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Bridging Countries and Building Capacity: A Bright Path Forward for Global Child Mental Health

By Peter Raucci, Director, Global Fellowships Strategy, Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute

In May of 2025, I had the opportunity to visit Kenya to explore a possible expansion of the Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute’s Clinical Fellowship model. Our goal was to build a new training pipeline connecting talented Kenyan clinicians with experts at the renowned Stellenbosch University in South Africa. The trip was eye-opening — not only because of the talent and dedication of the clinicians we met in Nairobi and Mombasa, Kenya’s two largest cities, but also because it reaffirmed a fundamental truth about global mental health. Collaboration across borders is essential.

This vision has now turned into a powerful reality. I’m proud to share that after identifying critical needs during the Kenya trip, we were able to select our first cohort of Fellows. These exceptional clinicians whose expertise, dedication, and deep commitment to their communities position them to be transformative leaders, are now on track to help pioneer this partnership.

Our inaugural fellows:

  • Muthoni Muthiga, psychiatrist
  • Milcah Olando, psychiatrist
  • Mercy Chege, psychologist

The plan is for the Fellows to spend a period of up to two years in South Africa and Kenya, receiving intensive training in child and adolescent mental health from the experts at Stellenbosch University. After concluding their Fellowship, all three have committed to continuing their work in Kenya’s public sector — exactly where their knowledge and skills are needed most.

SNF Global Center Clinical Fellows – Nairobi
SNF Global Center Clinical Fellows – Nairobi (left to right, top to bottom): Mercy Chege, Psychologist, Dr. Milcah Olando, Psychiatrist, Dr. Muthoni Muthiga, Psychiatrist

During the visit to Kenya, I witnessed an urgent and growing crisis in access to mental health care for youth. Through the SNF Global Center Fellowships Program, we aim to strengthen the capacity of the workforce by training local specialists like our inaugural Fellows. They can provide culturally responsive, evidence-based care while collaboratively building systems that prioritize youth mental health care.

Facilities like Kenyatta National Hospital and Mathari National Teaching and Referral Hospital in Nairobi — as well as public clinics in Mombasa County and Kilifi County — are in urgent need of CAMH specialists. For instance, in Kilifi County, only two psychiatric nurses serve a population of around 1.2 million people — leaving a staggering gap in mental health support for both youths and adults. Additionally, my conversations with clinicians at Aga Khan University (Kenya), a private institution with strong public partnerships that could serve as a vital hub for the Fellowship, further reinforced that sense of urgency. The clinicians I met are dedicated to improving outcomes for children and families. And what they need is time, training, mentorship, and the opportunity to grow into leadership roles in the field.

That’s why cross-country training opportunities like this matter. They don’t just build the skills of individual practitioners. They strengthen clinical networks, inspire new research, and ultimately transform systems of care. We are exploring ways to adapt our model to meet the unique needs and strengths of East and Southern Africa. Kenya has a fast-growing population of young people, yet trained CAMH specialists remain critically few. By training clinicians in South Africa and supporting their return to Kenya, we aim to help support a growing community of local experts working in public hospitals, university settings, and community mental health systems.

Ayesha Mian, MD, who sits on the Executive Council of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), joined me on the trip.

When reflecting on how much is being done in the field of global child and adolescent mental health, she says, “The answer must lie in disruptive solutions, collaborations, regional partnerships and cross disciplinary interventions that build and sustain systems. The partnership between Kenya and South Africa provides just such an opportunity, where the conversations ranged from on ground training of child and adolescent health care professionals to developing systems of care across the country and the region through policy, literacy, and capacity building.”

At the Serena Nairobi Hotel with attendees from Aga Khan University Nairobi, Stellenbosch University, IACAPAP, and health care and research representatives from across Kenya.

Partnerships between low- and middle-income countries (LMICs) and high-income countries (HICs) have the opportunity for impact. What’s just as powerful, perhaps even more transformative, are partnerships between LMICs themselves — countries where the economic, cultural, and systemic realities show evidence of pattern. South-South collaboration has the potential to build more contextually appropriate models of care with Fellows learning from mentors who understand the day-to-day realities of practicing in resource-constrained systems. Our Fellowship model has already proven successful in linking Mozambique with Brazil, where generalist clinicians receive training in child and adolescent mental health specializations.

This kind of collaboration isn’t about one-way knowledge transfer. It’s about co-creating solutions that are sustainable, regionally relevant, and driven by the people who will carry them forward. Over time, as this capacity grows, Kenya itself has the potential to become a regional hub for CAMH training — serving as a center of excellence for East Africa, including Uganda, Tanzania, and beyond.

