamalk is an Associate Professor of Graduate Medical Education

at the Department of Psychiatry and the College of Health Sciences in Addis Ababa University.
He is one of the early graduates of the Toronto Addis Ababa Psychiatry project, and is currently
completing a visiting professorship at the Department of Psychiatry at the University of
Toronto. Dr. Wondimagegns research interests include healthcare policy and service
development, psychotherapy adaptation, morality, and transcultural psychiatry.

Godfrey Zari Rukundo, MBChB, MMed Psych, FCAP, PhD

Head & Senior Lecturer, Department of Psychiatry
Mbarara University of Science and Technology
Child and Adolescent Psychiatrist
Mbarara Regional Referral Hospital
Email: gzrukundo@gmail.com

Dr. Godfrey Zari Rukundo is a Child & Adolescent Psychiatrist and Senior Lecturer in the
Department of Psychiatry at Mbarara University of Science and Technology and Mbarara
Regional Referral Hospital. Dr. Rukundo is a clinician, health sciences educator/trainer,
supervisor and mentor. He is a member of both the University Quality Assurance Committee
and the Kayanja Fellowship Committee at Mbarara University of Science and Technology.
Dr. Rukundo has more than ten years of experience in training/teaching and research, with
research interests in psychiatry, global health, HIV, psychoeducation, addiction, adolescent &
child psychiatry, and suicide prevention. He is also the current national coordinator of training
in Child and Adolescent Psychiatry in Uganda, with the aim of developing mental health services
for children and adolescents.

[20]
 Zukiswa Zingela, FCPsych, MMed Psych, MB ChB
Clinical Head & Specialist Psychiatrist, Department of Psychiatry
Dora Nginza Hospital, Eastern Cape Department of Health
Member, Anti-Stigma Team
South African Society of Psychiatrists

Zukiswa Zingela is involved in the supervision of multidisciplinary team community projects

focusing on psychoeducation of high school pupils on drug abuse, depression and suicide. She
is a member of the Anti-Stigma Team within the South African Society of Psychiatrists (SASOP)
organisation, and is a steering committee member advising youth treatment centre for
substance misuse, which opened in January of 2015.
Zukiswa is a Fellow of the College of Psychiatrists of South Africa(FC Psych (SA)), Master of
Medicine with Specialisation in Psychiatry(M Med (Psych)),(University of Pretoria) and has a
Bachelor of Medicine and Surgery(MB ChB) (Natal). Shas been a medical doctor for 21 years and
a specialist in psychiatry for the past 14 years. Between Jun 2003 and Feb 2008: she was a
Consultant Psychiatrist in National Health Service (NHS) Lancashire Mental Health Care Trust.

[21]
 Roy Abraham Kallivayalil, PALA
Secretary General, Indian Psychiatric Society Directive Board
World Psychiatric Association
Vice-Principal, Professor, & Head of Department of Psychiatry
Pushpagiri Institute of Medical Sciences
Phone: (944) 702-0020d
Email: ktm_roykalli@sancharnet.in

Professor Roy Abraham Kallivayalil has held an appointment as a WPA Secretary General since
2014. He also serves as President-elect of the World Association of Social Psychiatry, Chairman
of the Ethics Committee of the Indian Psychiatric Society, International Distinguished Fellowship
of American Psychiatric Association, a member of the Board of the Asian Federation of
Psychiatric Associations, a member of the American Psychiatric Association Caucus on Global
Mental Health, President of the National Alliance for Mental Health (NAMH) India, and a
member of the Central Working Committee, Indian Medical Association New Delhi.
Prof. Kallivayalil is the author of Suicide Prevention: A handbook for Community Gatekeepers,
published by National Alliance for Mental Health, India in 2009, and has authored and co-
authored over 36 scientific publications. He was an active research collaborator in both the
WHO Department of Mental Health Field Study for ICD-11 and the Indian Psychiatric Societys
multicentric study on assessment of health care needs of patients with severe mental illnesses.

[22]
 Rahn Bailey, MD, FAPA
President, National Medical Association
Professor & Chair of Department of Psychiatry
Wake Forest Baptist Medical Center
1 Medical Center Blvd
Winston-Salem, NC
Phone: (615) 327-6606
Email: rkbailey@wakehealth.edu
Rahn Bailey, M.D., is a national leader whose community-based programs focus on providing
care for the traditionally underserved and those with complex medical/psychiatric conditions.
He is widely known for his work in inpatient care, medical education, research, and forensic
evaluations. At Wake Forest Baptist Medical Center, he leads a team of full-time faculty,
residents and support staff that is tasked with enhancing and growing clinical, educational and
research programs in the department of psychiatry and behavioral medicine. He is a diplomat
of the American Board of Forensic Medicine, a Distinguished Fellow and membership chairman
of the American Psychiatric Association (APA), and a member of the American College of
Psychiatry. He has served as president and a member of the board of trustees of the National
Medical Association, and as president of the Tennessee State Psychiatric Association.
Dr. Bailey has a number of research grants, and is principal investigator on several studies
including the Adult Continuum Care Grant, SISTER (Supported Intensive System of Treatment
Empowerment and Recover) program, Rainbow Unit Grant, Adolescent and Family Treatment
Program, Adolescent Day Treatment Grant, and many others. He has authored numerous
publications including a book, A Doctors Prescription for Healthcare Reform.

Christina Borba, PhD, MPH

Assistant Professor, Boston University School of Medicine
Director of Research, Department of Psychiatry, Boston Medical Center
Doctors Office Building
720 Harrison Avenue, Suite #1150
Boston, MA 02118
Phone: (617) 414-1915
Email: Christina.Borba@bmc.org

Christina P.C. Borba, PhD, MPH has extensive experience in mixed methods research, teaching
and training, and development and management of randomized clinical trials. Her current
[23]
research focuses on psychotic disorders and cultural psychiatry in low-resourced settings in the
US and abroad, womens mental health, and gender differences in care.
Dr. Borba is currently examining socio-cultural aspects of schizophrenia in Ethiopia with a goal
of understanding why the disease prevalence ratio has been found to be 5:1 male to female (a
statistic unlike any other in the world). She is also involved in ongoing efforts in Liberia to
increase local research capacity with the University of Liberia, and to identify and conduct
priority mental health-related research with in-country academic leaders. At Boston Medical
Center, she works to expand departmental research capacity through research education
initiatives for residents and medical students, mentorship of junior faculty, new faculty
recruitment and the expansion of research infrastructure capacity within the department. She
supervises and provides research-related trainings for all research teams within the
Department of Psychiatry.
Dr. Borba has co-published several peer-reviewed articles and first authored two book
chapters. She is the recipient of the New Clinical Drug Evaluation New Investigator Award from
the National Institute of Mental Health. She received her doctorate in public health from Emory
University and her masters degree in public health from Boston University. She has lectured on
qualitative methods and has taught masters-level courses at Emory on research methods and
statistical analysis in the field of behavioral sciences. Prior to her doctorate, Dr. Borba managed
the efforts of a cross-functional research team including research coordinators, student interns,
and fellows, while being responsible for several clinical randomized control trials.

Nancy Carter
Co-Founder & Former Executive Director
NAMI Urban Los Angeles
Member, Boards of Directors
Mental Health America California
NAMI Westside LA & Step Up on Second
Phone: (310) 850-9332
Email: nancy@nancyccarter.com

Ms. Carter has made a name for herself as a family advocate, nationally renowned lecturer and
champion of the rights of those suffering with brain disorders. In her early career with the
entertainment industry, she worked as a guide at the United Nations. Disappointed at the lack
of female and minorities in the entertainment industry, Ms. Carter moved to Los Angeles and
started her own talent agency. After her son was diagnosed with bipolar disorder, Ms. Carter
left the entertainment industry and began her career in mental health advocacy. In 2003 she
started the Urban Los Angeles chapter of NAMI. In 2007 she received the Family Advocate
Award from the LA County Board of Supervisors and the NAMI California Consumer of the Year
Award of Excellence. She has received numerous other awards including: the Outstanding
Contributions in Mental Health from SHARE. Ms. Carter served on the NAMI California Board of
Directors as well as the NAMI National Board and in 2008 received the award for Outstanding
Service.

[24]
Ms. Carter has headlined lectures for the LA County Department of Mental Health, California
Annual Law Enforcement and Mental Health Conference, Southern California Black Psychiatrists
Association and the National Association of Black and Hispanic State Legislators. She has
appeared on BET, Power 106, 92.3 the Beat and PBS, and was featured in a special section on
mental health in the Los Angeles Times magazine. Ms. Carter has travelled around the world
with her Roots of Healing project which will bring together traditional healing practices with
Western medicine. She is currently working on her first book entitled, Brain Flu.

Pamela Collins, MD, MPH

Director, Office for Research on Disparities and Global Mental Health
National Institute of Mental Health
Room 7213, 6001 Executive Boulevard
Rockville, MD 20852
Phone: (301) 443-2847
Email: pamela.collins@nih.gov

Dr. Pamela Collins is the director of the Office for Research on Disparities and Global Mental
Health at the National Institute of Mental Health (NIMH). She has played a leadership role in
setting the global mental health research agenda through NIMHs sweeping Grand Challenges
in Global Mental Health effort. This project began in 2010, bringing together experts from more
than 60 countries to set research priorities to address the mental health treatment gap. The
results of this initiative were published in Nature in July 2011. The work led to the NIMH
funding a set of global mental health research hubs, which were described in the May 11, 2014
edition of The Lancet. Dr. Collins has worked to raise the profile of global mental health issues
and provide much-needed support, which has led to significant progress in the field.

Dr. Collins retains a faculty appointment at Columbia University in the College of Physicians &
Surgeons, Department of Psychiatry and the Mailman School of Public Health. Over the past 15
years, Dr. Collins work has focused on the mental health and psychosocial aspects of the AIDS
epidemic in the United States and Sub-Saharan Africa. In the U.S., her studies have addressed
social stigma related to mental illness, ethnicity, and women's HIV risk; the HIV prevention
needs of women of color with severe mental illness; and the mental health needs of African
immigrants living with HIV. She has conducted training of health care providers in mental health
and HIV/AIDS transmission, prevention, and counseling in Argentina, Zambia, Uganda, Rwanda
and South Africa. In South Africa, Dr. Collins's research examined the role of mental health care
providers in the development of HIV interventions in psychiatric settings. Today, she continues
to study the integration of HIV and mental health services in sub-Saharan Africa.

[25]
 Lori B. Chibnik, PhD, MPH
Assistant Professor & Associate Biostatistician
Department of Epidemiology, Harvard T.H. Chan School of Public Health
Channing Division of Network Medicine, Brigham and Women's Hospital
Department of Medicine, Harvard Medical School
Program in Medical and Population Genetics, Broad Institute
Kresge 902, 677 Huntington Ave, Boston, MA 02115
Phone: (857) 498-1849
Email: lchibnik@hsph.harvard.edu, lori@broadinstitute.org

Lori Chibnik, PhD, MPH is a biostatistician and Assistant Professor with a joint appointment in
the Department of Epidemiology at the Harvard T.H. Chan School of Public Health and the
Department of Medicine at the Harvard Medical School. She received her MPH in International
Health and her PhD in biostatistics from the Boston University where she worked on predictive
modeling methods for disease risk. Over her career she has developed and assessed predictive
models for diseases such as HIV, pre-natal screening and autoimmune diseases and continues
to apply her methods to various diseases.
Dr. Chibniks current research focuses primarily on genetics and genomics of Alzheimers
disease and dementia with an emphasis on longitudinal cohorts. In addition to her research,
she is internationally renowned for her training programs and innovative teaching techniques,
having developed multiple courses in biostatistics for varied audiences, most recently a series
specific to the needs of scientists in sub-Saharan Africa. Currently she directs the global
neuropsychiatric genetics training program at the Harvard-Chan School and the Broad Institute
of Harvard and MIT.

