Adolescent Health Research Institute (AHRI)
The Adolescent Health Research Unit was founded by Prof Alan Flisher, the first holder of the endowed Sue Struengmann Professorship of Child & Adolescent Psychiatry at the University of Cape Town. An increasing volume of research in adolescent health was performed at the University of Cape Town in the mid- to late 1990's and in 2002 Prof Flisher and colleagues took the steps to establish an ‘Adolescent Health Research Institute’ (AHRI). The AHRI was envisioned to be an interdisciplinary entity, not situated in any one division, department or school, with the overarching aim to bring together a critical mass of research and researchers around the theme of adolescent health and well-being. The establishment of the AHRI was approved unanimously by the Senior Management Team and Faculty Board of the Faculty of Health Sciences, the University Research Committee and the University Senate. On the basis of approval by the University Senate, the AHRI was established in 2003.
The purpose of research in the AHRI, as set out by Prof Flisher, was to address areas of national priority with a direct relevance to the burden of disease in adolescents. These areas have included substance abuse, exposure to violence, violent behaviour, diabetes, adolescent mental health, HIV/AIDS, sexual and reproductive health, and health system management of chronic illnesses.
The AHRI was last reviewed by the University of Cape Town in May 2006. The external reviewers provided a comprehensive review of the AHRI and concluded that: “It has been a privilege for us to be involved with the evaluation of the AHRI. The AHRI has many strengths – excellence in research and research outputs, and a commitment to research which makes a difference to people’s lives, especially within the context of major health and social challenges in our country and continent.
“The AHRI represents a significant asset to UCT. It enjoys considerable recognition and no work on adolescent behavioural health issues can be undertaken in this country without reference to the work of the AHRI. We gained the impression that the rapid growth and impressive output of the AHRI has taken place within the context of minimal support from UCT, and certainly less support than either of us would enjoy from our own organizations were we to be operating at the same high level as does Prof Flisher. There would be many institutions well prepared to invest considerable amounts in a research grouping like the AHRI, for a range of reasons including the prestige AHRI brings, the high quality of research outputs, the capacity building, and the service to the community. In financial terms, if the overheads on research funds attracted are added to the subsidy earned on publications, the AHRI represents a considerable source of income for the university.
Adolescent Health Research Unit (AHRU)
In our view, the AHRI is well poised to develop further and to take its place as a leading research node on the continent of Africa. For this to happen, a commitment of greater institutional support is required. A few key points raised in the 2006 review included the need for senior administrative support for the AHRI and the need for a deputy-director to support the director, and as a potential step in succession planning. The review supported the continuation of the Adolescent Health Programme, but, due to internal UCT harmonisation of terminology, the AHRI was re-categorised and renamed the Adolescent Health Research Unit (AHRU). We are not aware that any of the recommendations from the reviewers (such as administrative support, additional funding or deputy-directorship) were implemented after the 2006 review.
Prof Flisher very tragically died in April 2010. The 2010- 2012 period was characterised by significant challenges to find suitable colleagues at the University of Cape Town or elsewhere to take over supervision of research students, and to take over leadership of ongoing research projects. In her capacity as a senior team member working with Prof Flisher at the time, A/Prof Catherine Mathews, Chief Specialist Scientist in the Health Systems Research Unit at the Medical Research Council (MRC), agreed to act as interim director of the AHRU.
Prof Petrus de Vries was appointed as the 2nd Sue Struengmann Professor of Child & Adolescent Psychiatry in 2012. After discussions with the Head of Department and A/Prof Catherine Mathews, he indicated his willingness to take over directorship of the unit, on the condition that A/Prof Mathews be appointed as co-director for two reasons a) to ensure joint directorship and continuity with Prof Flisher’s previous work and b) to enable Prof de Vries to implement his original aim of setting up a Centre for Autism Research in Africa. The appointments were formally made by the Deputy Vice-Chancellor for Research, Prof Danie Visser, in July 2012, and the University accepted a proposal to review the AHRU two years after Prof de Vries and A/Prof Mathews took over the leadership. In the spirit of Prof Flisher’s original vision, research in the AHRU continues to reflect the health research needs of the country, and to examine these at the critical developmental stage of adolescence. Many health behaviour patterns are established in adolescence, many mental health problems have their onset during adolescence, and it is during this transitional, developmental stage that many problems may be prevented, detected early, or treated effectively. Many areas of risk in adolescence are inter-related, highlighting the importance of studying the rates, patterns and contributors to adolescent risk, and to investigate pathways to care, access to services, sustainability of support networks for adolescents, and interventions that may identify determinants of change.
It will be clear from the report that, inevitably, the activities and directions of a research unit are influenced by the leadership team. The last two years have very much represented a transitional phase for the AHRU, and we are grateful for this formative review to provide us with an opportunity to reflect on the excellent research performed by AHRU staff over the last decade, whilst incorporating new directions for future research.