Joining the Research Team in Global Mental Health Erin P. Finley, PhD MPH Anthropology in/of Global Mental Health Emory University April 30, 2016

What team(s) do we want to be on? Public Health Clinical Trials (including RCTs and Comparative Effectiveness) Program Evaluation Quality Improvement Health Services Research Implementation Research

Health Services Research Multidisciplinary study of how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors… Affect access to health care, quality of health care, cost of health care, health and well-being Among individuals, families, organizations, institutions, communities, populations. Academy for Health Services Research and Health Policy, 2000

Health Services Research

Implementation Research Efficacy Does it work in a study? Effectiveness Does it work in the real world? Implementation How to spread best practices?

Fisher, Shortell, Savitz, JAMA 2016

Implementation Research Efficacy Does it work in a study? Effectiveness Does it work in the real world? Implementation How to spread best practices? Hybrids

Why Anthropology Matters Anthropology has rigorous ethnography Anthropology understands context Anthropology has great theory Anthropology turns a critical lens back on health systems Closser and Finley 2016

Anthropology at the Table Communicate in accessible language Work on problems with obvious relevance Ground our work in rigorous, transparent methodology Get the facts right Be mindful of anthropological biases Provide recommendations for action Closser and Finley, 2016

Part II Autonomy/dignity vs. individual/community well-being Making ethics and values explicit Asking powerful questions Learning to problem-solve Therapeutic alliances

EMPOWER Implementation Core *Adapted from Kilbourne et al., 2007; ^Simpson et al., 2013; Adaptation by Hamilton et al., 2015

Dynamic Sustainability Framework Chambers, Glasgow & Stange, 2013

Why do we want to be at the table Why do we want to be at the table? What do we need to/need to do to get there and stay there?

Questions Where are anthropologists and anthropological well-integrated into contemporary health research? Where are the gaps in anthropologists’ current involvement in contemporary health research? What are the biggest challenges for anthropologists looking to contribute to contemporary health research? Toward the goal of making anthropological approaches a more standard part of health research – how can we more effectively communicate and demonstrate the benefits of anthropology across disciplines and stakeholders in global mental health? Why do we want to be at the table? What do we need to get there and stay there?