About Us
In 2008, the World Health Organization (WHO) initiated the Mental Health Gap Action Programme (mhGAP) to address mental health services in low—and middle-income countries (LMICs). The shortage of mental health specialists posed a significant barrier, prompting the introduction of a task-shifting training strategy to empower lower-level healthcare providers and community health workers to deliver care.
A team of MPH students from the University of North Carolina Gillings School of Global Health undertook a study in 2022 to explore effective methods to implement mental health pilot tests. They reviewed various anthropological approaches, including ethnographic experiences and qualitative interviews, and identified research on “best practices” for implementing mental health programs in LMICs. Key findings emphasized the importance of “nonspecific engagement elements,” such as collaboration and empathy, as foundational to psychological treatments.
Gender significantly affects mental health, especially for women in LMICs who struggle with poverty, inadequate living conditions, and gender inequality. These factors contribute to emotional difficulties and higher rates of clinical depression during and after pregnancy compared to women in high-income countries. Stereotypes about women’s emotional vulnerability and a shortage of female healthcare providers further hinder their access to appropriate treatment. The WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, has highlighted mental health for accelerated implementation of the 13th General Programme of Work (GPW13), which spans from 2019 to 2025. “Mental health is high on the global health agenda following COVID-19, increased conflicts and climate emergencies, and growing economic uncertainties. The time to act is now.” The students embraced this challenge seriously.
The following sections—Our Mission, Our Theory, and the ARC Protocol—outline the development of the Learning2Thrive (L2T) Program in maternal health care. The L2T initiative integrates historical and contemporary “group-centered” methods with tools to easily incorporate them and create tailored mental health resources for LMIC populations. By promoting task-shifting and creating culturally appropriate interventions, the program seeks to enhance community healing led by women, fostering greater connection and understanding.
Our Mission
In recent literature, research has shown that major NGOs promoting global mental health policy in low-and-middle countries focus on integrating a task-shifting strategy to train local community health workers. For example, a 2024 study in Senegal highlighted the positive impact G-Interpersonal Therapy in group settings had on improving depression symptoms in people living with HIV/AIDs. This study utilized a task-shifting approach creating impactful group dynamics that cultivated group cohesion and trust. The L2T Program represents an innovation that complements those strategies with the goal to create greater impact, equity, and sustainability.
Our Theory
L2T is committed to creating resilient, mentally healthy communities by strengthening an individual’s skills to build healthy, stable attachments. The L2T Platform was built so other organizations can adapt it to their own needs. More significantly, as knowledge about best practices grows in global mental health, L2T becomes a partner as a supplementary learning tool for healing communities to build group cohesion past the initial trial period.
Currently, literature that integrates attachment theory concepts to Interpersonal Group Therapy (IPT) has evidence indicating how attachment-based strategies can identify disruptions from trauma and focus on developing supportive relationships. By prioritizing the strengthening of secure attachments, L2T believes it can contribute to mental health challenges and build a more resilient, supportive global mental health community.
ARC Protocol
The L2T team designed and built a protocol that intentionally mirrors how the trauma at birth triggers an infant’s neurobiology to release a sequence of hormonal responses. This sequence facilitates an “attaching” dynamic with a person perceived as a caregiver and quickly restores an infant’s sense of safety after the perceived threat occurs. Over three years, team members researched and discussed these neurobiological dynamics, each suggesting design ideas for building what L2T now calls the ARC Protocol.
ARC is an acronym for attuning, resonating, and cultivating – three key mental-health skills that enable a person to stay present to others “in the moment”, fostering further and future interpersonal interaction. The ARC protocol begins with an attuning exercise, consisting of a unique mindfulness exercise designed to center people within themselves and allow them to find the flow of their internal self-awareness. After 12-15 minutes, the second step starts with a short time to reflect on the experience and answer the question, “I feel..” (3 times is best) before then using a simple resonating exercise, in which each group member shares their experience (if they wish) of the first step without interruption for 5 to 8 minutes. The protocol ends with a cultivating exercise that builds a person’s CBT skills to manage thoughts and feelings using mental and behavioral techniques. It is the third step, where everyone interacts with each other (similar to WHO’s G-IPT model) as they work through a series of tasks that prompt members to exchange ideas about fixing a specific interpersonal challenge.