On 11th and 12th July 2017, the Mental Health and Addiction Research Group (MHARG), the University of York and the Hull York Medical School hosted a two day workshop focused on global mental and physical health comorbidity research and research capacity in South Asia, with guests from Bangladesh, India and Pakistan. The meeting was supported by a Centre for Future Health Wellcome Trust/University of York partnership grant.
Discussions focused on determining the priorities for health for people with mental illness in Bangladesh, India and Pakistan. This raised interesting questions including whether to focus on prevention or treatment of physical illness; on common mental disorders or severe mental illness; and whether researchers should priorities the gaps where the governments are not working.
Delegates from Bangladesh reported a lack of data concerning the health and healthcare of people with mental health problems. Attendees agreed the need for a national survey and discussed the practicalities of such an undertaking. For instance, how do we ensure that a true representation of the population being studied is obtained, when specific groups may choose to partake in completing a survey and if recruitment to the survey is limited to specialist healthcare populations, rather than carrying out more resource intensive community surveys?
A research project is currently underway in the UK and Pakistan to gain data on those with serious mental illnesses (SMIs) and so discussion developed into one surrounding the positives and practicalities of undertaking the same project in both India and Bangladesh too, with agreement that this would be feasible, and commitment of the necessary resources by representatives from both countries. Delegates from Bangladesh were keen to involve the population of people with common mental disorder in the survey.
Although it is challenging to ensure that those with severe mental illness, who may lack capacity to consent, are included in research, with ethical arguments against research being too intrusive, it was concluded that it was also vital to make sure that those people were participants in research. There are also persuasive ethical reasons why they should be included.
In Pakistan, research questions will be asked to those who are receiving treatment at a psychiatric institute. However, there are many possibilities for how this might take place in India and Bangladesh. It was noted that any method of participant-recruitment might skew the data, as there are socio-economic differences between those receiving treatments in public versus private healthcare institutions. Maybe the best solution is to conduct research in more than one area to compare these factors?
Overall, this two day workshop, filled with discussions between researchers from around the globe, proved beneficial for establishing some of the main current healthcare priorities and beginning discussions around implementation and data collection. Working groups were established to develop some of this initial conversation further.
Abigail Fedorovsky – Communications Intern for York International Development Network