# Developing and Evaluating a Perceived Access Metric for Global Mental Health

> **NIH NIH R34** · UNIVERSITY OF WASHINGTON · 2024 · $204,888

## Abstract

Access to mental health care is a fundamental human right that should be a critical performance metric for all
governments and healthcare systems. However, there are few psychometrically evaluated measures of access,
especially for low-and-middle income countries. Theoretically informed, culturally grounded, and psychometrically
sound access metrics are needed to hold governments and healthcare systems accountable for making mental health
services accessible to all people, and to help design and evaluate new programs and policies focused on improving
access. This proposed project is a collaboration between investigators at the University of Ibadan in Nigeria and the
University of Washington in the United States. The project has two major objectives. The first objective is to develop
and psychometrically evaluate a metric of perceived access to mental health care that is cultural appropriate for Nigeria.
The second objective is to enhance the research capacity of early-state global mental health researchers in Nigeria. The
proposed research activities include three specific aims. For Specific Aim #1, we will conduct in-depth qualitative
interviews with patients with depression and/or anxiety living in Ibadan, Nigeria, along with their caregivers and
clinicians, to identify common impactful barriers that prevent or delay people from receiving needed care. Qualitative
research with the intended population is needed to ensure that the perceived access metric contains items about
barriers that are relevant for the population. However, because not all barriers to mental healthcare are modifiable, we
will need to divide barriers into two groups: 1) access barriers and 2) non-access barriers (i.e., attitudinal and need
barriers). For Specific Aim #2, we will obtain consensus from health providers and policy makers regarding the
modifiability of the identified barriers by healthcare systems and/or ministries of health. Once the access barriers are
identified, we will generate items to include in the perceived access metric and then revise them using cognitive
interviews with patients. Working with patients to first identify barriers and then providers and policy makers to
determine which barriers are modifiable will optimize the content validity of the access metric. For Specific Aim #3, we
will conduct a survey with 250 patients with depression and/or anxiety to assess the critical psychometric properties of
reliability, construct validity and cross-cultural validity. At the conclusion of the proposed research, we will have a
patient-centered metric of perceived access that is ready to use for policy evaluations, quality improvement, and
research. With valid and reliable metrics of access, gaps and inequities in access can be detected and the impact of
policies and programs designed to enhance access and address disparities can be meaningfully evaluated. The proposed
research is closely aligned with NIMH’s Strategic Plan Goal 4 (Objectives 4.1 and 4.3). ...

## Key facts

- **NIH application ID:** 10951373
- **Project number:** 1R34MH137174-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** JOHN C. FORTNEY
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $204,888
- **Award type:** 1
- **Project period:** 2024-09-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10951373

## Citation

> US National Institutes of Health, RePORTER application 10951373, Developing and Evaluating a Perceived Access Metric for Global Mental Health (1R34MH137174-01). Retrieved via AI Analytics 2026-06-25 from https://api.ai-analytics.org/grant/nih/10951373. Licensed CC0.

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