Tina Mensa-Kwao on partnering with youth to improve their mental health care

 

Tina Mensa-Kwao is a firm believer in the principle, “nothing about us without us” because she recognizes the importance of community members as essential collaborators in improving the quality of mental health services in a community, particularly for underserved youth. 

“Issues of mental health are prevalent in communities of color and those living in resource-limited settings, thus working with communities to address these gaps is critical,” says Mensa-Kwao. “I aim to prioritize the inclusion of youth as partners in research, interventions, implementation and policy development surrounding their mental health care.” 

Mensa-Kwao is a doctoral student in the Global Health Implementation Science & Metrics program at the University of Washington School of Public Health, where she focuses on understanding how to enhance the implementation of evidence-based practices to improve the mental health of young people globally. In this Q&A, she shares why she’s passionate about global health, her research efforts and its potential impact, her future goals as a professional, and advice for new students. 
 
Why did you decide to come to the University of Washington for graduate school? 

As a nexus for intervention design, evaluation, and global health, the Implementation Science (IS) doctoral program at the UW is uniquely suited to equip me with the necessary tools for critically analyzing health systems and scaling up effective evidence-based multilevel interventions in low- and middle-income countries. The IS program aligns with my training in behavioral science and my passion for health system strengthening while improving access to mental health care in underserved communities.   

The UW also has extraordinary professors working on global mental health projects, community-engaged global health research, training opportunities and resources like those offered by the Consortium for Global Mental Health, Implementation Science Resource Hub, and the International Training and Education Center for Health (I-TECH). My professional goal is to serve as a global health leader working with low-resourced communities to advance mental health care at both local and international stages. 
 
What interested you in studying public health and why are you passionate about it? 

As a first-generation Ghanaian American immigrant woman, I was introduced to the topic of mental health through a personal lens. After my family immigrated from Ghana, I grew up in a low-income, African American neighborhood. Being African immigrants, my sisters and I experienced frequent ridicule — a prevalent issue immigrants face.  

Growing up in a Ghanaian community, mental health problems were considered taboo and not openly talked about in my family. Not having a space to voice my thoughts negatively affected my mental well-being. Early on, I understood the reality of silent suffering and the social stigmatization of mental illness that results in a reluctance to seek help. These experiences motivated me to pursue a career in promoting youth mental health care and health equity; they inspire me to clarify the cultural nuances of mental health, debunk its stigma, and work to increase access to quality mental health services, particularly for youth in underserved settings.  

I am also passionate about improving health equity globally, addressing gaps in mental health care, and increasing access to evidence-based practices for youth living in resource-limited settings. I strongly believe in the principle, “nothing about us without us,” and aim to prioritize the inclusion of youth as partners in research, interventions, implementation and policy development surrounding their mental health care. 
 
How do you want to change the world with your public health degree? 

My mission is to work with low-resourced communities to address health inequities tied to social, political and economic determinants of health. After completing my doctoral program, I plan to pursue a career shaping better implementation of public health programs and improving health policies in the United States and globally.  

With my passion for stewardship, I envision a career of public service, whether that is working in the government, academia, philanthropy or for a non-profit. Issues of mental health are prevalent in communities of color and those living in resource-limited settings, thus working with communities to address these gaps is critical. The interdisciplinary training received in implementation science, research methods, health equity, leadership and dissemination as part of the IS program aligns with my goals to effectively translate mental health research findings that will inform and influence policy to advance mental health equity. By advocating for the inclusion of diverse voices in the design and implementation of programs and centering health equity in policy development and implementation, the scientific workforce will benefit from having more scholars with my background leading the field to new discoveries. 
 
What experiences at the UW School of Public Health (SPH) have been most influential? 

Since entering the UW, I have been committed to cultivating an inclusive community by listening and building community with others dedicated to ensuring the visibility of student and community voices. I seek and attain leadership opportunities in the communities that I am a part of, leveraging my positions to support equity, while also refining my leadership and advocacy skills to address issues of structural racism and social injustice.  

Early on, I noticed the fragmented and disconnected social fabric across the School. To address this, two doctoral students and I created a WhatsApp group for the Black SPH graduate student community in the spirit of building a support system for students identifying as Black. Coming back to campus after months of isolation, with many students moving from faraway homes to attend a predominantly white institution in a predominantly white city, made having a community essential for survival and maintaining good mental health. The group served as a social setting for sharing funding and academic resources, job opportunities, roommate matching, events, moral support, and more.  

At the start of every academic year, we reach out to department chairs across SPH to ensure all incoming Black students are aware of the platform and able to join. To date, we have over 100 active members on the platform. Through coordination efforts of this group, we have hosted numerous community building events, airport pick-ups for international students starting their UW journey, mentorship opportunities, and temporary housing. Creating this space has shown me the power of how true innovation doesn't always need to come from radical changes; it simply needs culture change. Organizing this informal space for Black students to support each other has made a large impact on the lives of many by creating a more inclusive culture for Black students. 

Another area where I saw a need was breaking down siloes for doctoral students across the SPH departments. I intentionally applied to join the SPH Dean’s

Advisory Council (DACS) year-long course because I wanted to be a student leader at the table discussing concerns, School issues, policies and budgetary matters. Serving on DACS, I had the unique opportunity to forge relationships within the Office of the Dean and students across educational levels in the School. As a result, I was able to leverage resources to start breaking down the siloes.  