Michelle P. Durham, MD, MPH, FAPA

Child & Adolescent Psychiatrist, Boston Medical Center
Associate Residency Director, General Psychiatry
Instructor, BU School of Medicine
850 Harrison Ave, Dowling 7
Boston, MA 02118
Phone: (617) 414-7501
Fax: (617) 414-5520
Email: Michelle.Durham@bmc.org

Michelle Durham, MD, MPH is a Board Certified Adult, Child and Adolescent Psychiatrist and
the Associate Training Director for the General Psychiatry Residency at Boston University/
Boston Medical Center. She received her medical degree from Louisiana State University in New
Orleans, LA, completed her residency training at Boston University/Boston Medical Center and
completed her child and adolescent psychiatry fellowship at Yale New Haven Hospital in New
Haven, Connecticut. She received her Masters in Public Health at the Emory Rollins School of

[26]
Public Health in Atlanta, GA. Dr. Durham joined the medical staff and faculty at Boston
University Medical Campus in 2014.
Prior to completing her medical education, Dr. Durham worked as the Assistant Director for the
Center of Excellence on Health Disparities at the Morehouse School of Medicine in Atlanta, GA
under the leadership of Dr. David Satcher, former U.S. Surgeon General. She is involved at the
state and national level in the Massachusetts Psychiatric Society, American Psychiatric
Association and American Academy of Child and Adolescent Psychiatry to improve the standard
of care for children and adolescents. Dr. Durhams interests lie in advocacy, mental healthcare
integration into the primary care setting, health disparities and training/education. She
provides consultation to school based health centers in Boston high schools and is skilled in the
assessment and treatment of African American and Latino populations and has a special
interest in access for minorities to mental health care. She is the consulting psychiatrist for the
TEAM UP Initiative to bring integrated care to pediatrics in urban community health centers.

Gregory Fricchione, MD
Director, Chester M. Pierce, MD Division of Global Psychiatry
Director, Massachusetts General Hospital Division of Psychiatry & Medicine
Director, Benson-Henry Institute for Mind Body Medicine
Professor of Psychiatry, Harvard Medical School
Associate Chief, Massachusetts General Hospital Department of Psychiatry
Email: Fricchione.Gregory@mgh.harvard.edu
Assistant: James Hills, jhills1@partners.org

Dr. Gregory Fricchione founded the International Psychiatry Division in 2003 with Dr. Chester
M. Pierce and served as its Director until 2009, reassuming the role in November of 2015. He is
an active researcher and has published more than 130 journal articles, making important
original contributions to the treatment of patients with catatonia and to the management of
cardiac patients who suffer from co-morbid psychiatric conditions. He is co-author of four
books on topics including general hospital psychiatry, catatonia, the connection between
depression and heart disease, and stress physiology. He also authored the book Compassion
and Healing in Medicine and Society on brain evolution and the relationship between
separation and attachment, and its importance for medicine and the human experience. Most
recently, Dr. Fricchione has been studying neurobehavioral mechanisms underlying diseases
that connect the mind and body. He has been a reviewer for many major medical journals.
Prior to MGH, Dr. Fricchione worked at the Brigham and Womens Hospital in Boston as
Director of the Medical Psychiatry Service from 1993 to 2000 and as Director of Research at the
Mind/Body Medical Institute from 1998 to 2000. He worked at the Carter Center at Emory
University in Atlanta, Georgia from 2000-2002, where he directed the Rosalynn Carter
Fellowships in Mental Health Journalism, and worked closely with former President Jimmy
Carter and Mrs. Rosalynn Carter on international public mental health issues and policy. This

[27]
included clinical and public mental health training projects in Ethiopia, where he also served as
a Visiting Professor of Psychiatry at Addis Ababa University.

David C. Henderson, MD
Professor and Chair, Department of Psychiatry
Assistant Dean of Diversity and Multicultural Affairs
Boston University School of Medicine
Psychiatrist-in-Chief, Department of Psychiatry, Boston Medical Center
Email: David.henderson@bmc.org
Assistant: Amandeep Sangha, Amandeep.Sangha@bmc.org

Dr. David C. Henderson is Chair of Psychiatry at the Boston University School of Medicine and
Chief of Psychiatry at Boston Medical Center. He is the Co-Director of the NIMH T32 Global
Psychiatric Clinical Research Training Program at Massachusetts General Hospital (MGH) and
Professor of Epidemiology at Harvard School of Public Health. He served as Director of the
Chester M. Pierce, MD Division of Global Psychiatry at MGH from 2009 to 2015.
Dr. Hendersons main research interests are psychopharmacological and antipsychotic agents in
the treatment of schizophrenia, impacts of antipsychotic agents on metabolic anomalies and
glucose metabolism, and ethnic and cultural psychiatry. He also studies trauma in areas of mass
violence and develops programs to assist vulnerable populations. In addition, he provides
technical assistance to governments and organizations on mental health policy and planning
most recently, for the Republic of Liberia in collaboration with the Ministry of Health and
builds global partnerships that increase local clinical, research and training capacity in resource-
limited settings. He has worked in international and conflict-affected areas for the past 18 years
in places such as Cambodia, Ethiopia, Iraq, Japan, New York City (post-9/11), Peru and Uganda,
among others.
Dr. Henderson has published numerous journal articles in the Archives of General Psychiatry,
American Journal of Psychiatry, British Journal of Psychiatry and Biological Psychiatry. He is
editor of the International Journal of Culture and Mental Health. He has lectured extensively in
the United States and internationally on schizophrenia, treatment-resistant schizophrenia,
metabolic disorders and schizophrenia, psychopharmacology, ethnopsychopharmacology,
trauma, and cultural psychiatry.

[28]
 Karestan C. Koenen, PhD
Professor, Department of Epidemiology
Harvard T.H. Chan School of Public Health
Kresge Building, Suite 505
677 Huntington Avenue, Boston, MA 02115
Email: kkoenen@hsph.harvard.edu

Karestan Chase Koenen, PhD does research and teaches about trauma and posttraumatic stress
disorder (PTSD). The broad goal of her work is three-fold. First, she studies why, when exposed
so a similar traumatic event, some persons develop PTSD while others are resilient. She is
particularly interested in how genes shape risk for PTSD. Much of this work is done through the
PTSD working group of the Psychiatric Genomics Consortium that she co-leads with Kerry
Ressler and Israel Liberzon. Second, she investigates how trauma and PTSD influence weight
gain and alter long-term physical health including chronic diseases such as cardiovascular
disease and type-2-diabetes. Third, she documents global burden of trauma and PTSD through
her work with the World Mental Health Surveys.
Dr. Koenen also advocates for victims of sexual violence. In May 2011, Dr. Koenen testified
before the House Foreign Affairs Full Committee about the epidemic of sexual violence and
victim blaming culture of the Peace Corps. She has written for the Boston Globe, the
Washington Post, the Huffington Post, and the Womens Media Centers Women Under Siege
Project, a journalism project founded by Gloria Steinem that investigates how rape and other
forms of sexualized violence are used as tools in conflict. Dr. Koenen also consulted with award-
winning documentary filmmaker Lisa Jackson on the film It Happened Here, which investigates
the epidemic of sexual assault on university campuses.

William Lawson, MD, PhD, DLFAPA

Associate Dean for Health Disparities
Dell Medical School, The University of Texas at Austin
Director of Community Health Programs
Sandra Joy Andrson Center
Director of Health Disparities Policy and Research
Austin Travis County Integral Care
Email: William.lawson@austin.utexas.edu

Dr. Lawson is Associate Dean for Health Disparities at the Dell Medical School and Director of
Community Health Programs and Professor at Huston-Tillotson University, where he leads the
Sandra Joy Anderson Community Health and Wellness Center. He is also UT Austin's
institutional representative for the Health Disparities Education, Awareness, Research and
Training (HDEART) Consortium. He recently left a 15-year position as Professor and Chairman of

[29]
the Department of Psychiatry and Behavioral Sciences at Howard University, and is an Editor at
the Journal of the National Medical Association.
Dr. Lawson has held numerous senior positions and received national recognition, including
past President of the DC chapter of Mental Health America, Past President of the Washington
Psychiatric Society, past Chair of the Section of Psychiatry and Behavioral Sciences of the
National Medical Association, and past president of the Black Psychiatrists of America. He
received the American Psychiatric Foundation Award for Advancing Minority Mental Health, the
2014 Solomon Carter Fuller Award by the American Psychiatric Association, the National
Alliance for the Mentally Ill Exemplary Psychiatrist and Outstanding Psychologist Awards, the
Jeanne Spurlock Award from the American Psychiatric Association, and he E.Y. Williams Clinical
Scholar of Distinction Award from the NMA. He has over 200 publications and has continuously
received federal, industry, and foundation funding to address mental and substance abuse
disparities.

Samuel O. Okpaku, MD, PhD

Executive Director
Center for Health, Culture and Society
1233 17th Avenue South
Nashville, TN 37212, USA
Phone: (615) 329-4182
Fax: (615) 327-9399
Email: sam.okpaku@gmail.com

Dr. Samuel Okpaku is a Nigerian-born psychiatrist and currently the Executive Director of the
Center for Culture Health and Society. Previously, he served as Chairman and Professor within
the Department of Psychiatry at Meharry Medical College and a Clinical Professor of Psychiatry
at Vanderbilt University Medical School. He holds a PhD in Social Welfare Research from the
Heller School at Brandeis University.
Dr. Okpakus research interests have included psychotherapy, reduction of disability, quality of
life issues, depression, culture and social factors in mental health and illness. His interest and
involvement in Global Mental Health derive from several factors. He has a strong interest in
culture, having either studied or worked in a variety of countries and cultures, and is sensitive
to the issues of poverty as it relates to mental health and equality. He continues to work in the
areas of health disparities and global psychiatry, and works to promote the relevance of cultural
psychiatry in mitigating current and future global socio-political conflict and crises, and post-
conflict reconciliation and reconstruction.
Dr. Okpaku has written and edited a number of books, including Sex, Orgasm and Depression
and Their Interrelationship in a Changing Society, Clinical Methods in Transcultural Psychiatry

[30]
(editor) and Mental Health in Africa and America Today (editor). He has also lectured nationally
and internationally, and published numerous professional and academic papers.

David Satcher, M.D., Ph.D. FAAFP, FACPM, FACP

Former Surgeon General of the United States of America
Director, National Center for Primary Care
Director & Founder, Satcher Health Leadership Institute
Co-Founder, African American Network Against Alzheimers
Morehouse School of Medicine
720 Westview Drive, SW
Atlanta, GA 30310

Dr. David Satcher was appointed director of the Centers for Disease Control and Prevention in
1993, and in 1998 he was appointed surgeon general by President Bill Clinton. Dr. Satcher has
received many awards throughout his career, including the New York Academy of Medicine
Lifetime Achievement Award (1997) and the Jimmy and Rosalynn Carter Award for
Humanitarian Contributions to the Health of Humankind (1999).
After graduating from Morehouse College in 1963, Dr. Satcher studied medicine at Case
Western Reserve University. In 1970, he earned both a medical degree and a Ph.D. in
chromosome genetics from the university. In 1982, Dr. Satcher became the president of
Meharry Medical College in Nashville, Tennessee. He moved onto the national stage in 1993,
when he accepted the directorship of the Centers for Disease Control and Prevention. Dr.
Satcher held this post until 1998.
In 1997, President Bill Clinton nominated Dr. Satcher to be the 16th surgeon general of the
United States. Dr. Satcher was confirmed as surgeon generala job that involves steering the
national policy for public healthin February 1998. He also became an assistant secretary for
health in the Department of Health and Human Services, a position he would hold until January
2001. While serving as surgeon general, Dr. Satcher worked to improve access to health care
and addressed health concerns such as obesity. He also identified suicide as a national health
crisis. In 1999, Dr. Satcher issued a call to action, saying the country must "put into place
national strategies to prevent the loss of life and the suffering suicide causes." He remained in
the surgeon general's office until 2002. After leaving his post as surgeon general, he became
the director of the National Center for Primary Care at the Morehouse School of Medicine. He
stepped in to serve as the president of the medical school two years later.
In 2008, Dr. Satcher created the Satcher Health Leadership Institute within the Morehouse
School of Medicine. He serves as its director, overseeing programs on sexual health, disease
prevention, mental health and the health needs of underserved communities. Dr. Satcher is the
author of the 2005 clinical guide Multicultural Medicine and Health Disparities.

