Newsletter 09 | Brain & Mind Institute | The Aga Khan University

We end the year 2023 in the afterglow of our inaugural conference entitled, “Healing the Brain: Bridging the Gap in Low-and Middle-Income Countries." This conference brought together University leadership and academics, government representatives, international organizations such as the AKDN, WHO, UN, and UNICEF, and global mental health champions, such as Dr. Vikram Patel from Harvard. The highlights and outcomes of this conference are covered in this newsletter, below. In our Education Domain, our team led by Dr. Kendi Muchungi and Prof Tayyeb Tahir offered a highly popular course entitled Mental Health Ambassadorship, which teaches one how to recognize signs of common mental illnesses and to respond empathetically. This course also helps one to recognize the biological, psychological, and social determinants of mental ill health and helps destigmatize mental illness. In short, we hope this course will generate mental health ambassadors who will open up difficult conversations and promote help-seeking for mental ill health more widely. In addition, BMIlaunched its first Mental Health Resilience Bootcamp – which was very well received by course participants. This course gives one a 'toolbox' to deal with everyday stressors at work and home and is designed to mitigate the progression of mental illness. This Bootcamp will be offered more widely in 2024.

Dr Anne Njogu *Project Manager*	Catherine Bikeri *Project Manager*	Cynthia Smith *Student Fellow*	David Njenga *Research Assistant*
Grace Mugo Project Assistant	Harriet Kigaro Research Assistant	Katherine Kairichi *Manager, Communications* *and Stakeholder Engagement*	Mashaal Hooda *Research Specialist*
Rehema Mwema *Project Manager*	Vincent Orao Research Assistant	Warisha Zahid *Research Associate*	Zahra Haji Clinical Psychologist and Associate Scientist

The State of Mental Health Globally The Brain and Mind Institute (BMI) at the Aga Khan University recently hosted the “Healing the Brain: Bridge the Gap in Low and Middle-Income Countries (LMICs)" conference, in Nairobi, Kenya, from 15th to 17th November 2023. According to the World Health Organization, 25% of the East African population is experiencing mental health concerns. Depression and anxiety are the most common mental health conditions affecting 10 percent of the population. This burden is glaringly evident in Kenya, ranking fifth in Africa for depression cases, with over 1.9 million people involved and a global suicide rate standing at 114th. The economic toll is staggering, estimated at 62.2 billion shillings, covering medical expenses, productivity losses, and premature deaths attributed to mental health conditions. Mental health conditions cost the global economy $1 trillion annually, with projections soaring to $6 trillion by 2030.

The Brain and Mind Institute is further ending the year on a positive note, as its founding director,Prof Zul Merali, was appointed to the World Dementia Council. He is among the nine new international leaders to join the council. The new council members come from different disciplines in the dementia field and are from Asia, Oceania, Europe, Africa, and the Americas. The BMI family is proud and delighted in this well-deserved recognition. The World Dementia Council helps change the lives of people with dementia by securing change through our projects, events, and publications. Through the collaborative strength of governments, industry, researchers, and health and social care systems all working together we can transform the prospects for people affected by dementia in all its forms so that the disease no longer negatively impacts lives in the way it does today. The World Dementia Council (WDC) is an international charity. It consists of senior experts and leaders drawn from research, academia, industry, governments, and NGOs in both high-income and low- and middle-income countries, including two leaders with a personal dementia diagnosis. The WDC has an executive team based in London, UK.

