Challenges and strategies for implementing mental health measurement for research in low-resource settings.

The gap between need and access to mental health care is widest in low-resource settings. Health systems in these contexts devote few resources to expanding mental health care, and it is missing from the agenda of most global health donors. This is partially explained by the paucity of data regarding the nature and extent of the mental health burden in these settings, so accurate and comparable measurement is essential to advocating for, developing, and implementing appropriate policies and services. Inaccurate estimation of mental illness prevalence, and misunderstandings regarding its etiologies and expressions, are associated with unnecessary costs to health systems and people living with mental illness. This paper presents a selective literature review of the challenges associated with mental health measurement in these settings globally, presents several case studies, and suggests three strategies for researchers to improve their assessments: utilize qualitative data, conduct cognitive interviews and train research teams with a focus on inter-rater reliability. These three strategies presented, added to the complement of tools used by mental health researchers in low-resource settings, will enable more researchers to conduct culturally valid work, improve the quality of data available, and assist in narrowing the treatment gap.