[31]
 Eliot Sorel MD, DLFAPA
Senior Scholar, Office of Clinical Practice Innovations
Clinical Professor, Global Health & Psychiatry
George Washington University
Founder & Chair, World Youth Democracy Forum
Elliott School of International Affairs
Phone: +001 (202) 293-2112
Email: esorel@gmail.com
Eliot Sorel, MD is an innovative global health leader, educator, health systems performance
expert, and a practicing physician. A practicing physician, Dr. Sorel works collaboratively with
primary care and public health colleagues. The innovative total health approach, a primary care,
mental health, and public health collaborative integrated model, was initiated by Dr. Sorel at
the WPA 2013 Bucharest Congress, as a means of enhancing quality, access, and sustainability
of care, particularly as pertains to comorbid, non-communicable diseases that lead in the global
burden of disease and disability. He developed and led health systems, has taught and
consulted in Africa, Asia, Americas & Europe. He initiated and led Depression & Comorbidity in
Primary Care in China, India, Iran, Romania, & Slovenia, a clinical public health research project;
also initiated a health systems performance collaborative comparing global health systems
performance in Africa, Asia/Pacific, Europe, and the Americas.
Dr. Sorel co-chaired the scientific committee of the WPA International Congress on Primary
Care Mental Health: Innovations & Trans-Disciplinarity at the Palace of Parliament and cosigned
the WPA Bucharest statement on collaborative & integrated care adopted at the congress. He
serves on the Oversight Committee of the US Health Disparities Transdisciplinary Collaborative
Center at the Satcher Health Leadership Institute with a focus on non-communicable diseases
in Region 4 of the United States. He is author and coauthor of over sixty scientific papers and
seven books, and has received Doctor Honoris Causa degrees from Carol Davila Medical
University and the Politehnica University, both of Bucharest, Romania. The President of
Romania decorated Dr. Sorel with the Star of Romania Order of Commander in January of 2004.

Altha Stewart, MD
Director, Center of Excellence for Health in Justice Involved Youth
Associate Professor, Department of Psychiatry
University of Tennessee Health Science Center
225 920 Madison Building, 920 Madison Avenue
Memphis, TN
Phone (901) 448-4266
Email: astewa59@uthsc.edu
Altha Stewart, MD is an experienced healthcare administrator and nationally recognized expert
in public sector and minority issues in mental health care. She is a founding member of the

[32]
Board of Directors of the ACEs Awareness Foundation and FACES of Memphis, and currently
chairs the Department of Childrens Services (DCS) interagency collaboration that develops
coordinated service plans for youth in DCS or Juvenile Court custody. Dr. Stewart is vice-chair of
the Memphis/Shelby County Juvenile Justice Board, a cross system advisory body that works
collaboratively in a community partnership seeking program improvements and policy changes
to address the emerging and changing needs of youth that are at risk of delinquency.
Dr. Stewart served as the Shelby County team lead on the recently completed
SAMHSA/MacArthur Foundation funded grant, Improving Diversion Policies and Programs for
Justice Involved Youth with Behavioral Health Disorders, as well as the Reducing Racial and
Ethnic Disparities (RED) Certificate Program awarded to Shelby County and sponsored by the
Center for Juvenile Justice Reform at Georgetown University and the Center for Childrens Law
and Policy.
An invited participant at the White House Conference on Mental Health, Dr. Stewart is the
recipient of numerous awards and honors including the NAMI Exemplary Psychiatrist Award,
Pathfinders in Medicine Award from Wayne State University in Detroit, and the American
Psychiatric Associations Alexandra Symonds Award. Dr. Stewart is Secretary of the American
Psychiatric Association and is past president of the American Psychiatric Foundation, the
Association of Women Psychiatrists and the Black Psychiatrists of America.

Consul General Teddy B. Taylor

United States Diplomat & Consul General
Cape Town, South Africa
Minister Counselor, Senior Foreign Service
Previous Ambassador to Papua New Guinea, Solomon Islands & Vanuatu
Phone: +27 (21) 702-7300
Fax: +27 (21) 702-7493
Email: consularcapetown@state.gov

Teddy B. Taylor currently serves as the U.S. Consul General in Cape Town, and has held this
position since September of 2014. Mr. Taylor is a native of Washington, D.C. and a career
member of the Senior Foreign Service holding the rank of Minister Counselor. In a diplomatic
career spanning three decades, Mr. Taylor has served tours in Latin America, Europe, the
Caribbean, the South Pacific, and now Africa. He most recently completed a two year
assignment as a Diplomat in Residence at Howard University in Washington, D.C.
In 2009, Mr. Taylor was nominated by President Barack Obama and confirmed by the U.S.
Senate as United States Ambassador to Papua New Guinea, the Solomon Islands and the
Republic of Vanuatu, serving from 2009-2012. Prior to his Ambassadorial posting, he served as
Principal Deputy Assistant Secretary of State for Human Resources in the Department State. He

[33]
has also served tours at the Foreign Service Institute, the Bureaus of Consular and Latin
American Affairs in the Department of State, and a detail assignment to the former United
States Information Agency. Specializing in consular affairs, Ambassador Taylor is the recipient of
numerous professional awards including the Department of States prestigious Barbara Watson
Award for Consular Excellence. He was a member of the forty-sixth Senior Seminar; the
Department of States premiere leadership training program and his foreign languages are
Spanish, Turkish, and Hungarian.

[34]
 Panel Summaries

1. The Intersection of Policy and Research

Co-Chairs: David Ndetei, Solomon Rataemane, Eliot Sorel

Evidence Based Medicine to Policy - What works?

Jimmy Volmink, BSc, MBChB, DCH, FRCP, MPH, DPhil, MASSAf | South Africa

[35]
 Translating Scientific Evidence into Global Health Policy:
Making Mental Health Count for Individuals and Populations Health
Eliot Sorel, MD, DLFAPA & Rahn Bailey, MD, FAPA | USA

ABSTRACT
Scientific evidence in all sciences, inclusive of the brain and neurosciences, as well as in
assessing health systems performance is rapidly evolving in the 21st century. This new evidence is
augmenting the understanding of the brain and its functions, its transactions with the human genome,
the immune system, the microbiome, the social determinants of health, and the dominant global
burden of diseases presented by non-communicable diseases, inclusive of mental disorders, and their
comorbidities. Together they are stimulating new research and innovation in addressing the challenges
of primary, secondary and tertiary prevention continuum as well as the current health systems
fragmentation. The author presents contemporary scientific evidence, its impact on developing Total
Health models of integrated health systems, and its translation into global health policy to benefit
individuals and populations health.

Key words: TOTAL health, scientific evidence, translation, global health policy

[36]
1

Translating Scientific Evidence into Global Health Policy:

Making Mental Health Count for Individuals and Populations Health
Eliot Sorel, MD, DLFAPA & Rahn Bailey, MD, FAPA | USA
Bridging the KnowDo Gap: Knowledge Translation in Global Health
Bridging the knowdo gap is one of the most important challenges for public health in this
century. It also poses the greatest opportunity for strengthening health systems and ultimately
achieving equity in global health.
Knowledge translation (KT) is emerging as a paradigm to learn and act towards closing the gap.
While knowledge is more than research evidence, knowledge translation strategies can harness
the power of scientific evidence and leadership to inform and transform policy and practice.
There are pioneering efforts as well as new initiatives in various developed and developing
countries with respect to knowledge translation. Countries (policy-makers, health workers,
researchers and the community) can work together and share experiences and lessons in
bridging the gap.
Although there are ongoing innovations and learning by doing, there is still no comprehensive
framework or common platform for better understanding the know do gap and systems to
address it.

World Health Organization (WHO) Comprehensive mental health action plan 20132020 was adopted
by the 66th World Health Assembly. The four major objectives of the action plan are to:

Strengthen effective leadership and governance for mental health.

Provide comprehensive, integrated and responsive mental health and social care services in
community-based settings.
Implement strategies for promotion and prevention in mental health.
Strengthen information systems, evidence and research for mental health.

Goal: To promote mental well-being, prevent mental disorders, provide care, enhance recovery,
promote human rights and reduce the mortality, morbidity and disability for persons with mental
disorders.

1. Life-Course approach: Policies, plans, and services for mental health need to take account of
health and social needs at all stages of the life course, including infancy, childhood, adolescence,
adulthood and older age.
2. Multisectoral approach: A comprehensive and coordinated response for mental health requires
partnership with multiple public sectors such as health, education, employment, judicial,
housing, social and other relevant sectors as well as the private sector, as appropriate to the
country situation.
3. Empowerment of persons with mental disorders and psychosocial disabilities: Persons with
mental disorders and psychosocial disabilities should be empowered and involved in mental
health advocacy, policy, planning, legislation, service provision, monitoring, research and
evaluation

[37]
 1

Innovative approach to integrate research, policy statements, & implementations

David M. Ndetei, MD, PhD | Kenya
While research is vital to inform policy for any service including mental health services, it is
critically important to understand that research and its findings, no matter how scientifically solid they
may be, do not necessarily translate to policy, and policy development does not necessarily lead to
policy implementation. Indeed it has been said it takes an average of 17 years for research findings to
translate to policy implementation. To me the biggest challenge is how to minimize the time gap
between research findings and policy recommendations on one hand, and policy implementation on the
other hand. For example, the WHO Mental Health Action Plan, 2013 2020, gave us a 7 year window
to achieve certain policy implementation practices. We must remind ourselves that we have only about
3 years to go. To me one of the most critical innovations that we must come up with is how best to
synchronize the timing of research findings, policy recommendations and policy implementation, so that
to the extent possible, the three of them are part of an integrated process occurring more or less at the
same time. We must therefore take at least three approaches:
1. Involve the key stakeholders in the development of our research, participatory discussions on policy
issues and the implementation of the policy issues. In our experience, this can be done through
participatory theory of change.
2. Recognize the fact that different stakeholders have different key roles to play. The consumers of
the services i.e. the communities are key and we must never assume that they do not know what is
best for them, and what is acceptable to them social- economically and social-culturally. We must
therefore never take a top down approach on what is best for them. There are numerous examples
where this does not work and can be counterproductive even with the best science to back it.
Science must be contextualized. In this regard, it is also important to realize that consumers have a
power that policy makers do not have: they know their rights, and, above all, they have the votes.
3. At the level of implementation, we should recognize that there are other very demanding health
and national issues, some of which have no scientific basis other than common sense; which rightly
compete for resources from very limited pool of money which more often than not is dwindling. We
should therefore never assume that science alone can be the bargaining chip. Economic language
may work better than scientific language, consumer voice may be louder than our voice.
Look at this scenario: The minister for health has several advocates of different health disciplines,
literally shouting at him/her, how each one of them needs priority. It is therefore human for him/her to
be confused. When eventually he/she sorts out his/her confusion, he/she goes to the Minister of
Finance who has the money, who in turn has several ministries shouting at him/her on their own
priorities. Eventually the minister goes to the cabinet and the executive who too have their own
political priorities. We must be innovative in the way in which we present our case. It is becoming
increasingly clear that economic language very clearly stated, is the one that will take the attention. For
example something like this: for every 1 dollar you put in terms of a service, you get back into the
economy 4 dollars. In the case of Kenya, we are extremely lucky in that health services have been
devolved to 47 counties, with most of the policies that matter at operational level being determined and
acted upon at that level. Using Makueni County in Kenya, we have been able to demonstrate that the
principals outlined above are not theoretical, but can be implemented. In a span of less than 5 years of
AMHF involvement, Makueni County Government is funding mental health services, fully on tax payers
money.