In the last quarter of 2023, the Aga Khan University's Brain and Mind Institute (BMI) launched its inaugural Resilience Training Program, aimed at enhancing mental resilience and emotional intelligence across diverse professional groups within the AKU community. This four-day immersive workshop engaged 400 participants from Kenya, Tanzania, and Pakistan, representing various departments of the university and hospital. Led by experts such as Dr. Pamela Browne, Sakina Taki, Dr. Zahra Haji, and Dr. Kendi Muchungi, the program addressed the specific challenges faced by different professional sectors, providing practical tools and strategies for building resilience, managing stress, and improving overall well-being. The program covered a wide range of topics, including stress management, transgenerational trauma, depression, substance abuse, pathways to care, and building mental resilience. The focus was on equipping participants, including hospital staff, faculty, medical residents, and university faculty, with crucial skills to cope with the high-stress environments typical of modern professional settings.
The Brain and Mind Institute (BMI) at the Aga Khan University made a courtesy visit to the County Government of Kilifi to deliberate on how best the Institute can collaborate and partner with the County Government of Kilifi in ensuring the promotion and enhancement of mental and brain health within the county, during a two-day visit from 20 – 21 November 2023. On the first day, the BMI delegation engaged leaders at the Kilifi County Department of Health. The following day, the team met stakeholders at the Mariakani Sub County Hospital. Stakeholders included representatives from Kaloleni and Rabai sub-counties, and Community Health Workers and Community Health Volunteers working in the two sub-counties.
The UtiliZing Health Information for Meaningful Impact in East Africa through Data Science (UZIMA-DS) study is a five-year project funded by the National Institute of Health (NIH) that aims to address the analytical and computational barriers that impede the ability to use technological advances in data science to change health care at the community and individual level. This NIH U-54 grant led by Amina Abubakar, PhD, Professor and Director for the Institute for Human Development, Aga Khan University and Akbar Waljee, MD, MSc , Medicine in the Division of Gastroenterology, Director of the Michigan Integrated Center for Health Analytics and Medical Prediction (MiCHAMP), includes many partners, including the Brain and Mind Institute, which leads the mental health component. We are leveraging existing surveillance data as well as novel mobile technologies (e.g., mobile apps, wearables) for the development of AI/ML-based prediction models to identify adolescents, youth, and healthcare workers at risk of depression and suicide ideation in Kenya. Our preliminary findings show that symptoms of depression (31.5%) and anxiety (25.5%) are relatively high among Kenyan healthcare workers, with female nurses afflicted disproportionately. Participants included doctors, nurses, nutritionists, psychologists, physiotherapists, patient porters, pharmacists, and radiographers. We plan to use predictive analytics to identify those at risk ofcommon mental health disorders. Artificial Intelligence (AI) and Machine Learning (ML) predictive analyses will be used for this purpose.
Posttraumatic stress disorder (PTSD) poses a serious public health problem due to its prevalence. It is a commonly occurring mental health consequence of exposure to life-threatening events such as combat, sexual assault, natural disasters, and serious accidents. Frequently associated with the occurrence of other mental disorders such as depression and increased risk for suicide, it is also a risk factor for other adverse health sequelae, including type 2 diabetes and cardiovascular disease. Understanding the biological basis of risk for PTSD is therefore an important research goal ultimately aimed at prevention and mitigation. Unbiased large-scale genomic discovery provides one of the best current approaches for identifying the biological basis for PTSD. African populations both in the diaspora and on the African continent face a disproportionately high burden of trauma and PTSD yet experience inequity due to underrepresentation in PTSD genetic research, disparities in research, and access to treatment informed by the global north. This underscores the basis for the study, as data from African populations in genetic studies are critical to generate a complete picture of genetic risk factors and identify relevant treatments and therapies.

The Mental Health Ambassadorship Program, initiated by the Brain and Mind Institute (BMI) at the Aga Khan University focuses on advancing mental health awareness and practices through a comprehensive Micro-Certificate course. The course aims to reduce stigma, nurture empathy, and provide early detection and recognition of mental illness. To increase open access, no prerequisites are required. This program features webinars and interactive modules led by experts who contributed to its success.In addition to staff from AKU, we provided access to community organizations, including Futbol Mas, the Nivishe Foundation, and the Nairobi County Mental Health Unit, to enhance outreach and efficacy. This course is offered simultaneously at both major AKU campuses in Nairobi and Karachi. Despite challenges such as coordinating across time zones and cultural nuances, the program has achieved a remarkable 82% retention rate in its first run, graduating 36 participants. The program's success implies that we will expand course offerings in 2024.

Read our publications by clicking on the links below: Views on COVID-19 vaccination among residents of Eldoret, Kenya during the 2021 vaccine rollout by Edna N. Bosire et al. Who should pay the bill for the mental health crisis in Africa? By Cyprian M. Mostert et al. 12-month substance use disorders among first-year university students in Kenya by Shah, J., & Atwoli, L. (2023)