Why searching for psychosis in diverse settings is important for global research and mental health systems development

The INTREPID programme of research aims to establish comparable studies of incident psychosis in a number of low- and middle-income countries (LMICs).

The importance of this cannot be under-estimated, as this will enable the testing of existing findings and evidence across differing environmental contexts; and will permit the identification of new and unique evidence that is only apparent within specific contexts. The epidemiological, aetiological and phenomenological insights derived from this programme are likely to inform major research advances of the next decades. Of equal importance, by adopting novel methods for detecting psychosis ‘cases’ in low-resourced settings, the researchers will be able to test two key hypotheses that could revolutionize clinical research and service provision within LMIC settings: (1) that informal providers can be incorporated successfully into an adequate (and perhaps even superior) case-detection system that is community and population-based (rather than hospital-based); and (2) that informal providers can be integrated meaningfully into the pathway to care (and perhaps even long-term management) of patients with incident psychosis living in low-resourced settings.