[38]
1

Translating research into policy: the case of rheumatic heart disease

Bongani Mayosi, PhD | South Africa

[39]
 2. Service Delivery Models
Co-Chairs: Greg Fricchionne & Mashadi Motlana

African Academic Psychiatry Departments and their Role in Services Delivery

Dawit Wondimagegn, MD | Ethiopia

[40]
 The Modern African Psychiatric Hospital Setting
Godfrey Zari Rukundo, MBChB, MMed Psych, FCAP, PhD | Uganda

Overview
Hospitals and healthcare have come a long way, from ancient sleeping temples in which
treatment was mainly by hypnosis and chanting, to the modern or semi-modern hospitals and treatment
modalities we see today. Similarly, physicians and other health workers have also evolved over the years
through further training and exposure to the current super-specialized personnel we have in many
centers. This evolution is continuing to the future. Different countries and different hospitals are at
different phases of evolution. Each stage has its advantages and disadvantages. At the same time, there
are different challenges and opportunities.
Characteristics of a Modern Hospital
A hospital is described as modern or not depending on the stage of evolution or development at
which it is. Different countries and regions may have different descriptions of what they may call a
modern hospital. In each area/region the more sophisticated hospital or one with most of the
characteristics described here below is considered to be modern. Some of the parameters looked at in
designating a hospital as modern include: 1. Exterior and interior design of the building, 2. Availability of
well-furnished private rooms, 3. Sufficient office space and consultation rooms, 4. Availability of
banking facilities, restaurants, groceries, etc, within the hospital premises or close to it, 5.
Vegetation/flower areas in the hospital, 6. A Quiet neighborhood, 7. Availability of library materials for
patients and visiting family members, 8. Enough parking space, 9. Availability of sophisticated
technology, and 10. Availability of staff with appropriate training and emotional intelligence.
In Africa, the concept of a modern psychiatric hospital may not differ from the concept in other
regions and there may be several variations. For example, someone may refer to modern psychiatric
hospital as one in which western medications and other treatments are offered. In this case, it would be
compared to traditional health practices being offered by none trained healers in their homes or
shrines. In addition, the concept could mean a hospital where the patient does not need to have an
attendant or a relative with him/her when he/she is unwell.
In Africa, the psychiatric hospitals or wards are isolated from the rest of the other hospitals or
departments, patients put on uniform, in some centers, mentally ill patients are treated as criminals
against their will, and there is no clear legal framework for protection
Reflection
As we advocate for modern psychiatric hospitals and services in Africa we need to consider answers
to the following questions.
1. What therapeutic environment can be offered?
2. What is the importance of family involvement in patient care?
3. How efficient and effective are specialized services like occupational therapist, psychologist,
peer support work, psychiatrist, social worker, legal representative?
4. Where is the place of spiritual intervention in the modern psychiatric hospital?
5. Can we have a hybrid of a modern psychiatric hospital in Africa?
6. Can we also stop the tendency of copying interventions from other countries without
considering local appropriateness?

[41]
 On the Intricacy of Developing, Institutionalizing, and Implementing
Mental Health Strategies at the National Level
Tedla Giorgis, PhD | Ethiopia

Ministries of Health (MOHs) and Mental Health

Ministries of Health (MOHs) are faced with many conflicting demands, and often prioritize a few
disorders rather than taking a comprehensive public health approach. These institutions grapple with
chronic underfunding, unstable political contexts, high disease burdens, inadequate human resources,
and inefficient allocation, all of which continuously challenge health systems in low-income countries. In
the face of a large disability burden in these countries relative to diabetes, asthma, and cardiovascular
disease, mental disorders are often not addressed in NCD agendas.

Developing Mental Health Policies and Strategies

MOHs national plans inadequately address mental health, partly because of limited internal
planning and partly because of a lack of country donor requirements for the inclusion of mental health.
Strategies to overcome these barriers include understanding the organizational structure of the MOHs,
such as processes for development and chaperoning of strategies; identifying crucial directorates, such
as Policy and Plan, Resources Mobilization, and HMIS; and including these directorates in the integration
of mental health. It is also crucial to identify and nurture advocacy organizations and other champions
within and outside MOHs. Due to a lack of internal capacities in knowledge on mental health,
organizations such as Universities and NGOs provide important external support. We must integrate
with and leverage these organizations, including allocating finances to existing MOH health priorities.
In addition, it is imperative that we attach mental health to the overall NCD agenda, anchoring
these topics in the NCD directorate. Mental health must be reflected in the strategy document, for the
purpose of resource mobilization, budgeting and allocation. Strategies to address mental illness should
be multisectoral, requiring a holistic approach and strengthening of intersectoral linkages, especially
with faith-based institutions. Mental health must be included in the basic package of essential health
services, especially those delivered by primary care with limited expenditure. In addition, planned and
periodic events should be developed to remind stakeholders of these issues, such as the Ethiopia:
Annual National Mental Health Symposium and World Mental Health Day.

Implementation and Scaling Up of Mental Health Programs

Lessons learned in Ethiopia from their scaling up of mental health services in health centers using
WHOs mhGAP approach include:
1. Scaling up should be closely coordinated between the MOHs (to provide guidance and possible
financial support), Regional Health and Zonal Health Bureaus (to own and supervise the scaling up),
local universities (to provide supervision)
2. Progress report should be planned to measure progress and ensure accountability
3. Ownership should be clearly defined (resting with the Regional Health Bureaus for sustainability)
4. Conduct drug quantification to procure psychotropic medications (complex process to predict)
5. As the training of mhGAP was limited supplement with strong sustained supervision
6. Be careful with rapid scaling-up without increasing awareness ensuring referrals (referrals from
various sources have to be strengthened such as families, Health Extension Workers, etc. (E.g.,
scaling up in 160 Health Centers in one year had ramifications)

[42]
7. Sustainability of continued supervision and supplies of medication should be negotiated with
Regional or Zonal Health Bureaus ahead of time

Institutionalizing Mental Health Programs

According to HE Dr. Kesetebirhan Admasu, Minister of Health of Ethiopia (Presentation at the
World Bank/World Health Organization Solving the Grand Challenges in Global Mental Health:
Maintaining Momentum on the Road to Scale Up, April 15, 2016:

1. Integrate mental health in primary health care services mental health should be part and parcel
of the primary health care delivery system, rather than a stand-alone stigmatized service.
2. Political commitment policy makers should be committed to developing policies and strategic
plans and wield their political capital to promote mental health, rather address mental health in
an ad hoc manner.
3. Country ownership delivery of mental health services should not be at the mercy of
unpredictable national and international resources planning, budgeting and implementation
should of mental health services should be institutionalized.
4. Scale-up for impact rather than timid, piece meal and opportunistic implementation, engage in
a scale up for impact that is bold and intentional.

[43]
 Role of Stigma in Reducing Access and Service Delivery
Gordon Donnir, BSc, MBChB, MGCPsych, Ex. MBA | Ghana

Contextualizing Stigma in the Ghanaian Context

Stigma in general represents a persistent predicament in the lives of those who suffer it. Varied
stigmatized circumstances abound, as stigmatizing processes affect multiple areas of peoples lives, such
as housing, criminal involvement, health, and earnings. There are numerous components of stigma,
including labeling, stereotyping, separation, status loss, and discrimination. Stigma therefore is the
occurrence of its components to varied extents.
In the Ghanaian context, health is anchored on the cultural and spiritual doctrines of being
whole, meaning living in the right relationships or balance with self, others (the environment) and
nature (the supernatural). Ill-health is associated with broken relationships, such as those with others
and/or nature (but most particularly nature). In contrast, mental ill-health is tightly linked with broken
relationships with the supernatural, either from personal transgressions, from the transgressions of
others in the family lineage, or from another who seeks to destroy that person and his/her associates.
This view is held with utmost seriousness in ways that lets the environment (family and others) isolate
themselves from the afflicted. In this way, stigma is tightly associated with the isolation (in all manner of
ways) of the afflicted, so as to avoid or escape from being afflicted as well through any form of
association or to avoid shame, indignity, ridicule and labels (affecting marriage, friendship, chieftaincy,
nomination or elevation to certain high or esteemed positions etc). These labels affect the individual and
may extend to all domains associated with the individual, such as familial or tribal relationships.
Accessibility of Mental Health Care in Ghana
There are two main contexts for health care in Ghana: orthodox medicine, also known as
modern medicine, and traditional or spiritual healing. Currently, the treatment gap for modern medicine
is estimated at 98%. Poor accessibility of orthodox care is tightly linked to geographical distribution of
mental health facilities and the lack of mental health services in general hospitals across the country,
which represent a lack of infrastructural and human resources. However, it is also linked to the view that
mental illness is not hospital illness, which often leads the first point of call for mental healthcare to fall
on spiritualists or traditional healers. The empirical reasoning of these healers is to look for what might
have led to the broken relationship with the supernatural, or to unearth the person behind the ill
persons predicament and other reasons related to the curse. In contemporary times, pastors, priests,
and prophets have easily fit into the shoes of traditional healers. The separation of mental health
facilities from general hospitals results in stigmatization of the facilities themselves and even the
personnel working within them, which further contributes to poor accessibility
In contrast to modern medicine, accessibility to traditional or spiritual healing is not affected by
geographical or language barriers. The supernatural reasons given for ill-health sit well with the belief
systems of those who seek care, and thus more are acceptable. These healers do not have a formal
referral system, and are usually far removed from community, ensuring confidentiality and isolation.
Paradigm Shift
The adoption of new modern mental health laws and policies calls for an integrative approach to
modern medicine and traditional healing in an attempt to narrow this treatment gap, as well as to widen
accessibility and scale up care. Regulatory statutes can be put in place to prevent human rights abuses
and punish perpetrators, and policies can advocate for public education. These efforts lead to proper
training of faith-based healers, and, ultimately, to the integration of these healers into a framework of
mental health fraternity based on mutual respect.

[44]
 Exemplary North South Collaboration and Local Capacity Development
for Mental Health Services in LAMICS
Atalay Alem, MD, PhD | Ethiopia

The prevalence of mental disorders has been found to be similar in countries of low and high
income. The gap between the number of trained mental health workers and the burden of mental
disorders is one of the most pressing problems for low income countries (LMICs). Lack of trained human
resources is reported to be the most significant limiting factor to the provision of appropriate, evidence-
based psychiatric care and services in LMICS.

North-South Collaboration in human resource production over the years which was meant to
benefit low-income countries has been observed to be rather depleting human resource from low and
middle income countries (LMICS). This is because the majority of people who were sent to the Northern
countries for training have not returned to their home countries after completing their training.
Globalization in medical education often means a brain drain of desperately needed health
professionals from low to high income countries. Despite best intentions, partnerships that simply
transport students to western institutions for training have shockingly low return rates.. Ethiopia for
example, has sent hundreds of doctors abroad for specialty training including psychiatry over the past
40 years. The vast majority did not return. This represents a highly problematic net transfer of financial
and human resources from the Ethiopian people to western countries that have failed to develop their
own adequate health human resource plan. Thus, a partnership that would support the training and
retention of psychiatrists in Ethiopia, would require a model based on psychiatry education led by
Ethiopians, for Ethiopians, in Ethiopia.

