The research agenda for global mental health and substance-use disorders has been largely driven by the exigencies of high health burdens and associated unmet needs in low-and middle-income countries. Implementation research focused on context-driven adaptation and innovation in service delivery has begun to yield promising results that are improving the quality of, and access to, care in low-resource settings. Importantly, these efforts have also resulted in the development and augmentation of local, in-country research capacities. Given the complex interplay between mental health and substance-use disorders, medical conditions, and biological and social vulnerabilities, a revitalized research agenda must encompass both local variation and global commonalities in the impact of adversities, multi-morbidities and their consequences across the life course. We recommend priorities for research-as well as guiding principles for context-driven, intersectoral, integrative approaches-that will advance knowledge and answer the most pressing local and global mental health questions and needs, while also promoting a health equity agenda and extending the quality, reach and impact of scientific enquiry.
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The authors thank J. Dewit, A. Garton, Y. Bodenstein and J. Nguyen at the National Institute of Mental Health for construction of the interactive map. M. A. was supported in part by the following grants: R01DA016351 and R01DA027232, and a BRAIN R21 grant (R21DA024626). F. B. was supported in part by Grand Challenges Canada Grant GMH 0094-04. We are grateful to B. Good for his insightful review and suggestions.