Spotlight Interview with T32 Global Psychiatry Fellows
Location: Boston, USA
Background: The NIMH-funded Boston University Medical Campus - Massachusetts General Hospital (BUMC-MGH) T32 Global Psychiatry Clinical Research Training Program aims to develop independent clinical scientists who can address the most pressing global mental health challenges. The postdoctoral fellowship is a three-year training program that combines rigorous didactic instruction, clinical research methods training from Boston University and Harvard University, practice in working effectively with disadvantaged communities, and immersive, mentored clinical research experiences in global settings.
This spotlight interview celebrates three of our fellows on their completion of the training program this month. Congratulations to Drs. Kimberly Hook, Amelia Stanton, and Maria Prom! Read their full bios here.
Can you share your research focus and mentors?
Dr. Amelia Stanton: My research is broadly in improving sexual health disparities, particularly among pregnant women in South Africa. Specifically, I am interested in mitigating psychological barriers to initiating and sustaining pre-exposure prophylaxis (PrEP) use for HIV prevention in pregnant women with high risk for HIV. My U.S.-based mentors are Drs. Conall O’Cleirigh and Christina Psaros, both at MGH who have a lot of experience in improving engagement in HIV care and extensive global experience. My mentors in South Africa are Drs. John Joska and Landon Myer at the University of Cape Town who are both involved in HIV-related work and intervention adaptations specific to the South African context, and they are trying to understand how to integrate HIV care into antenatal care.
Dr. Kimberly Hook: My work is associated with treating common mental health disorders, particularly depression, anxiety, and trauma, with a secondary focus on substance use disorders. My time has been spent working in Ukraine with my international mentor, Dr. Sergiy Bogdanov. In addition to analyzing Dr. Bogdanov’s pre-existing data (measure validation, etc.), we also collected qualitative data to support my K01 proposal. I also work closely with colleagues in Internal Medicine at Boston University who work substantially in Ukraine and Russia, specifically around TB and HIV prevention and treatment. In this partnership, my role is to consider and analyze mental health outcomes and the impacts of stigma on mental health.
Dr. Maria Prom: My research focuses on improving mental health systems and services in under-resourced setting with sustainable, feasible, and acceptable care models that can be scaled up. I am really interested in integrated care and training non-mental health professionals, and I am focused specifically on perinatal mental health. I received guidance from my U.S. based mentors, Drs. Bizu Gelaye and Christina Borba. Dr. Gelaye has a great partnership and research infrastructure in Peru with my international mentor, Dr. Marta Rondón. Additionally, I’ve been able to work with Dr. Nancy Byatt who focuses on perinatal mental health care in under-resourced settings in Massachusetts. Moving forward, I am hoping to adapt and implement her programs to make an impact in Peru’s mental healthcare systems. I plan to focus on the training and ongoing supervision of non-mental health professionals. It’s an important way to make an impact in low- and middle-income countries (LMICs), especially due to the lack of trained professionals in psychiatry.
Why did you join the T32?
Dr. Kimberly Hook: I knew I wanted a career in global mental health, and there are very few opportunities to launch that career. My goal was to use the fellowship as a springboard to continue my work in the field and sustain a long-term career. Knowing that strong working relationships are a critical part of global mental health, I focused on creating strong, meaningful partnerships. My collaboration with Dr. Bogdanov has been the result of an investment of work and time (on both sides) and is both personally and professionally fulfilling.
Dr. Amelia Stanton: I would agree with Kim. For me, I was always committed to women’s health, to sexual health, and especially to improving sexual health for populations at greatest risk for poor sexual health. The fellowship was an opportunity to take that work global and find context that it could be really useful in. I’ve been very proud of the accomplishment of establishing strong and long-lasting relationships with collaborators in South Africa that require time, care, and maintenance. The fellowship gave me the tools to maintain those relationships, support work on the ground there, and to build resources for the team there.