Following this principle, Ethiopia addressed training needs of psychiatrists and mental health
researchers through partnerships with University of Toronto (U of T) in Canada, Umea University in
Sweden and Kings College London in the United Kingdom. Research trainings were done in a sandwich
model where trainees went to UK or Sweden for few months for short courses whereas most of their
training and research took place in Ethiopia. The students were co-supervised by faculty from Ethiopia
and Sweden or UK. This partnership has produced 14 people with PhDs and the Department of
Psychiatry in AAU has started a PhD training program in mental health epidemiology. The Department is
the first and the only clinical department to run a PhD program in the School of Medicine at AAU.

The partnership between U of T and Addis Ababa University (AAU) which was started in 2003
was named Toronto Addis Ababa Psychiatry Project (TAAPP). This partnership focused on training
clinical specialists in psychiatry which was the first residency program in psychiatry in Ethiopia. U of T
supplemented local teaching by providing on-the-ground core teaching and supervision for 3 months a
year. Through this program the number of psychiatrists has grown from 11 in 2003 to 60 in 2016.
Psychiatrists could now train locally, and the faculty enlarged as new graduates were recruited,
establishing the departments educational capacity and sustainability. Graduates of this program have
also been deployed in the regions of the country and two other medical schools have started residency
program in psychiatry. This strategy has significantly reduced the risk of the out-migration of potential
residents seeking training in the west. We believe that this is a good model of north south collaboration
for local capacity development which other LMICS also can benefit from.

[45]
 3. Service Access Challenges
Co-Chairs: Greg Fricchionne & Mashadi Motlana

Access to Forensic Mental Health Services in Africa: Double-Jeopardy and Human

Rights Shifts in Post-Colonial Societies Kubi-Kuhle
Funeka B. Sokudela, MBBCh, MMed Psych, Dip Health Sys Mgmt | South Africa

The need to observe the basic rights of those in need of forensic mental health services in the
continent is addressed. Country-specific examples and comparisons are set in terms of the relationship
between mental health and the law as practised. The plight of Africans within and outside the continent
in the face of double-discrimination based on skin colour, gender, and age needs to be explored. The
double-jeopardy framework is applied to mentally ill individuals accused of crime as well as to mentally
unwell survivors of crime in this context. Borrowing from Chappell and Havens (1980) example, it can
be argued that being mentally ill and being accused of a crime has more negative outcomes than being
mentally ill without a criminal charge or having a criminal charge without being mentally ill especially if
you are dealt with in legal frameworks that may carry old discriminatory notions.
Pertaining to forensic mental health care access gaps, the speakers hypothesis is that, there are
deep disparities in the observance of the human rights of both survivors of crime who may be mentally
ill as a consequence and of those who are alleged criminals who may be affected by mental illness.
Exchange of expertise and the need to explore disparities in standards of care in this area of are
explored. The close relationship between human rights preservation for victims of crime and for the
alleged offender are scrutinised. The plight of the mentally-ill person who is vulnerable to being a victim
or to being a perpetrator of crime is unpacked. Has Africa moved to recognise the need for its current
society to deal with post-colonial baggage that has her grappling with poverty, inequality and human
rights violations of some of her most vulnerable viz. the mentally ill victim survivor and the mentally-ill
alleged offender?
The relationship between discrimination and human rights violations of both a mentally ill
persons as well as incarcerated offenders has to be further scrutinised in societies where there is an
increased rate of violent offending as well as increased trauma-related mental health conditions as seen
in populations like South Africa and elsewhere - with or without war.
Recent results from a study of men in a forensic observation unit in South Africa reveal a need to
further explore prevention and mental health promotion approaches in order to quell the age-old
perceived link between African men and offending. The researcher discovers some perceived reasons
why males may be perceived to be highly represented in intimate partner violence statics. The plight of
survivors of gender-based violence and the plight of remand-detainees awaiting trial in South Africa are
unpacked in the context of human rights-based universalism versus cultural relativism philosophical
underpinnings. What-works models of prevention and mental health promotion in early childhood and
adolescence are proposed. Diversion programmes for minor offenders and substance abuse related
crimes are illustrated.
Forensic mental health services across the continent are compared and proposals to patch
service access gaps using organisational, financial, regulatory, and persuasion transformative tools are
made. Collaborative inter-sector approaches between actors in mental health, academia, justice and the
policing systems are proposed. Is it not time for our society to observe the human rights of those who
are facing double-jeopardy at the hands of decision-makers?

[46]
 Current State of Mental Health Service in Ethiopia with Emphasis on Integration Efforts
Solomon Teferra, MD, PhD | Ethiopia
Ethiopia is a country located in what is commonly known as the Horn of Africa. It is the second most
populous country with a population of close to 100 million. The country is considered one of the five
ancient civilizations and the only country in Africa that was never colonized. With the secession of
Eritrea, it has become the largest land-locked country in the world. The capital city, Addis Ababa, is the
seat of several international institutions such as the African Union (AU) headquarters and the United
Nations Economic Commission for Africa (UNECA), to name just a few.
Long years of civil war and natural disasters severely affected the development of the country for
decades. In the past 25 years, Ethiopia has gained relative peace and stability which resulted in
economic and social development. Global financial institutions such as the World Bank and IMF testified
to the sustained economic and social development spanning over a decade which made the country one
of the few countries that attained the Millennium Development Goals (MDGs), which included universal
education of children, significant reduction in child mortality and poverty reduction. Health service has
been one of the areas of focus for the government. Primary care coverage has remarkably improved,
ensuring access to basic promotive, preventive and curative services to the majority of the population.
Several studies have shown that mental, neurological and substance (MNS) related disorders are
prevalent in Ethiopia causing significant burden, and the majority have no access to modern mental
health services. Mental health service, which has been provided for the entire country by the only
psychiatric institution, Amanuel Hospital, for several decades, has benefitted from the recent economic
and social development. Although decentralization and integration efforts were underway with the start
of the psychiatry nursing program more than two decades ago, the expansion and integration of mental
health services was boosted by the introduction of the first Five-Year National Mental Health Strategy in
2012. The number of mental health professionals has increased significantly, with the current figures
showing nearly 500 hundred psychiatry nurses, 200 mental health professionals with bachelors degree,
150 mental health professionals with masters degree and about 60 psychiatrists were trained and
deployed in different health facilities in the country. Besides mental health professionals, the country
adopted the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) and
trained 350 non-mental health professionals to date to deliver mental health service on selected priority
mental disorders in primary health care centers. Procurement of essential psychotropic medications
were also made and distributed to different health facilities. Moreover, the country included mental
health in its five year national health plan, dubbed the Health Service Transformation Plan (HSTP), with
specific indicators of performance and dedicated annual budget. These efforts to address mental health
problems in an integrated fashion, with focus on primary health care to ensure access to services close
to where patients live, focusing on selected priority mental health problems, is commendable. The
country is also working on drafting the first Mental Health Act.
But, challenges still remain such as lack of mental health focal persons at different levels of the health
care administration system, low level of attention given to mental health by regional health
administrators, lack of uniformity of laws at different regional governments for instance one region
making mental health service free of charge while others lack such provisions, low human resource
capacity, less motivation of non-mental health care service providers to accommodate mental health
service as part of their duty, inconsistent supply of essential medications and in some cases low demand
for services because of low level of awareness and high level of stigma. Although civil society
organizations and charities play a big role in advocating for mental health and providing support for
vulnerable mentally ill individuals in other parts of the world, their role in Ethiopia thus far is
insignificant, with their limited activities only confined at the capital city.

[47]
Improving Outpatient Access for Patients with Substance Use Disorders
Solomon Tshimong Rataemane, MD | South Africa

[48]
Unequal Access to Medical Care Compared to Mental Healthcare in the Private Sector
Mashadi Motlana, MBChB, Mmed Psych, SAPsych | South Africa

In South Africa the right to access to health care is enshrined in the constitution. In 1998 the Medical
Aids Schemes Act was passed to protect the rights of those to those required to pay for health care
services and may be subject to catastrophic health care expenditure. The Council of Medical Schemes
regulates medical aids that are not for profit organisations designed to ensure access to health care.
Unlike health insurance products the regulations provide social protection and prescribe minimum
benefits for members of a medical aid schemes.
Medical Aids are directed to pay for all costs related to diagnosis, treatment and care of the following:
1. Life threatening emergencies
2. 27 chronic conditions
3. Defined set of 270 diagnostic and treatment pairs (DTPs)
For mental health care users this translates into the following:
1. Emergency treatment
2. Limited to suicide attempt (3 days)
3. Depression is only covered for hospitalisation for 21 days or 15 consultations depending on the
health plan selected
Examples of limitations to mental health care with reference to prescribed minimum benefits.
1. Number of conditions: Only 2 conditions recognised as chronic conditions i.e. schizophrenia and
bipolar disorder. Only patients that can afford higher plans may be covered for depression
with a life-time prevalence of 9.7% in South Africa.
2. Length of stay: 21 days are not sufficient in severe mental illness
3. Level of care: No provision of out patient services if 21 days of in hospital care is exhausted
4. Professional services: Psychiatric consultations and those of psychologists derived from same
funding pool. The majority of psychiatrist in private practice charge 200-300% above medical aid
rates. The mental health care user usually has to pay out of pocket for consultation and pay the
provider upfront before claiming from the medical aid scheme. Auxiliary health care providers.
Very small provision for occupational therapists and social workers
5. Medication: Limited to those drugs which appear on formularies. Psychiatric drugs are often
expensive and benefits are exhausted early in the year.
6. Outcomes: Mental health care users have poorer outcomes as they often cannot afford
continue with outpatient treatment after admission because they have exhausted their benefits
and have to rely on the public health system
At public hospitals mental health care users have to pass a financial means test in order to be declared
indigent. Mental health care users with an income ranging from R 36 000 R 70 000 are liable to pay
20%- 70% for health care services on a sliding scale according to the Uniform Patient Fee Schedule
private hospital rates. Individuals with an annual income above R 70 000 are liable to pay for services in
full. The mental health care user may already be in a precarious financial position as a result of having to
make out of pocket payments to providers in the private sector. In practice patients admitted to units
with longer lengths of stay such as Eating Disorder Units refuse hospital treatment due to the
unaffordability of the services.

[49]
 Building a better mousetrap: Why People of African Ancestry Do Not Benefit
William Lawson, MD, PhD, DLFAPA | USA

In recent years, substantial advances have been made in neuroscience. Moreover there has
emerged an increasing recognition that recovery can occur even in severe mental illness. Yet in the
United states, disparities in outcome continues to be the rule rather than the exception. African
Americans consistently show a greater burden of illness, more incarcerations, more frequent
hospitalizations, a requirement of more medication, the use of more antipsychotic medication, more
emergency services, and a shortened life expectancy. These kinds of racial disparities have been
reported in multiple settings including the Veterans Administration despite a single payer system> They
have also been seen in Western Europe despite socialized medical care system, and in the Caribbean.
Outcomes have reportedly been better in Third World countries but those findings have been disputed.
Nevertheless, the findings consistently show poorer outcomes for people of African ancestry despite
even when income differences are taken into account, and where technological advances have
presumably been the greatest.

The answer to this seeming paradox are two key issues. First outcomes related to recovery may
be less common in people of African ancestry. Factors that seem to promote recovery include hope,
rehabilitation , and the belief that each person regardless of the severity of their condition is capable of
living a full and independent life in the community . Multiple United States studies have shown that
providers tend to be pessimistic about the outcomes of African Americans and to provide limited
therapy options if at all. This problem is exacerbated by the finding that African Americans are less likely
to get care from mental health specialists. Rehabilitation services are not provided as often They are less
likely to be provided services in the community that may lead to more independent living. The failure to
adequately apply the recovery model then impacts the other concern.

African Americans are less likely to benefit from new technological advances including new
pharmacotherapies. Newer antidepressants are less likely to be prescribed, when they are prescribed.
Older antipsychotics are less likely to be provided. Cost is certainly a factor but other
ethnopharmacological factors may be involved. More effective medications such as clozapine for
example may not be available because it is likely to cause agranulocytosis and African Americans tend to
have a benign leukopenia that is not as widely known. Newer long acting injectables are not as
available. Also electrophysiological interventions such as Transmagnetic stimulation is not used as often.