The Fellowship model reflects the Child Mind Institute’s commitment to translating clinical excellence into scalable, global workforce solutions that strengthen public systems of care.

Learn more about the Global Fellowships Program

The post Bridging Countries and Building Capacity: A Bright Path Forward for Global Child Mental Health appeared first on Child Mind Institute.

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Tideglusib improves novel object recognition memory in the preclinical DBA/2J mdx mouse model of Duchenne muscular dystrophy

IntroductionDuchenne muscular dystrophy (DMD) is a severe X-linked neuromuscular disorder characterized by progressive muscle wasting. Approximately 1 in 3 DMD patients experience cognitive dysfunction, with research suggesting an Alzheimer’s disease (AD)-like pathology. We have previously shown that treatment with the glycogen synthase kinase 3β (GSK3) inhibitor, tideglusib, improves muscle quality, function, and insulin sensitivity in the DBA/2J (D2) mdx mouse model of DMD. In this brief follow-up study, we report the effects of tideglusib treatment on cognitive function.MethodsMale D2 WT and mdx mice were purchased from Jackson Laboratories. Mice were separated into the following groups: (1) WT, (2) mdx-vehicle, and (3) mdx-tideglusib (10 mg/kg/day via oral gavage for 4 weeks). A novel object recognition test was performed to assess recognition memory. Hippocampus and serum samples were collected for BACE1 activity assays, amyloid beta (Aβ) ELISAs, and western blotting.ResultsCompared to vehicle-treated mdx mice, tideglusib-treated mdx mice demonstrated improved recognition memory. These changes to recognition memory were accompanied by greater expression of beta-catenin, an indirect downstream marker of GSK3 inhibition. While there were no changes in BACE1 activity, tideglusib-treated mdx mice had higher concentrations of Aβ in the serum and lower protein levels of receptor of advanced glycation end products.DiscussionThe results from this brief follow-up study offer preliminary support for tideglusib as a treatment for both muscle and brain impairments in mdx mice, potentially improving cognitive function through enhanced vascular Aβ clearance.
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Exploring neural mechanisms of Mandarin tone sandhi perception via fNIRS: the role of gesture in multimodal integration

IntroductionThe use of pitch gestures in teaching Mandarin tone (i.e., gesture-augmented instruction) has been reported to facilitate lexical tone acquisition. However, the neural mechanisms underlying how gestures aid the learning of complex phonological rules, such as tone sandhi, remain unclear. This study investigated whether gesture-based learning enhances tone sandhi perception primarily through multimodal integration or by promoting cognitive control.MethodsForty-four Vietnamese-speaking learners were randomly assigned to either a gesture training group or a no-gesture control group. Post-training, participants performed a disyllabic tone discrimination task while functional near-infrared spectroscopy (fNIRS) data and behavioral responses were recorded.ResultsResults revealed significantly greater neural responses in the left dorsolateral prefrontal cortex (L-DLPFC) in the gesture group compared to the control group. Moreover, enhanced L-DLPFC activation was positively correlated with improved behavioral discrimination accuracy. The gesture group also exhibited strengthened functional connectivity between the L-DLPFC and bilateral prefrontal cortices, accompanied by accelerated hemodynamic responses.DiscussionCollectively, these findings suggest that gesture-assisted learning facilitates tone sandhi mastery primarily by augmenting prefrontal executive control and fostering multisensory integration. This pattern aligns with a weak embodied cognition framework, in which gestures serve as distributed scaffolds that support, rather than replace, abstract tonal representations.
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Oral administration of kratom leaf extract alleviates anxiety-like behavior, urinary bladder pain, voiding dysfunction, and bladder hypercontractility via attenuating muscarinic receptor response in male mice exposed to chronic water avoidance stress