Dr. Maria Prom: The T32 fellowship was actually a big reason why I chose to pursue my psychiatry residency training at MGH, knowing that the fellowship was something I could apply and do afterwards. Pursuing a career in Global Psychiatry can come with many challenges and the T32 provides a unique opportunity to develop a strong foundation in the field. It’s remarkable to have three years of support, including incredible mentorship. I have been collaborating in Peru since medical school and the T32 also offered an opportunity to continue collaborating with my established partners, as well as develop new partnerships in Peru. Ultimately, my team of mentors has been very impactful on my career.
Why is global mental health important to you?
Dr. Maria Prom: I grew up in lower socioeconomic status in an under-resourced rural area in the US. Through that lens, I saw how mental health and the lack of care can have an impact on under-resourced communities. And globally, there is a significant burden of illness from mental health issues that impacts individuals, families, and society. By improving mental health, you can intervene and impact the cycle of poverty and inequity in LMICs, rural areas, and other under-resourced areas throughout the world. You can also impact the cycle of intergenerational trauma that often co-occurs in under-resourced settings. Research within global health is especially important to me as it can support the development and implementation of mental health programs that are evidence-based. This is so important in LMICs where limited research is conducted, and adaptation is essential to better fit the local context, language, culture, and resources.
Dr. Amelia Stanton: I think that mental health in most contexts is understudied and under-conceptualized. Though the pandemic did a decent job of shining additional attention on mental health, especially in LMICs, mental health has not been historically prioritized, yet we know that mental health has a huge impact on functioning, on public health, HIV, TB, and other “more impactful” diseases. Mental health is an important piece of the puzzle, and to some degree, we are only now realizing that on a large scale. Addressing mental health is an important part of treating and preventing these devastating diseases in a global context.
Dr. Kimberly Hook: Adding to that, noncommunicable diseases (NCDs), and specifically mental illnesses, are drivers of leading causes of disability worldwide. Not only are they drivers, but they interact with and negatively impact more prioritized diseases. These all go hand-in-hand. If mental health is neglected, it will be very difficult to reduce the burden of other diseases. Additionally, mental illness and mental health in and of itself is critical. Mental well-being impacts our ability to work, our social functioning, and our overall quality of life. Mental health and access to mental health care is something we must continue to address.
What is your favorite memory during the fellowship?
Dr. Kimberly Hook: One of my favorite memories is my last trip to Ukraine early this year, especially in light of the present war. It was wonderful to see Dr. Bogdanov in-person and to reconnect. I was able to meet his entire family, and they invited me out to their house in the country. After having been apart for two years due to the pandemic, it was really important to have this time together again.
Dr. Amelia Stanton: I think similarly it's the non-work moments that are really special and memorable. For me, I remember my first trip to South Africa in July 2019 and my team took a day to visit the penguins in Cape Town. I love animals, and it was great to really learn more about the climate in South Africa. But most importantly, it was nice to enjoy the day with my colleagues as a group, to bond as a group, and to establish that sense of team camaraderie, which is harder to build when members of the team are in different countries and working remotely.
Dr. Maria Prom: All my favorite memories are from when I was traveling in Peru. I am so appreciative of those moments when I was able to meet with our collaborators and observe their work with patients and other care providers. It was always so inspiring to see their dedication to improving mental health despite the constant lack of resources they face. Also, I have so many memories of great conversations while enjoying delicious Peruvian meals.
What is one piece of advice you would like to share with future fellows?
Drs. Amelia Stanton & Kimberly Hook: Reach out to mentors. It’s important to think about who are the people that will really be supportive and who have the experience to facilitate your research career. You want to have a team of mentors who focus on and value mentorship.
Dr. Maria Prom: Persistence. A career in global mental health is not easy. If it's really your passion, then you have to be persistent in moving your path forward. Also, ensure that you have a team of mentors; it’s essential to have supportive mentorships for all the different areas of your development.
Closing Thoughts
The fellows would like to express their gratitude to all their international and domestic mentors and colleagues for their meaningful collaborations and relationships.
By Joanne Won, June 2022