Approaches such as recovery have added new hope and can certainly benefit patient outcomes
when combined with new technological advances. However their benefits cannot be realized until
people of color have equal access.

[50]
 4. Training & Education: Bridging Gaps in Capacity
Co-Chairs: Altha Stewart & Zukiswa Zingela

What Models of Education and Training for Psychiatrists in Africa

Sam O. Okpaku MD, PhD | USA
My brief remarks will be based on my experiences as someone with training and background in
Internal Medicine, Psychiatry, and Social Research, whose entire professional training and being abroad
outside Africa but has maintained intimate contact with African colleagues and conditions. Professor
Ayo Binitie, who is since deceased, presented a paper at a Conference Mental Health in Africa and the
Americas Today. In his paper he asked several questions: When we think about postgraduate psychiatric
education in the African context, we have to ask certain fundamental questions:
Is this the time for training in psychiatry as a medical specialty?
Why should we train psychiatrists in Africa?
Is the community prepared to use the services of psychiatrists?
What services does the community want from psychiatrists?
Do psychiatrists provide what the community wants, or should we do more and educate the
community?
Finally, having decided on what psychiatrists do and what they ought to do, how do we train to
meet these requirements?
He emphasized the importance for African psychiatrist to relate to their communities, communicate
across native borders, and interact with the international community. 30 years later, some of his words
still echo today and are relevant to this topic. In my brief introduction to the topic, I will tease out
several requirements for such training. These include a firm foundation and vigor in knowledge
acquisition and criticism, as is illustrated by The Social Construction of Reality (Peter Berger and Thomas
Huckman) and Scientific Revolution (Thomas Kuhn) This foundation should be supported by a broad base
of knowledge and clinical skills as these graduates will occupy leadership and become mentors.
1. Trainees and graduates should be aware of the contribution of Black and African psychiatrists to
Modern Psychiatry. This is a vital aspect of any diasporic endeavor.
2. A comprehensive approach that goes beyond Westernized concepts of mental health and
psychiatry e.g. the role of traditional healers, the usefulness of mindfulness, and other Eastern
approaches, and appropriate individual and family techniques.
3. The need for an interdisciplinary approach that is to include the fields of sociology, psychology,
anthropology, economics, and neurosciences. Some major contributors to mental health
training and research are psychologists, social workers, and sociologists.
4. The need for cultural relevance. In many centers in Africa, an integrative approach to service
delivery through primary care has been the order of the day. An example of cultural relevance is
to Cuban Mental Health System which I consider to be one of the best in the world.
5. A curriculum that emphasizes research is an integral part of clinical training and practice. People
should be asking questions about what they are doing and what results are they achieving. (I will
recall my observations from the 1986 Kenya Conference when many African psychiatrists were
lamenting the lack of opportunities for research. I disagreed with them. The curriculum should
also have provision for local and external mentorships and opportunities for retraining. The APA
considered providing training for mid-career psychiatrists about 2 decades ago.
Finally, whatever models are chosen it is likely that it will need to be syncretic.

[51]
 Adverse Childhood Experiences: A Global Health Problem
Altha Stewart, MD | USA

Worldwide, children suffer early exposure to many types of trauma, violence and abuse early in
life. These adverse childhood experiences (ACEs) have been demonstrated to affect their lifelong health
experience and provide remarkable insight into the development of many medical and psychological
disorders. In many parts of the world, children are exposed to the most horrific types of trauma and
violence in the midst of wars and natural disasters that occur in their countries. Child abuse and neglect
(CAN) is also a serious public health problem locally and globally. The World Health Organization
reported that in 2000, 57,000 children under 15 years of age died due to fatal CAN, across the globe. In
developing countries, the rate of fatal CAN under 5 years of age is 2.5 times higher than in developed
countries. The consequences of adverse childhood experiences (ACEs) such as child maltreatment and
other traumatic stressors for health risk behaviors and long-term chronic diseases has been the focus of
a growing number of studies. These have occurred in a context of raised global awareness of ACEs
following the launch of reports such as WHO's 2002 World report on violence and health and the 2006
UN Study on Violence against Children.
In the decades since the first Adverse Childhood Experiences (ACE) Study results were published,
a number of other initiatives in developed and developing countries have begun examining the
consequences of child maltreatment and other traumatic stressors for health risk behaviors and long-
term chronic disease consequences. These include a comparative risk assessment of child sexual abuse
to inform the global burden of disease (GBD) estimates; the Global Schools-based Student Health Survey
(GSHS), and country-specific projects (e.g., in Australia, China, Malaysia, Singapore, South Africa, and
Swaziland). And over the last decade, both CDC's Violence Prevention Division and WHOs Department
of Violence and Injury Prevention and Disability have prioritized child maltreatment prevention,
resulting in widespread interest at country level in conducting surveys to examine the prevalence and
consequences of child maltreatment and commence the development of policies and programs
designed to prevent child maltreatment and mitigate its acute and long-term consequences.
Unfortunately, while some high-income countries are addressing the larger public health implications
attached to ACEs by stepping up their primary prevention efforts, most of the world's children are in
low- and middle-income countries, where, although the prevalence of childhood adversities is
sometimes higher than in wealthy countries, governments have yet to act on the recognition that
childhood adversities underlie serious, long-lasting health related consequences which, compromise
individual health and development, including the ability to learn in school, generate costly health
problems such as chronic medical conditions, alcohol and drug abuse, and mental illness, and create a
climate where economic development is inhibited and crime can flourish, resulting in impoverished and
unsafe communities.
The United States ACEs study showed the undeniable relationship between a child's emotional
experiences and their physical and mental health in adulthood. After several decades of study in the
United States, there are finally efforts underway to study this issue in the global arena. The Adverse
Childhood Experience International Questionnaire - ACE-IQ (WHO, 2009), and Childhood Traumatic
Questionnaire - CTQ (Bernstein and Fink, 1998) were based on the scientific model of adverse childhood
experiences and used to identify a method for effectively using the adverse childhood experience
research for a wide range of practical applications outside the United States. As more countries struggle
with increasing health care costs and the global burden of disease, efforts to address these early
childhood issues with culturally appropriate and effective policies and practices must be supported by
the global health community.

[52]
 Family Engagement across Cultures: Healing Family Trauma through Story
Nancy Carter | USA

The effect of trauma in African American families is at an all-time high. Those of us who live,
work and care for persons with serious mental illness are experiencing an increase in anxiety and
emotional distress. Overt aggression towards African-Americans, especially young males, has everyone
in every family on edge. It is impossible to escape the news and social media. How do we find peace in
the midst of it all? Where is our bridge over troubled water? I believe our healing lies in our stories.
The oral tradition of our ancestors that dates back a thousand years is as valid today as it was then.
When we share our stories, our humanity is kept alive. The Griots of West Africa kept the culture alive
over time and we must continue that tradition today. Storytelling creates an avenue of connection that
heals and transforms lives. In story we find strength and resilience.
My story reaches across 8 generations. From the shores of Senegal to the beaches of Southern
California, I carry my familys legacy of intergenerational trauma and survival. I use story in my work to
engage families in the journey towards healing for themselves as well as their loved ones. My
presentation will detail the techniques of storytelling and how I help families to reveal their own truth
through the storytelling process.

[53]
 Training and Education in Psychiatry in Ghana
Gordon Donnir, BSc, MBChB, MGCPsych, Ex. MBA | Ghana

The Ghana College of Physicians and Surgeons

An act of Parliament established the Ghana Postgraduate Medical College on 28th January,
2003. This act christened the Ghana College of Physicians and Surgeons (GCPS), and dramatically
reduced brain-drain to mostly western countries.

Opportunities in Psychiatry
The promise of the new faculty of psychiatry at GCPS provided an opportunity for medical
graduates to enroll into psychiatry. These graduates were given a definitive number of years to
complete the program, with government sponsorship assured. However, these faculty did not come
without challenges. Regarding infrastructure, the program only had one major training site and about
five trainers in total, all of whom were psychiatrists. The program had no clinical psychology support or
psychiatry social work support, and, as all trainers were general psychiatrists, those psychiatrists who
were available had difficulty with subspecialty teaching and skills acquisition. Overall, there was no real
structure to the academic work.

Early Opportunities & Subsequent Challenges

Initially, regular visits were held with diasporan psychiatrists of varied backgrounds, as many
wished to give back to their alma mater by way of teaching. This provided a window to co-opt these
psychiatrists knowledge, skills, and time in helping guide the first few enrolled residents. After a time,
however, these diasporan psychiatrist visits withered away. While there was some measure of interest
in psychiatry by medical graduates, there was just one site for training. The program was in need of an
additional training site. These issues were exacerbated by changes in the programs government
sponsorship package, which disadvantaged psychiatry. In light of these changes, there was a clear need
to engage foreign partners to provide necessary training and knowledge in all of psychiatry. This was
occasionally provided by visiting professors, who would sometimes provide lectures.

New Opportunities
The Global Mental Health Divisions of Universities in Advanced Economies have been willing to
engage with developing countries to train and teach, with inherent mutual benefits.

[54]
 Building Child and Adolescent Mental Health Capacity in Sub Saharan Africa
Olayinka Omigbodun, MBBS, MPH, Dip Psych, FMCPsych, FWACP | Nigeria

Six years ago the MacArthur Foundation provided a grant to the University of Ibadan to Build
Child and Adolescent Mental Health (CAMH) capacity in Sub Saharan Africa. This was to be executed
primarily through the development and implementation of a Master of Science degree programme in
Child and Adolescent Mental Health (MSc. CAMH). Despite delays with the take off of the project as a
result of logistic and infrastructural difficulties, a Centre for Child and Adolescent Mental Health
(CCAMH) (www.ccamhi.ui.edu.ng) is now established in the University. The multi-professional and multi-
national collaboration of tutors and course leaders in CCAMH led to increased understanding and
knowledge of CAMH, positive attitudes, and teamwork skills essential for successful management in this
field.
From the start of academic activities in January 2013, the course leaders, tutors and
administrative team in CCAMH sustained momentum and worked tirelessly so that in three and a
half years (3 years), 43 CAMH professionals from 5 countries in sub-Saharan AfricaGhana, Kenya,
Liberia, Nigeria and Sierra Leonecompleted training with each student completing a research
project from primary data. In 2016, CCAMH welcomed her most diverse set of students from Eritrea,
Ghana, Nigeria, Sierra Leone, Zambia and Zimbabwe into Cohort 4 of the MSc. CAMH programme
thereby expanding the number of countries in Africa that would have a trained CAMH professional.
CCAMH also welcomed the first set of students on the Postgraduate Diploma Programme in Child
and Adolescent Mental Health (Pg. Dip. CAMH). The Pg.Dip. opens opportunities to many others who
might not qualify for entry into a masters programme to learn about Child and Adolescent Mental
Health. This was only made possible by the multiplier effect of CCAMH in the University of Ibadan.
CAMH professionals, who completed training in the pioneer set of CCAMH, coordinate and facilitate
sessions on the Pg.Dip. CAMH.
The Centre also ran 14 short continuing professional development (CPD) courses with a total of
400 participants and hosted the first CAMH conference in Nigeria in June 2016. This presentation
describes the impact of training, research and service on the development of CAMH in sub Saharan
Africa.

[55]
 5. Training & Education: Collaborations in the 21sr Century
Co-Chairs: Altha Stewart & Zukiswa Zingela

Training Psychiatrists in Under-Resourced Areas: Challenges and Opportunities

Zukiswa Zingela, FCPsych, MMed Psych, MB ChB | South Africa

Introduction
South Africa faces a chronic challenge of medical doctors and specialists, with some disciplines more
affected than others. Psychiatry faces an unprecedented shortage in some areas to the point of having
little to no psychiatrists in the public sector in some provinces. There are currently around 575
Psychiatrists in SA. The situation is further complicated by poor or erratic support from Department of
Health, resulting in multiple barriers to successful solutions. This affects not only postgraduate training
but cuts across undergraduate training as well.

