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Report on Activities of “WPA International Mental Health Research Fellowship” at Institute of Psychiatry, King's College London - April 29th, 2011

PREAMBLE

My WPA Research Fellowship at the Department of Epidemiology, Centre for Public Health, Institute of Psychiatry (IOP), Kings College London started on April  26th, 2010 and ended on April 29th, 2011. On arrival at IOP, I was warmly received at the Department, introduced to the members of staff and shown my desk with an internet ready computer and other materials I would need for my Fellowship training.

Throughout the Fellowship I was involved in academic (educational) and research activities. I always had  a regular (fortnightly) research supervision meeting with the Head of Department (Prof Martin Prince) where my progress in each of my activities were  discussed, reviewed and advice and guidance given.

ACADEMIC ACTIVITIES

A. Courses Attended

1. Short courses
I attended a total of 6 short courses organized by the Health Service and Population Research Department and they included the following:

a. Economic Evaluation in Mental Health: This course provided me with an understanding of economic evaluation and its relevance to mental health policy and practice. I learnt about identification, measurement and valuation of costs, measurement of outcomes and methods of cost-effectiveness analysis.

b. An Introduction to Qualitative Research Methods: Here I learnt the purpose and appropriate use of qualitative research methods which equipped me with the basic skills to design and conduct qualitative research in the mental health field. I also learnt research methods of in-depth interviews, focus group discussions and participant observation. The course also introduced me to different theoretical approaches to data collection and analysis including the grounded theory approach and Interpretative Phenomenological Analysis (IPA).

c. Mental Health Policy: In this course I was taken through financing and resource allocation; Commissioning and governance; Need, prevalence and demand, Provision and delivery of treatment and support, Choice and control and System interfaces.

d. Measurements in Mental Health: In this course, I learnt about diagnostic classification and structured diagnostic assessments, scale theory (classical and IRT approaches) and scale development, practical considerations in drafting questionnaires, culture-fair assessment and cross-cultural comparison and evaluating psychometric properties of an instrument.

e. Mental Health Services Research: Evaluating Complexities: This course broadened my knowledge on how to choose appropriate research designs for studying complex interventions in mental health services. I learnt the theoretical basis for interventions, implementation of evidence based interventions, and cluster randomized trials.

f. International Mental Health Courses: These courses provided me with an in-depth understanding of the clinical and public health significance of mental health in the global context and the challenges involved in scaling up the coverage of evidence-based interventions to close the ‘mental health gap”. The courses also equipped me with advanced skills in epidemiological, trial and policy research in cross cultural mental health.

2. Statistics courses
I attended 3 major courses on statistical analysis including;

a. Introductory Statistics: Here I learnt about Statistical concepts, Simple analyses for categorical and continuous data, Regression and Correlation, Analysis of Variance, General Linear Model, Multiple testing and power analysis.

b. Training in Statistical Software: These are basic and advanced courses in statistical analysis using STATA and SPSS data analysis and statistical software.

c. Specialist Statistical Methodologies for Behavioral Research: Here I was taken through the concepts of  Model selection, Logistic and Poisson analysis, Scale development, Longitudinal and clustered data, Causal modeling and Clinical trials.

3. Masters Classes
I joined the Masters classes with core study units in essential concepts and skills, including research methodologies, research ethics, study design, and statistical analysis. I also joined the elective specialist modules, including psychiatric epidemiology, measurement in mental health research, complex mental health service interventions, social psychiatry, qualitative research methods, international mental health, and advanced statistical methods.

B. Other Educational Programmes
I was fully involved in other educational programmes in the department including the following:

a. Journal club meetings
b. Case conferences and grand rounds
c. Maudsley debates
d. Epidemiology interest group and  Health Service and Population Research Department seminars

C. Future Academic Plans
I already registered for the MSc in Clinical Trials by distance learning programme and I have plans to start a PhD in Psychiatric Epidemiology in the department soon.

RESEARCH ACTIVITIES
My research activities were mainly domiciled in the Department of Epidemiology although I had interactions with other departments as follows:

1. Department of Epidemiology

a. Perinatal Mental Health in Ethiopia: I was assigned to analyze data from the Perinatal Maternal Mental disorder in Ethiopia (P-MaMiE) study. This large scale study seeks to find out the mechanism through which maternal mental health affects infant health, for example through earlier cessation of breastfeeding, poor maternal help-seeking behaviour on behalf of their infant (e.g. vaccination and treatment for illnesses) and difficulties maintaining an hygienic home environment.

I have just submitted a finished manuscript based on the data to an international journal.

b. 10/66 Dementia Studies: I was introduced to members of the 10/66 research group where I learnt the theories and methodologies of the studies. The research group is a network of more than 100 scientists from across the world who work together to discover the prevalence and causes of dementia in different countries and to find evidence-based solutions.

2. Other Departments
I was introduced to research studies in other departments where I attended research meetings and presentations of papers. I was particularly involved with the Department of Psychosis especially with the AESOP and GAP studies. The AESOP (Aetiology and Ethnicity of Schizophrenia and Other Psychoses) study is a large first-presentation study of schizophrenia and other psychotic disorders while the GAP (Genetics and Psychotic Illness) study is to identify new susceptibility genes for psychosis and establish their clinical significance in terms of symptoms, course(cause???) of illness, response to medication and other biological and neurological traits.

3. Conferences

a. I participated in the conference “Epidemiology and Treatment of Perinatal Psychiatric Disorders: Building on the Evidence Base” organized by the Department of Perinatal Mental Health. This conference included results of innovative epidemiological studies and major trials of interventions for perinatal disorder.

b. On recommendation of my supervisor Prof Martin Prince, I was nominated to represent my country at the World Health Summit at the Charité in Berlin where the Institute of Psychiatry and the Psychiatric Department of the Charité hosted the Symposia on Mental Health where we discussed challenges and future directions for mental health in low and middle-income countries.

c. I am also billed to attend the conference titled “Perinatal Psychiatry in the 21st Century: The Legacy of Channi Kumar” in IOP soon.

3. Future Research Plans
I am presently developing a detailed research proposal (with supervision and support from Prof. Martin Prince) to be submitted to Wellcome Trust for a Randomized Controlled Trial of non-pharmacological intervention to be implemented in my home country Nigeria.

CONCLUSION
My one year in the Institute of Psychiatry has exposed me to a broad range of research and academic activities. I express my sincere appreciation to the World Psychiatric Association (WPA) and the Institute of Psychiatry (IOP) for the unique opportunity. I really enjoyed my stay and made a lot of friends.

As I return to my clinical, academic and research work in Nigeria, I hope to use my recently acquired academic knowledge and research skills to benefit my country through sharing of knowledge with my colleagues as well as forging collaborations to carry out sound but, culturally relevant research in my country.

Abiodun Adewuya
April 29th, 2010

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