Psychological stress causes and deteriorates interstitial cystitis/painful bladder syndrome with urinary frequency, incontinence, bladder pain and urgency. The major alkaloid of kratom (Mitragyna speciosa), mitragynine, shows analgesic, anxiolytic, and smooth muscle relaxant effects. However, the effects of kratom leaf extract on stress-induced anxiety-like behavior, urinary bladder pain and urinary bladder dysfunction remain unknown. Therefore, this study aims to examine the effect of kratom leaf extract administration on anxiety-like behaviors, bladder pain, bladder contractile properties, and mast cell number in mice exposed to water avoidance stress. Male C57BL/6 mice were exposed to water avoidance stress (WAS) protocol for 10 consecutive days and compared with the stress-exposed mice receiving oral administration of kratom leaf extract (2.5 and 5 mg/kg of mitragynine) or solifenacin (10 mg/kg). Anxiety-like behaviors were assessed using open field test. Bladder pain sensitivity was evaluated with von Frey test, while voiding behavior was analyzed using voiding pattern analysis. Bladder contractility was examined using an in vitro organ bath technique, and urinary bladder mast cell infiltration was assessed by toluidine blue staining. Results show that mice receiving WAS had a reduction in the total duration and number of unsupported rearing behaviors, reduced voiding area, and increased bladder pain responses; however, these effects were reversed by treatment with kratom leaf extract (2.5 and 5 mg/kg of mitragynine). Interestingly, the WAS group also exhibited markedly increased tonic contractions in response to carbachol, a muscarinic agonist; these responses were attenuated in mice treated with kratom leaf extract (2.5 and 5 mg/kg) The enhanced tonic contractile response to carbachol was abolished by pre-incubation with ondansetron (a 5-HT₃ antagonist). The WAS group showed an increased total number of mast cells in the urinary bladder, which was reduced by treatment with kratom leaf extract at both 2.5 and 5 mg/kg. Our results indicate that treatment with kratom leaf extract attenuated chronic stress–induced bladder pain responses, voiding abnormalities, and mast cell numbers, and was associated with reduced contractile response to muscarinic stimulation, suggesting a potential modulatory effect on stress-induced bladder dysfunction.
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Chronic stress and cognitive dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome: HPA axis dysregulation and hippocampal plasticity

Cognitive dysfunction is a common and disabling clinical feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), often described by patients as “brain fog.” These symptoms typically manifest as difficulties in attention, memory, and concentration. Chronic stress has been proposed as an important contributing factor in ME/CFS. The hypothalamic-pituitary-adrenal (HPA) axis plays a central role in the stress response, and prolonged adverse stress may contribute to HPA axis dysregulation, including altered cortisol rhythmicity and impaired negative feedback regulation. Such dysregulation may be associated with cognitive dysfunction in ME/CFS through mechanisms involving neuroinflammatory responses, oxidative stress, and disturbances in neurotransmitter homeostasis. Studies suggest that these alterations may affect hippocampal structure and function, thereby contributing to impaired learning and memory processes. As a key brain region involved in cognition and stress regulation, the hippocampus may be implicated in the neurobiological mechanisms underlying cognitive dysfunction in ME/CFS. This review integrates current evidence on the potential role of HPA axis dysregulation and related neurobiological alterations in chronic stress-associated cognitive dysfunction in ME/CFS, with the aim of providing a theoretical basis for identifying potential intervention targets and informing strategies centered on HPA axis regulation.
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Psychometric properties of Lithuanian translation of the self-report version of the Liebowitz social anxiety scale in young adult sample

BackgroundSocial anxiety disorder starts in adolescence or young adulthood and may have damaging effects on psychosocial development of the individual. Any intervention starts from assessment and the Liebowitz social anxiety scale with later developed self-report version is a valuable tool for practitioners for almost four decades. Even though the original version and adaptations have consistently demonstrated good reliability, there remains considerable debate regarding the factor structure. The aim is to test the factor structure and internal consistency of Lithuanian translation of the self-report version of the Liebowitz social anxiety scale (LSAS-SR) in a non-clinical young adult sample.MethodData of 452 young adults (mean age 21.3, 69.7% female) who volunteered participate in the study was used. Two factor solutions were tested: a single-factor model, with anxiety/fear and avoidance ratings loading on one factor, and a higher-order factor model, including two second-order scales (anxiety/fear scale and avoidance scale) and four first-order subscales (social interaction anxiety, performance anxiety, social interaction avoidance, performance avoidance). Internal consistency assessed using Cronbach’s alpha.ResultsLithuanian version has excellent internal consistency for the total score, scales and subscales, with Cronbach’s alfas ranging.85-.96. Confirmatory factor analysis shows that both tested models have acceptable data fit (RMSEA = .062-.067; CFI = .93-.94), however strong associations between (sub)scales, i.e. correlations exceeding.80, suggests that the use of scale and subscale scores may be less informative, especially in cross-sectional research, but could provide nuanced information in individual assessment.ConclusionFurther research on psychometric properties of Lithuanian versions of LSAS-SR should focus on verifying these results in a representative sample and in a clinical sample as well as testing the convergent and discriminant validity.
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The temporal stability of core symptoms of social media addiction and their comorbidity with anxiety and depression in adolescents: a longitudinal network analysis