Training of Psychiatrists in SA
Training of Psychiatrists in SA is undertaken through 8 Medical Schools, with a 9th one already in
existence possibly to join postgraduate training in the near future. The examination process is
undertaken through the Universities and Colleges of Medicine of South Africa (MMed I and FCPsych I &
II). Registration as specialists is then done through the Health Professions Council of SA. Of these
medical schools, 3 are referred to as Historically Disadvantaged Institutions (HDIs) or Universities
(HDUs). The HDUs offering undergraduate and postgraduate medical education are Walter Sisulu
University (WSU) in the Eastern Cape and Sefako Magkatho University (SMU) in the North West. These
HDUs are significantly under resourced due to a number of factors including unequal and inadequate
resources from inception.

WSU as a Case Study of an Under-resourced HDU

WSU as a case study presents an opportunity to examine challenges inherent within such institutions
and how some of these can be adapted into opportunities for innovative medical education strategies;
this is in the backdrop of social and educational inequalities that are polarizing South African
universities.

WSU Postgraduate Programmes and Outcomes

Postgraduate programmes for different disciplines have been in existence in WSU since August 1999.
HPCSA postgraduate accreditation was only partial in the beginning with the WSU Psychiatry
programme only fully accredited for the full four year training six years later in 2010. The first five years
or so following initiation of the postgraduate training programme were the most challenging period with
widespread inadequacies noted in most training programmes, difficulty recruiting staff and other
serious deficiencies. Since full accreditation in 2010, WSU has produced six Psychiatrists, with one who
was supported to study further and become a Child Psychiatrist and another one who qualified with a
PhD in 2015. Another three psychiatrists are expected to qualify in the next 6 to 12 months.
What has WSU done right? What can be improved? Some of the challenges, both past and present, will
be discussed and the innovative approaches used to address them will be examined. Survival of WSU
will be discussed as a necessary requirement to the survival of medical education within the Eastern
Cape, not only for psychiatry but for all disciplines.

[56]
 Global Mental Health Education
Gregory Fricchione, MD | USA
The Ethiopian experience (Toronto-Addis Ababa Psychiatry Program) suggests the possibility of a
number of strategic opportunities for international mental health partnerships all of which would be
kindled by the maturation of the field of global psychiatry. In this regard, the enormous challenge of
building resources and capacity for the provision of basic mental health services to LMICs is going to
require a revolution in medical education both here in the US and in other HICs and in those very same
LMICs. This becomes part of a larger topic: how shall we educate physicians in the 21st century.
A blue ribbon panel recently assembled to discuss new paradigms for educating health
professionals for the 21st century. This effort was called Education of Health Professionals for the 21st
Century: A Global Independent Commission. The Commission consisted of 20 professional and academic
leaders from diverse countries who developed a shared vision and a common strategy for education in
medicine, nursing and public health. In order to overcome the barriers to global health care, the
commission took a global perspective and added to this multi-professionalism and a systems approach.
The Commission gathered data and found that there are 2,420 medical schools, 467 schools
with departments of public health and many post-secondary nursing educational institutions around the
world. These educational institutions train about 1 million doctors, nurses, mid-wives, and public health
professionals annually. Four countries, the United States, China, India, and Brazil, each have over 150
medical schools yet 36 other countries have no medical schools at all and 26 sub-Saharan African
countries have 1 or no medical schools. This creates tremendous disparities in health provision and it is
clear that medical school distribution is not aligned well with either population or the national burden of
disease. There is also clearly a large disparity in health expenditures for the professional education. In
the United States, $100 billion a year is spent whereas in many countries less than 2% of health
expenditures is provided for health education43.
The Commission proposes several reforms. They recommend adoption of competency-based
curriculum, the promotion of inter-professional and trans-professional education that breaks down
professional silos and enhances collaboration, the exploitation of the power of information technology
to promote learning, and adaptation locally but harnessing resources globally, and by doing so
conferring capacity to be flexible in addressing local challenges while using global knowledge and
experience. Additionally, distance learning and international exchange programs will help this proposed
reform. Strengthening educational resources including faculty syllabuses, didactic materials and
infrastructure, promotion of a new professionalism that uses competencies objectively as criteria for
classifying health professionals, establishing group planning mechanisms, and dealing harmoniously with
the supply and demand for health professionals to meet the health needs of populations are also
important ways to advance this reform. Another important feature of this redesign will be to expand
from the concept of academic centers to that of academic systems. This will involve the extension of the
classical care education continuum and more extensively engaging primary care settings in communities
as sites of learning. Linking together alliances and collaborations between educational institutions,
governments and non-governmental organizations (this proposed reform would include twinning
relationships between universities in HICs and universities in LMICs) will be essential in maximizing
effectiveness. The Commission realizes that in order to carry out these proposed reforms, leadership
will need to be mobilized, investments will need to be made, accreditation across countries will need to
be aligned, and global learning strategies will need to be strengthened.
This report will be reviewed in the context of the mental health education in Africa in general
and the recent Ethiopian experience in particular.

[57]
 TOTAL Health: Integrating primary care, mental health, and public health
Eliot Sorel MD, DLFAPA | USA

ABSTRACT
Non-communicable diseases (NCDs) lead in the global burden of diseases and of disability. NCDs
frequently occur as comorbid conditions. An often encountered cluster is that of cardiovascular
disorders, diabetes, depression and anxiety. NCDs are determined by multiple factors, biological,
psychological, genetic, social, nutritional, environmental and the transactions between them. In
aggregate, they account for more than 30% of the global burden of diseases and more than 50% of the
global burden of disability.

A recently completed study on Depression and comorbidity in primary care in China, India, Iran,
and Romania and showcased at the World Bank and WHO Innovators Fair in Washington DC, this past
April, reveals the relevance of TOTAL Health across cultures. The TOTAL Health model integrates primary
care, mental health, and public health starting with the perinatal period and continuing throughout the
life cycle. TOTAL Health is predicated on health promotion, protection, illness prevention and care that
is collaborative and integrated. The model and its relevance for individuals and populations health
across cultures is presented.

[58]
 Building a Better Training Program: A Mixed Methodology Approach
Lori Chibnik, PhD, MPH | USA

Historically, training programs, be they short courses or semester-based, local or remote, have
targeted a single audience. While this model might result in well-trained individuals, unless those
individuals have a support system in their home institution they risk becoming isolated which, in turn,
leads to brain drain. In order to ensure sustainable development in the area of capacity building, we
need to go beyond trainings focused solely on the individual and instead invest in career development
with both horizontal and vertical engagement.
To achieve this goal, the Harvard T.H. Chan School of Public Health and the Broad Institute of
MIT and Harvard are teaming up with multiple African institutions to create a global neuropsychiatric
genetics training program to start July 2017. We aim to enroll 15 Scholars targeting post-doctoral fellows
and junior faculty with the backing and involvement from their institutions. The 2-year program will
include three components, specifically:
1. Workshops: A series of neuropsychiatric
epidemiology and genetics workshops focusing on
epidemiology, genetics, writing, mentoring and
building a research program.
2. Mentoring: Weekly virtual training and mentoring
sessions to follow the progress of projects and learn
from renowned researchers in the field of
neuropsychiatric epidemiology and genetics;
3. Skills training:: Onsite skills based training to be
taught at each collaborative institution, open to a
larger audience, including graduate students,
fellows, research assistants and project managers.
By bringing the three components together we will be able to engage our Scholars on a
horizontal plane by promoting team building and peer-to-peer teaching, and on a vertical plane, by
encouraging involvement by their institutions and mentors who supervise them and training the
students and scientists who they work with on projects. We will also encourage and work with the
Scholars to provide mentorship to the students at their institutions. This integrated method has the
additional impact of promoting intra-Africa collaboration and providing fundamental skills to the next
generation of researchers through the skills-based trainings.
A vital aspect of this program is the institutional involvement. The curriculum for all aspects of
the program will be developed with the active participation of senior faculty leaders from each
institution and all onsite trainings will be taught together with the trainers from Harvard and local
faculty with the goal of incorporating the materials into the curriculums of each institution.
Without engaging LMIC scientists and physicians on all levels from senior researchers to
graduate students and providing them the knowledge and skills necessary to perform studies in their
populations, there is a significant risk that the recent advances in neuropsychiatric genetics will widen
the massive research and treatment gaps in the rest of the world. This partnership, at the intersection of
clinical neuroscience and global mental health, aims to address this gap by enhancing neuropsychiatric
epidemiology and genetic research capacity in LMICs through the training and capacity building.

[59]
6. Examples of Global Research Collaboration
Co-Chairs: Dan Stein, David C. Henderson

Title
David Henderson

[60]
African College of Neuropsychopharmacology: Laying a Foundation
Dan Stein

[61]
 A Multi-Centric Depression Screening Study in Primary Care Setting From India
Roy Abraham Kallivayalil, PALA | India

Background
There is scarce data on depression prevalence in primary care in contrast to the wealth of
epidemiological data on prevalence from India. The aim of this preliminary study was to conduct
screening for depression among patients attending primary health care (PHC) setting general physicians
outdoors over one week
Method
This was a multi-centric cross sectional study of patients visiting PHCs of three different parts of
India i.e North, South and East regions. Patients giving informed consent were screened for depression
using Patient Health Questionnaire-9 (PHQ-9), an international valid self-report questionnaire. The
socio-demographic data and co-morbidities of patients found positive for having depressive symptoms is
also reported.
Results
A total of 551 patients were screened. 52.1% were females. 33.7% male and 38% female had
clinically significant depressive symptoms PHQ 95. Nearly equal proportions of the patients had mild,
moderate, moderately severe symptoms in male and females. Among male patients, 23.6% had mild,
21.3% had moderate and 5.1% had moderately severe depression as per PHQ-9. None of the male
patient had severe depression. In females, 22% had mild, 20.6% had moderate, 6.9% had moderately
severe and 0.4% had severe depression. Most patients with depression had medical co-morbidities.
Diabetes Mellitus and Cardiovascular Diseases were the most common medical disorders in patients
having depression.
Conclusion
The prevalence of depressive symptoms in patients attending PHCs in India is high. Diabetes
Mellitus and Cardiovascular Diseases were the most common medical disorders associated with
depression in our sample.

[62]
 Addressing Global Mental Health Challenges through
Collaborative Research and Training
Pamela Y. Collins, MD, MPH | USA

ABSTRACT
Optimizing care and treatment for people for mental disorders requires a diverse set of actors
and a global effort. This effort is accelerating in Africa through research collaborations that address local
service delivery priorities, create avenues for developing new investigators, and engage the end-users of
study findings. More is needed. As new studies generate promising pilot data and effectiveness data,
how do we meet the need for further translation alongside continued knowledge generation? The next
steps should include determining which innovations will scale up, training new researchers to translate
findings across contexts and settings, learning to disseminate and implement what works, engaging
resources to support service delivery, carefully evaluating the outcome of treatments in real world
settings, disseminating successes and failures, and stimulating new science across the translational
continuum.

