Research Component - Partnerships for Mental Health Development in Sub-Saharan Africa

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This research project describes a body of work that seeks to provide new information about tackling one of the most burdensome disorders affecting mankind everywhere: psychosis (including schizophrenia and related disorders). Schizophrenia and other psychoses are among the leading causes of the global burden of disease in low-, middle-, and high-income countries alike. In 2006, an estimated 25 million people were affected by schizophrenia in low- and middle-income countries (LMIC). According to estimates, schizophrenia accounted for 1.1% of all Disability Adjusted Life Years and 2.8% Years Lived with Disability. Persons suffering from schizophrenia are more likely to experience premature mortality, by way of suicide, stigma, violations of their human rights, and poor overall health care. Only a few of those affected by psychosis receive biomedical care in Sub-Saharan Africa (SSA). On the other hand, traditional health providers (THPs) constitute a ready source of care for diverse mental health problems, especially psychotic disorders. Indeed, the pathways to biomedical care for persons with mental disorders in many of these countries shown that a significant proportion of them have consulted traditional healers on their way to orthodox care. Consequently, several SSA countries have made attempts to integrate traditional healers into the formal public health sector. Also, the World Health Organization has long canvassed for formal collaboration between THPs and public health service. One recurring concern about a formal integration is the common observation that THPs sometimes use harmful practices and their intervention approaches often lead to abuses of the human rights of their clients. Practices such as beating to drive away demons and shackling to deal with perceived agitation or restlessness are often used. In view of the strong relationship between what goes on at the healers' facility and the work of primary care providers in regard to the treatment of mental health problems in the community, a programme to facilitate collaborative shared care between the two may be important to efforts to improve mental health service delivery at primary care level through task-shifting. The proposed hub will 1) conduct an assessment of current traditional and faith healing practices as they relate to the treatment of psychosis; 2) develop a manualised collaborative shared care package to improve the evaluation of mental health problems by CAPs, reduce the use of harmful intervention approaches and of