Document text
Principal Investigator: Daiane Borges Machado
Organization: FUNDACAO OSWALDO CRUZ
Fiscal Year: 2024
Award: $382,592
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
Physical, emotional, and social changes, including exposure to poverty, abuse, or violence, increases youth
vulnerability to mental illness. These factors interfere with development, limit opportunities, and hamper
achievement of a fulfilling life as adults. Addressing these issues can lead to improved outcomes at the
population level and better cost-effectiveness for health services. This should be especially important to low- and
middle-income countries, due to the substantial number of financially and socially vulnerable individuals in these
settings.
Cash transfer programs have been a promising way to address some of the social drivers for poor mental health
among youth. It has been shown that such programs can alleviate income restriction, increase schooling and
access to health facilities, and decrease alcohol consumption and violence in families. However, it is still unclear
which pathways and mechanisms explain the association between socioeconomic support and lower mental
illness among youth.
In this project, we will evaluate the effect of social drivers on youth mental health-related hospitalizations and
suicide, test mechanisms and pathways of a countrywide socioeconomic intervention, and examine the timing
of the intervention during the life course. For example, determining whether cash transfers delivered earlier in
life can contribute to better outcomes over time. This project will also investigate the cash transfer effect on
vulnerable groups (African descendants, women, and youth with lower income).
We will evaluate social drivers’ determination and the association between being beneficiaries of the Conditional
Cash Transfer program, called the Bolsa Família Program (BFP), and mental illness and its long-term effects
using robust methodologies for big datasets, such as Regression Discontinuity Designs, Propensity Score
Matching and difference-in-differences. We will test mechanisms and pathways, between BFP and mental
health-related hospitalizations and suicide among youth using Structural Equation Modeling. Furthermore, we
will perform microsimulations to generate projections regarding how mental health-related hospitalizations and
suicide trends will be in the future based on the current state, and how BFP implementation scenarios will affect
these trends.
The results of this project will be of vital importance to guide policies and programs to improve mental health and
reduce mental health-related hospitalizations and suicide in youth. It will provide information to improve the
effectiveness of these programs worldwide. Finally, it can potentially advance the global debate on the economic
response to the pandemic and times of economic crises. If cash transfers can decrease mental health problems
among youth and reduce suicide, it will have a dramatic impact on saving lives.
Terms: <0-11 years old><21+ years old><Access to Care><Achievement><Achievement Attainment><Address><Adult><Adult Human><Affect><African><Age><Alcohol Drinking><Alcohol consumption><Appointment><Behavior><Behavioral><Big Data><BigData><Black Populations><Black group><Black individual><Black people><Blacks><Brazil><COVID-19><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><CV-19><Child><Child Youth><Children (0-21)><Communities><Coronavirus Infectious Disease 2019><Country><Data><Data Set><Development><Diagnosis><Disease><Disorder><Economic Income><Economic Recession><Economical Income><Economics><Education><Educational aspects><Effectiveness><Emotional><Equation><Equity><EtOH drinking><EtOH use><Ethnic Origin><Ethnicity><Exposure to><Family><Future><Gender><Health><Health Facilities><Health Services><Health Services Accessibility><Health care facility><Healthcare><Healthcare Facility><Hospital Admission><Hospitalization><Household><Impoverished><Improve Access><Impulsivity><Incidence><Income><Individual><Intervention><Intervention Strategies><LMIC><Life><Life Cycle><Life Cycle Stages><Link><Long-Term Effects><Longterm Effects><Low income><Mediator><Mental Health><Mental Hygiene><Mental disorders><Mental health disorders><Methodology><Modeling><Municipalities><Neighborhoods><Notification><Outcome><Pathway interactions><Persons><Phase><Policies><Policy Maker><Population><Poverty><Prevalence><Prevention><Program Effectiveness><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Qualifying><Race><Races><Schools><Social Change><Social Protection><Social modification><Social transformation><Specific qualifier value><Specified><Subgroup><Suicide><Testing><Time><United States><Violence><Vulnerable Populations><Woman><Youth><Youth 10-21><access to health services><access to services><access to treatment><accessibility to health services><adulthood><aged><ages><alcohol ingestion><alcohol intake><alcohol product use><alcohol use><alcoholic beverage consumption><alcoholic drink intake><availability of services><beneficiary><care access><care facilities><cohort><coronavirus disease 2019><coronavirus disease 2019 pandemic consequence><coronavirus disease 2019 pandemic impact><coronavirus disease-19><coronavirus infectious disease-19><cost effectiveness><design><designing><developmental><disparity in health><early life exposure><economic><effective therapy><effective treatment><effects following the COVID-19 pandemic><ethanol consumption><ethanol drinking><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><experience><exposure to violence><fatal attempt><fatal suicide><health care><health data><health disparity><health service access><health services availability><impact of the SARS-CoV-2 pandemic><improved><improved outcome><incomes><innovate><innovation><innovative><intent to die><intergenerational><interventional strategy><kids><life course><longitudinal data set><longitudinal dataset><low and middle-income countries><meeting><meetings><mental illness><model-based simulation><models and simulation><mortality><pandemic><pandemic disease><pathway><prevent><preventing><programs><psychiatric illness><psychological disorder><racial><racial background><racial origin><reduce suicidality><reduce suicide><reducing suicidality><reducing suicide><response><scale up><service availability><simulation><social><social vulnerability><socio-economic><socio-economically><socioeconomically><socioeconomics><suicides><treatment access><trend><violence exposure><violent><violent behavior><vulnerable group><vulnerable individual><vulnerable people><youngster>