IntroductionSocial media addiction (SMA) is often comorbid with anxiety and depression. This study examined the temporal stability of core SMA symptoms and the bridging symptoms with anxiety and depression.MethodsA total of 1,240 adolescents (179 males, 1,061 females; mean age = 15.46 ± 0.63 years, age range: 14 – 18) completed the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire–9 (PHQ–9), and the Generalized Anxiety Disorder–7 (GAD–7) on two separate occasions in 2023 (T1) and 2024 (T2). The four symptom networks, including the BSMAS networks, two comorbidity networks (the BSMAS–GAD and the BSMAS–PHQ), and the integrated BSMAS–GAD–PHQ network, were estimated using Gaussian graphical models. Core symptom centrality was assessed using Expected Influence (EI), whereas bridge symptoms were identified using Bridge Expected Influence (BEI).Results1) Although SMA, anxiety, and depression levels of respondents rose significantly over the year, all four networks showed strong temporal stability, with the edge weights (r = .892 –.973, p < .001), the EI (r = .806 – .961, p ≤ .002), and the BEI (r = .699 – .804, p ≤ .008) highly correlated between T1 and T2; network comparison tests showed no significant changes in overall structures of all four networks, with most edges showing stable weights. 2) Within the BSMAS network, BSMAS2 (tolerance) and BSMAS6 (conflict) exhibited the highest EI at both time points. 3) In the comorbidity networks, BSMAS3 (mood modification), BSMAS5 (withdrawal), and BSMAS6 (conflict) consistently served as bridge symptoms on the SMA side at both T1 and T2. 4) Across both time points, PHQ1 (anhedonia) and PHQ7 (concentration problems) exhibited the highest BEI on the depression side, whereas GAD1 (nervousness) and GAD5 (restlessness) did so on the anxiety side. 5) These bridge symptoms were also confirmed in the integrated network.DiscussionThese findings illuminate the temporal persistence and development of symptom relationships, offering a more dynamic understanding of SMA–depression–anxiety comorbidity in adolescents.
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From stigma to support: the mediating role of sympathy between nurses’ perceived stigma and helping behavior tendency for alcohol use disorder

BackgroundThe detrimental effect of stigma on healthcare for individuals with alcohol use disorders (AUDs) is well-established, often resulting in social distance and diminished helping behavior tendencies. However, contemporary neuroscience reconceptualizes addiction as a brain disease, potentially altering emotional responses to stigma. This study examines a seemingly paradoxical possibility: that under specific conditions, perceived stigma is primarily associated with sympathy (rather than anger or fear), which in turn is linked to helping behavior tendencies among nurses.MethodsA cross-sectional survey was administered to 348 clinical nurses from tertiary hospitals in China. Participants completed standardized scales assessing perceived stigma of patients with AUDs, causal attributions, emotional responses (including sympathy, anger, and fear), and helping behavior tendencies. Data were analyzed using Pearson correlation and mediation analysis (PROCESS macro, Model 4) with 5,000 bootstrap samples to test the mediating role of sympathy.ResultsPerceived stigma showed a significant positive correlation with sympathy (r= .160, p<.05), which was in turn positively correlated with helping behavior tendencies (r= .269, p<.05). Critically, mediation analysis revealed that sympathy fully mediated the relationship between perceived stigma and helping behavior tendencies. The standardized indirect effect was significant (β= 0.15, 95% CI [0.08, 0.23]), accounting for the total observed relationship, as the direct effect was non-significant. Additionally, compared to non-psychiatric nurses, psychiatric nurses perceived patients as significantly less dangerous and reported lower levels of fear and anger, along with a stronger intention to help and a lower tendency to avoid patients.ConclusionChallenging conventional perspectives, this study supports a dual-pathway model in which perceived stigma can indirectly associated with professional helping behavior tendencies through the elicitation of sympathy. While other emotions like anger and fear were also measured, the findings highlight the pivotal role of cognitive-affective processes, shaped by neurobiological understandings of addiction, in determining nursing care. Specifically, sympathy, but not anger or fear, was found to mediate the stigma-helping relationship. Enhancing neuroscience-informed education and targeted empathy training, particularly for general nurses, could transform stigmatizing attitudes into supportive care, ultimately improving outcomes for patients with AUDs.