We congratulate Kwabena Kusi-Mensah for winning the 2020 Lasker Essay Contest for his essay “As One Single Tribe: Thinking Globally and Locall2). Kwabena is a psychiatrist with training in Child and Adolescent Mental Health. He is pursuing a PhD in Psychiatry at the University of Cambridge, working with Dr. Andrew Bateman. Kwabena tells us more about his research, his ambitions for mental health in Western Africa, and what he hopes we can learn about mental health by using cross-cultural approaches.
You’re now in your first year of a PhD in Psychiatry. Can you tell us what your research is on?
I am working on developing culturally appropriate tools for assessing frontal lobe functioning (specifically executive functioning and adaptive functioning) for children and adolescents in West Africa, as well as risk factors affecting cognition and mental well-being.
What has been your scientific trajectory so far?
I am a specialist Psychiatrist with additional training in Child and Adolescent Mental Health (CAMH) based in Kumasi, Ghana. I undertook my medical training at the Kwame Nkrumah University of Science and Technology in Ghana where I graduated in 2011. From then I did residency training in General Adult Psychiatry in various centres in Ghana and Nigeria from 2014 till 2019. While doing my residency training, I concurrently undertook a master’s degree in CAMH at the Centre for Child and Adolescent Mental Health in the University of Ibadan in Nigeria from 2016 – 2017, where I graduated with distinction. My passion for children’s mental health led me to establish the first multidisciplinary CAMH clinic integrated into a general hospital in Ghana in 2017 at my home institution in Kumasi, after returning from post-graduate training in CAMH in Nigeria. I have since started a PhD in Psychiatry here in Cambridge since October 2019.
What inspired you to join the University of Cambridge, and how have you found your time in Cambridge so far?
My dream is to become a physician-scientist in a region of the world where these are sorely lacking. Cambridge comes with an unassailable reputation in higher learning- that goes without saying. The high quality of cutting-edge research going on in the Department of Psychiatry was a strong attraction for picking Cambridge as a place of to nurture my nascent academic career. Further, I was drawn to the work being done by Dr Andrew Bateman- my supervisor- because of the specific problem I was immediately interested in tackling- that of psychometrics and assessment of cognitive functioning. In my warm interactions with him, I felt reasonably assured that combining the formidable resources of Cambridge and the nurturing environment indicated, I would definitely flourish as an academic here.
Can you tell us what the Laskar Essay competition is about?
The Lasker Foundation is an American charitable foundation dedicated to rewarding scientists who have contributed significantly to the advancement of medicine in the world through the recognition of research excellence, advocacy, and education. Many of its prize recipients have gone on to win the Nobel Prize. The Lasker Essay competition was instituted to encourage early-career researchers in the medical space to “to discuss big questions in biomedical research and policy”, and to bring these together to interact with senior researcher during award ceremonies. This year, the competition topic was “describe how a notable scientist has inspired them – through the scientist’s personality, life experiences, and/or through their scientific contributions”. 11 prize winners were chosen out of hundreds of applicants, and their essays (including mine) is available here: http://www.laskerfoundation.org/new-noteworthy/articles/winners-2020-lasker-essay-contest/
In your essay, you write about the importance of valuing unique (cultural) perspectives. You’re also a trained psychiatrist who has worked in Ghana. Can you tell us how you hope to combine your experiences in Cambridge and in Ghana to inform your future work?
Cambridge is a fantastic place where one is exposed to the best ideas in the world. It is truly a global centre of excellence. At the same time though, I am very cognizant of the fact of the uniquely local nature of the problems I and many like me grapple with, in my neck of the woods. Often, there appears to be a tension between these two seeming polar opposites for young researchers like myself from a developing country background who come to world-institutions like Cambridge: do I go with the flow of the high-tech research going on here targeted at the cutting-edge of “first world problems”, or do I focus on the not-so-trendy “old problems” of my “third world” reality? But for me, I think the answer lies in a re-framing of that dilemma from an ‘either/or” one to a “both/and” perspective (which is the point I sought to make in my essay). I believe that maintaining a global perspective while tackling local problems will not only allow one to be efficient in applying the lessons from the past discovered by others, but also keep one relevant to the peculiar needs of the people one serves. The wheel need not be reinvented, but sometimes it may need to be modified and improved for one’s local pot-hole-filled terrain. My hope is that with the training, exposure and networks I gain from my time in Cambridge, I will be able to combine that with my intimate knowledge of the peculiar challenges of the region I work in, to provide unique insights into potential solutions for challenges facing the mental health of young people in my region.
What do you think the major challenges are in translating mental health research findings to a Western African context?
I think the first major problem is a lack of local research capacity in mental health, and therefore not enough of a critical mass specifically in the research space to spearhead translation of local research into practice. As a developing region, most of the focus on healthcare human resource capacity-building is on service delivery, and not enough on research capacity building. This leads to the second major problem: that of a disconnect between policymakers and academia. Thirdly, because of the two foregoing problems, there is a resultant lack of commitment on allocating resources to translational research on the part of governments and other private stakeholders, which results in a vicious cycle of not attracting enough young talent into the mental health research space because it is so resource starved. My long-term career goal therefore is to help break this cycle by spearheading a concerted effort to build research capacity in the sub-region. Hopefully, we can get to a place where mental health research in a good portion of Africa is truly self-sufficient and self-sustaining.
As a world-leading research centre in mental health, how should Cambridge be thinking about the challenges of mental health in developing nations?
In line with the general thrust of the current re-framing of the developed world’s relations with the developing world- particularly sub-Saharan Africa, I believe a posture of “trade not aid” is the way to go. The last 25 years has seen remarkable democratic stability and economic progress in Africa (Ghana for example has successfully seen peaceful democratic transitions to opposition parties 3 times since 1992- more times than the UK in the same period), making it rife for remarkable progress in learning and academia. In countries like Ghana and Rwanda, institutions’ governance culture and infrastructure are quickly developing that can support a dramatic building up of local research capacity. I think the time is now ripe for Cambridge to double up on its efforts to collaborate with African institutions, and to make knowledge transfer and capacity-building in mental health research one of its top priorities. Where there may have been some hiccups in the past with such efforts, I am confident that this will not be the case (at least not to the same extent) in a renewed effort in that regard because of the strides that are currently being made on the continent. In the words of Dr Kwame Nkrumah, “there [truly] is a new African in town”.
Finally, if funding was not an issue, what is the one major research idea you’d like to pursue?
Hmm, that is a difficult one- there are many problems where I come from! But I guess one research area I would put money into would be the question of why mental illness in general (e.g. psychosis, depression) appears to take a significantly relatively milder course in many African populations across the life cycle, compared to western countries (and this has been well documented in the literature).
But if I could use that money to truly do whatever I wanted, I would channel it into some sort of structured formal capacity-building programme or scheme to build research capacity among the younger emerging generation, in order to produce the top-quality human resource that can do the type of work that can answer these types of questions!
Kwabena’s prize-winning essay can be read here: http://www.laskerfoundation.org/media/filer_public/d7/a7/d7a75ff6-c83b-499d-8e95-c517645c4325/kwabena_kusi-mensah_essay.pdf