[63]
Collaborative Networks: Harnessing Research Training
Soraya Seedat

[64]
 7. Research Capacity Building: Next Steps & Lessons Learned
Co-Chairs: Bonga Chiliza, David C. Henderson

Genetics and Psychiatry in the United States: Lessons Learned

William Lawson, MD, PhD, DLFAPA | USA
Advances in genetics have certainly improved our understanding of disease states and the
development of new treatments. However the experience of African Americans in the US has shown
that these interventions must not be oversold. Outside of psychiatry there have been important lessons
learned. For example definitive treatments were developed despite the genetic understanding of the
disease for over 50 years. An effective treatment was found for congestive heart failure that led to an
indication specific for African Americans. However the indication by the FDA led to a firestorm of
criticism. A key issue has been the role of race and racism in the US that will cloud genetic research.
These issues include use of slave in research, the Tuskegee study in which African Americans with
syphilis were not treated with antibiotics when they became available, or the use of IQ tests to promote
a social policy of educational segregation because it was felt that tests showed a genetic inferiority of
people with African Ancestry. We found in a study of the genetics of bipolar disorder that African
Americans who volunteered for the study nevertheless were more likely to believe that such findings
would be used to the detriment of people of color.

Nevertheless the benefits of such research can be significant. Studies in the genetics of
schizophrenia and bipolar disorder showed the similarity of the genetics and has led to a reclassification
of these disorders. Studies in Alzheimers show that the genetic markers for risk may differ for African
peoples. Genetic tests are commercially available for the enzymes underlying he metabolism of
psychotropic agents. The research behind these tests have shown the importance of individualized
medicine and why there may be racial diversity in pharmacological trials. Unfortunately, African peoples
are grossly underrepresented in this type of research. Certainly subjects concern about how the
research will be used is a factor. A key factor however is the failure of investigators to include individuals
of color.

More must be done to educate the public and providers about the significance and
interpretation of these findings. Care must be taken to consider the ethical questions of this important
research.

[65]
Rolling the Dice: A Young African Researcher Plays Snakes and Ladders
Bonga Chiliza

[66]
 Neuropsychiatric genetics in Africa: Waste not or want not?
Karestan Koenen, PhD | USA
Global Mental Health: 'the area of study, research and practice that places a priority on improving
mental health and achieving equity in mental health for all people worldwide' (Patel & Prince, JAMA, 2010).
Both global mental health and neuropsychiatric genetics have made enormous strides in the
past decade. However, these two fields grown on parallel tracks, with little to no interaction. Questions
remain as what, if any role, neuropsychiatric genetics has in global mental health.
In 2015, the Stanley Center launched a partnership to improve and achieve equity in mental
health by expanding the infrastructure and research findings from largescale psychiatric genetic
epidemiology to Africa. Psychiatric disorders are highly prevalent in all regions of the world,8,9 including
Africa, and disproportionately contribute to disease burden in low- and middle-income countries.10,11
Through the work of the Stanley Center and Psychiatric Genomics Consortium (PGC), the genetic
architecture of key psychiatric disorders schizophrenia and bipolar disorder is finally being
understood. The PGC has 800+ investigators, 9 disorder groups, 400,000+ subjects in analysis, and
4x1012 genotypes. Crucially, the Stanley Center and the PGC have produced fundamental knowledge
about the genetic basis of psychiatric disorders (along with the methods to extract such knowledge)
including major papers in Nature Genetics, Nature Neuroscience, Lancet, and Molecular Psychiatry plus a
landmark paper in Nature where we discovered 108 genome-wide significant loci for schizophrenia in
~36,000 cases and ~113,000 controls (one of NIMH Director Insels top five findings for 2014). 1-7
The breakthroughs in neuropsychiatric genetics promise to lead to new drug targets and ultimately
treatments that will reduce the global burden of psychiatric disorders. However, for historical and
practical reasons, the vast majority of these genetic findings are on subjects of Northern European
ancestry. Currently, there are major limitations in our knowledge of the genetic and environmental risk
architecture of psychiatric disorders in persons of African descent. Insofar as psychiatric disorders have
at least partially different combinations of genetic risk variants, like most common noncommunicable
diseases that have been studied, we are limited in our ability to understand biological mechanisms and
produce optimal medications of African populations. Without engaging African scientists and physicians
and performing studies of African populations, there is a significant risk that the recent advances in
neuropsychiatric genetics will result in a widening of the massive research and treatment gaps between
Africa and the rest of the world. This partnership, at the intersection of clinical neuroscience and global
mental health12, aims to address this gap by:
Enhancing neuropsychiatric genetic research capacity in Africa through the training of scientists.
The goals is to expand knowledge of the genetic & environmental risk factors for neuropsychiatric
disorders in Africa through very large-scale sample collection and analysis through,
Supporting the development of locally led research programs in neuropsychiatric genetics and
leverage unique opportunities in population genetics.
Our plan aims to address five major barriers to accomplishment of long-term large-scale
neuropsychiatric genetics research in Africa. First, historically, there are perceptions that African
collaborators have been disappointed by U.S., UK and European scientists conducting safari research
whereby their time, expertise and even samples were exploited without benefit to their careers or the
people they serve. We plan to address this barrier through supporting locally led research programs and
capacity building efforts. We have significant experience in building such capacity.13 The second barrier
is lack of funding. African scientists are not eligible for most of the training mechanisms offered by the

[67]
National Institutes of Health and other funding agencies. Global mental health training programs pay for
U.S.-based scientists to go to Africa but not the reverse. Thus, we will provide support for African
scientists to training jointly in the U.S. and Africa. Third, the development and maintenance of
infrastructure for large-scale psychiatric genetic epidemiology requires long-term relationships.
By training the next generation of leaders at collaborative institutions, we have the opportunity to
create an infrastructure that will endure. Fourth, many African countries lack infrastructure (and funding
for purchase, maintenance, and operation) that would be needed to conduct large-scale
neuropsychiatric genetics research, e.g. refrigeration for blood samples, cloud-based technology for
phenotypic data collection. We will work with partners in Africa and with interested foundations to help
address infrastructure needs. Fifth, there are always complex ethical and human subjects issues related
to the collection, storage, analysis and particularly sharing of genomic data that are even greater in a
cross-national project of this scale. We will address this barrier through close collaboration with African
partners, consulting with experts on these issues in global mental health research and through
capitalizing on the work of H3 Africa. Moreover, the Broad Institute has experience addressing such
issues in global collaborations with other areas of the world such as Latin America that will be useful in
this new effort. By addressing these barriers, we aim to ensure the nascent revolution in
neuropsychiatric genetics is extended and made accessible to peoples throughout Africa.

[68]
 Title
Christina Borba

[69]
Bibliography

Translating Scientific Evidence into Global Health Policy:

Making Mental Health Count for Individuals and Populations Health
Eliot Sorel, MD, DLFAPA & Rahn Bailey, MD, FAPA | USA
1. Sorel, E., Health, Health Care, and Health Systems: 21st Century Challenges & Opportunities,
International Medical Journal, Volume 21, No 4, p 1, October 2014
2. Sorel, E., Total Health for All in the 21st Century, Dignity in Mental Health, pp 17-18, World
Federation for Mental Health, Occoquan, Virginia, September 2015
3. Sorel, E., Raney, L., Integrated Care, American Psychiatric Association, Position Statement, July
2016

Unequal Access to Medical Care Compared to Mental Healthcare in the Private Sector
Mashadi Motlana, MBChB, Mmed Psych, SAPsych | South Africa
1. Medical Schemes Act No. 131 of 1998
2. M. Tomlinson et al The Epidemiology of Major Depression in South Africa: Results from the South
African Stress and Health Study S. African Medical Journal 2009.99(5) 367-373

What Models of Education and Training for Psychiatrists in Africa

Sam O. Okpaku MD, PhD | USA
1. Okpaku SO: Preface to Mental Health in Africa and the Americas Today. Conference Proceedings,
Edited by S.O. Okpaku
2. Okpaku SO: Introduction to Mental Health in Africa and the Americas Today. Conference
Proceedings, Edited by S.O. Okpaku
3. Binitie A: Postgraduate Education in Africa on Mental Health in Africa and the Americas Today.
Conference Proceedings, Edited by S.O. Okpaku
4. Mbugua CM: Training of Mental Health Nurses in Kenya: Challenges and Problems in Mental Health
in Africa and the Americas Today. Conference Proceedings, Edited by S.O. Okpaku
5. Okpaku SO & Herbert G: Research priorities for mental health in low and middle income countries in
Essentials of Global Mental Health (Cambridge University Press) Edited by S.O. Okpaku
6. Pam, O; Alan A: Medical Education and global mental health in Essentials of Global Mental Health
(Cambridge University Press). Edited by S.O. Okpaku
7. Sumathipala A: Research Infrastructure in Essentials of Global Mental Health (Cambridge University
Press). Edited by S.O. Okpaku

[70]
 TOTAL Health: Integrating primary care, mental health, and public health
Eliot Sorel MD, DLFAPA | USA
1. Sorel, E., et al., Depression and Comorbidity in Primary Care in China, India, Iran, and Romania,
International Medical Journal, Vol. 23 No. 2, p. 118 (April 2016)
2. Sorel, E., et al., A Study of Depression Screening in Primary Care Setting of China, International
Medical Journal, Vol. 23 No. 2, pp. 119-121 (April 2016)
3. Sorel, E., et al., An Exploratory Multi-Centric Depression Study in Primary Care Setting of India,
International Medical Journal, Vol. 23 No. 2, pp. 122-124 (April 2016)
4. Sorel, E., et al., Depression Screening in Primary Care and Correlations with Comorbidities in
Romania, International Medical Journal, Vol. 23 No. 2, pp. 128-131 (April 2016)
5. Sorel, E., Total Health for All in the 21st Century, Dignity in Mental Health, pp 17-18, World
Federation for Mental Health, Occoquan, Virginia, September 2015

Neuropsychiatric genetics in Africa: Waste not or want not?

Karestan Koenen, PhD | USA
1. Schizophrenia Psychiatric Genome-Wide Association Study Consortium. Genome-wide association
study identifies five new schizophrenia loci. Nature Genetics. 2011;43:969-976.
2. Schizophrenia Working Group of the Psychiatric Genomics Consortium. Biological insights from 108
schizophrenia-associated genetic loci. Nature. 2014;511:421-427.
3. Psychiatric GWAS Consortium Bipolar Disorder Working Group. Large-scale genome-wide
association analysis of bipolar disorder identifies a new susceptibility locus near ODZ4. Nature
genetics. 2011;43(10):977-983.
4. Major Depressive Disorder Working Group of the PGC. A mega-analysis of genome-wide association
studies for major depressive disorder. Molecular Psychiatry. 2013;18:497-511.
5. Cross-Disorder Group of the Psychiatric Genomics Consortium. Identification of risk loci with shared
effects on five major psychiatric disorders: a genome-wide analysis. Lancet. 2013;381:1371-1379.
6. Cross-Disorder Group of the Psychiatric Genomics Consortium. Genetic relationship between five
psychiatric disorders estimated from genome-wide SNPs. Nature genetics. Aug 11 2013;45(9):984-994.
7. Pathway Analysis Subgroup of the Psychiatric Genomics C. Psychiatric genome-wide association
study analyses implicate neuronal, immune and histone pathways. Nature neuroscience. Feb
2015;18(2):199-209.
8. Demyttenaere K, Bruffaerts R, Posada-Villa J, et al. WHO World Mental Health Survey Consortium:
prevalence, severity, and unmet need for treatment of mental disorders in the World Health
Organization World Mental Health Surveys. JAMA. 2004;291(21):2581-2590.
9. Whiteford HA, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and
substance use disorders: findings from the Global Burden of Disease Study 2010. The Lancet.
2013;382(9904):1575-1586.
10. Collins PY, Patel V, Joestl SS, et al. Grand challenges in global mental health. Nature.
2011;475(7354):27-30.
11. WHO. Mental Health Atlas 2011: World Health Organization Geneva; 2011.
12. Stein DJ, He Y, Sahakian B, Williams J, Patel V. Global mental health and neuroscience: potential
synergies. Lancet Psychiatry. 2015;2:178-185.
13. Stein DJ, Daniels W, Emsley R, et al. A brain-behaviour initiative for South Africa: the time is right.
MetabolicBrain Disease. 2006;21:279-284.

[71]