Dissemination and implementation of evidence based, mental health interventions in post conflict, low resource settings. 2014

Laura K Murray, and Wietse Tol, and Mark Jordans, and Goran Sabir Zangana, and Ahmed Mohammed Amin, and Paul Bolton, and Judith Bass, and Fransisco Javier Bonilla-Escobar, and Graham Thornicroft
Associate Scientist, Clinical Psychologist, Johns Hopkins School of Public Health; Dept of Mental Health, Applied Mental Health Research Group (AMHR).

The burden of mental health problems in (post)conflict low- and middle-income countries (LMIC) is substantial. Despite growing evidence for the effectiveness of selected mental health programs in conflict-affected LMIC and growing policy support, actual uptake and implementation have been slow. A key direction for future research, and a new frontier within science and practice, is Dissemination and Implementation (DI) which directly addresses the movement of evidence-based, effective health care approaches from experimental settings into routine use. This paper outlines some key implementation challenges, and strategies to address these, while implementing evidence-based treatments in conflict-affected LMIC based on the authors' collective experiences. Dissemination and implementation evaluation and research in conflict settings is an essential new research direction. Future DI work in LMIC should include: 1) defining concepts and developing measurement tools, 2) the measurement of DI outcomes for all programming, and 3) the systematic evaluation of specific implementation strategies.

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