Programs and Projects

Mental Health International

One of CHHD’s primary programs supports a bottom-up approach to improved global mental health (GMH) in low and middle income countries (LMICs). We are supporting the development of consumer (user) and family groups (CFGs/UFGs). These groups provide support and education to the people and families that suffer the tragedies of mental illnesses. They are peer and self-help groups, often with the support or facilitation of professional volunteers.

The World Health Organization (WHO) and the Movement for Global Mental Health have worked for a number of years to push down on governments, focusing on improved mental health policies and goals. We believe that working from the bottom up to strengthen civil society groups of mental health advocates who are passionate and knowledgeable is of equal importance if we are to achieve improved mental health policies, government funding, increased services and recovery empowerment that results in reduced stigma and greater human rights for persons with mental illness and their families in low resource countries.

Matagalpa reunion de Us y FCs 2

In 2007, The Lancet journal launched a series to bring attention to the gap in services for people with serious mental illnesses (SMI) in LMICs. In some countries, as many as 90% of people with SMI do not have access to mental health treatment. This was followed by another series of GMH articles in 2011, one of which lamented the lack of progress in closing the treatment gap for poor people around the world. It is imperative that families and users of mental health services be empowered to participate in their own advocacy for change.

Another article highlights the barriers that we face to improved mental health services, then says: “Many of the barriers to progress in improvement of mental health services can be overcome by generation of political will for the organisation of accessible and humane mental health care …. Mobilisation and recognition of non-formal resources in the community must be stepped up. Community members without formal professional training and people who have mental disorders and their family members, need to partake in advocacy and service delivery. Population-wide progress in access to humane mental health care will depend on substantially more attention to politics, leadership, planning, advocacy, and participation.”(*)

CHHD is committed to build the capacity of community user and family groups so they can help achieve these goals and become partners in global mental health. Our first program is now underway in Central America. We are seeking partners for additional funding or research support.

Sam Nickels
Director, CHHD

(*) Barriers to improvement in mental health services in low-income and middle-income countries. The Lancet, Volume 370, Issue 9593, Pages 1164 – 1174, 29 September 2007.

Programs and Projects

Mental Health

Serious Mental Illness (SMI) is a challenging problem in low income countries. On a global basis, 450 million people suffer from mental illnesses. In low income countries the number of people without access to mental health services runs between 70% and 90%. Access to community services for people with illnesses and their family caregivers is even more limited. Daily 3000 people across the world commit suicide; unipolar depression is the major cause of suicide (World Health Organization). More people die annually from suicide then all the world’s wars combined. Family suffering is tremendous. Proven models include peer and family education and support programs. CHHD partners with ACISAM (the Association for Training and Research in Mental Health) in El Salvador to provide programs of education, support, empowerment and income generation for persons with mental illness and their family caregivers. 14 years running, this program has provided many people a variety of benefits (Nickels, Flamenco, and Rojas, 2016, see article at: ).

People celebrate at a conference in San Salvador

Our current goals:

  1. Regional Network of Mental Health. We have a $295,000 4-year Inter-American Foundation grant through ACISAM to expand our programs from El Salvador to 3 other central american countries, which started the end of 2014. The effort focuses on strengthening the capacity of user and family groups to provide peer education and support services, and to advocate for improved mental health services in their countries. We are also developing economic initiatives to assist persons and families with psychosocial disabilities because this is the most marginalized of disability groups in terms of high unemployment rates and difficulty for families to maintain work.
  2. Through a RIISS project and a BasicNeeds-El Salvador project, both of which we are seeking funding to carry out, targeted to expanding community based mental health services throughout the countryside of El Salvador to provide access to mental health services where the treatment gap is very high. This will be accomplished through partnerships with NGOs to provide a variety of income and community based services, and to form a collaboration with the ministry to health to provide services and to support the program with evaluation and research. The goal is to reach a large proportion of the 200,000 people who currently do not have access to mental health services.
  3. To create and strengthen research collaboratives in El Salvador and across the Central American region that support the above efforts and engage stakeholders in new ways to identify needs, improve services by integrating best practices with current programs, and use rigorous methods to evaluate programs and interventions important to users, families, NGOs and ministry of health officials.

New Family Education and Support Program Manual Released:  In the fall of 2017, we completed a major revision to our family education manual. At nearly 500 pages of content, instructional guidelines, and motivational activities called “dinamicas,” this is the main resource used in our family education and support classes, and the basis for trainings with ministry of health personnel and community leaders. To see a brief video in English on the manual, click this link:


El Salvador’s First National Mental Health Forum for user and family associations across the country. Organized by our partner nonprofit mental health agency ACISAM. Click here to see a video on the event in July 2017:



El Salvador

Since 2006 we have supported a Scholarship Program for high school and university students from the low-income community of La Linea, San Martin, one of the worst gang areas in the country. El Salvador is consistently among the most violent countries in the world, measured by murder rate and femicide rate.

Congo (DRC)

From 2010 to 2016 we facilitated the start-up of a community development organization that serves an area in central Congo (Congo Village School Project) with education, agriculture, water, and women’s empowerment programs.


From 2012 to 2014 we helped to revamp the start-up of a nonprofit (Seeds for Communities of Peace) based in the U.S. and run by Burundhi refugees who fled the genocide of Burundhi and Rwanda, to assist with programs for orphans in Burundhi and to support African refugees in the U.S. through the cultural adjustment process.


From 2014 to 2015 we supported the start-up of a community development organization serving Guinea West Africa.

United States

For several years we have supported the efforts of New Community Project in Harrisonburg, VA by partnering with them to facilitate the purchase of a house where refugees live in a broader support community as they transition into the U.S. culture.