Throughout the academic year, I organized two inaugural events for doctoral students, which have continued at the School to this day. My first event, “First Year Mix and Mingle” was attended by over 75% of the first-year doctoral students. This space allowed new doctoral students across departments to connect personally and professionally.  

The second event was the “Spring Fling,” which brought together faculty, staff and doctoral students. For these events, I prioritized community partnerships, such as enlisting Black catering companies to support their businesses while building bridges with the School. When I notice a gap, I work with others to think through ways to fill it. I am a self-starter who is internally driven and works well with others, yet I recognize my shortcomings and seek assistance when needed. I’ve come to realize the importance of using humility while working with diverse individuals across the SPH and in the larger Seattle community to bridge gaps. 
 
What sort of research are you working on and what kind of impact do you hope it will have?

I spent the first year of my doctoral program as a research assistant working with Dr. Pamela Collins, a professor in global health and psychiatry and behavioral sciences on a study that aimed to develop a prototype databank called MindKind that would enable young people across the globe to provide data about their mental health by using a mobile application to respond to prompts. We examined whether youth willingness to participate in research is impacted by their ability to be involved in how their data is collected, shared and used, and engaged young adults with an interest in mental health as partners to design, prototype and test the databank framework. Working on this databank allowed me to gain insight on best practices for engaging young people in mental health research.  

I also collaborated on the World Health Organization (WHO) Special Initiative for Mental Health, which seeks to ensure universal health coverage involving access to quality and affordable care for mental health conditions in 12 countries to 100 million more people. The initiative’s goal is to implement strategies and interventions that facilitate mental health reform. For this project, I conducted a baseline situational analysis for Ghana, the eighth country to join this initiative, in collaboration with the WHO Ghana country office, and produced a report for WHO on the country’s mental health strategies, policies and programs. This report will inform the Ghanaian government and WHO’s design process for the implementation of expanded services. 

As a second-year doctoral student, I have continued working with Dr. Collins in multiple capacities, including supporting the Lancet Commission on Adolescent Health and Wellbeing where I serve as a youth commissioner. As part of the commission, I am conducting a systematic review to assess the evidence base for the effect(s) of interventions and policies applied during adolescence on outcomes during adulthood and on the outcomes of the beneficiaries’ children. I am also conducting a secondary qualitative analysis to understand the developmental factors that influence adolescent mental health in urban areas from a global priority setting study conducted in 2019. Findings from these projects will inform a Commission report.  

Finally, I am working on a Delphi study to define youth global mental health in collaboration with researchers at Columbia University and University of Pennsylvania that aims to understand the needs, priorities and scope of youth-focused global mental health. Findings from this research will highlight avenues for leveraging innovative methods and promoting collaboration to meet the staggering mental health needs of youth globally. Learning about the youth global mental health through my training and research has motivated me to find novel ways to maximize youth engagement in mental health research and practice.  
My research experiences have shaped my long-term goals of becoming an independent investigator and lifelong advocate for youth and young adults affected by mental illness. My ultimate goal is to generate evidence and guidance around meaningfully engaging youth in their mental health care to inform future research and practice across a variety of interventions and settings. I plan to draw on anti-racist participatory action research methodologies and intersectionality framework in centering youth in their solutions to create healthier, more equitable communities for vulnerable young people with mental health impact, and demanding health-affirming policies and practices. My research will impact the larger community by using an intersectionality lens to better understand youth mental health care and how strategies that embrace diversity can move us closer to inclusive and equitable societies. 
 
What is one piece of advice that you have for potential new public health students or one thing you wish you knew before beginning your public health studies? 

Expect the unexpected! How we handle the unexpected impacts our future forever. It is great to come into a program with an idea of what you want to do — whether that is knowing the kind of research you want to participate in or the professors that you want to work with. However, it is equally important to be flexible and anticipate that things might not always go as planned. With that said, my advice is to expect the unexpected, be okay with change, and learn ways that you can positively and proactively handle change.  
 
What interests do you have outside of (or related to) public health? Any extracurricular activities?  

My personal experiences of vulnerability and oppression, as well as understanding the power of advocacy guide my efforts. My personal motto is, “Lift as I climb!” I mentor Black undergraduate students as they navigate the public health field, the challenges associated with attending a predominantly white institution, and their future aspirations. Our shared identities help cultivate bidirectional mentoring relationships built on trust, vulnerability and relatable experiences. I also serve as a student board member of the UW SPH’s Center for Anti-Racism and Community Health, where I help develop strategic approaches to disrupt structural racism and amplify Black and Indigenous scholarship. Through these opportunities, I have learned to practice humility, seek to understand different perspectives, and actively listen and value lived experiences. 

Moreover, I work as a research fellow on the women’s health team for Gates Ventures Exemplars in Global Health, I spearhead the youth engagement strategy of the Adolescent Sexual and Reproductive Health and Rights Exemplars project, which examines the policies and programs that have been successful in select low- and middle-income countries to reduce high levels of pregnancies, including prevention and management of unintended pregnancy. This research also seeks to determine how the lessons learned and best practices can be applied to improve sexual and reproductive health and rights outcomes for adolescents across geographies. As part of this project, we are engaging youth leaders in each Exemplar country to help guide the work through a global youth advisory council.  

In my free time, I thoroughly enjoy traveling and learning about new cultures. I am on the road to 100 countries, having travelled to 35 countries thus far!