Six mental health caring projects in building countries denote effective, affordable options


IMAGE: Assessed after 6 months, a superiority of basin was reduction than 10 percent among roughly 250 Friendship Bench participants contra roughly one-third in a control organisation of identical size. view some-more

Credit: Dixon Chibanda

  • 100,000+ people reached by Grand Challenges Canada’s mental health program, 10,000+ treated
  • Pakistan ‘Family Networks for Kids’ devise shifts tasks from health workers to relatives, neighbours; creates clever network of new recruits to caring for youths with behavioral difficulties
  • Kenya’s normal healers, faith healers and village health workers impute 1,600 to clinics, 500 diagnoses result
  • Zimbabwe’s low-cost ‘Friendship Bench’ demonstrates absolute impact in shortening depression

Toronto — Based on a successful commander devise in that normal Kenyan healers and village workers helped brand roughly 500 cases of mental illness, Grand Challenges Canada, that is saved by a Government of Canada, currently announced a vital scale adult investment to be matched by partners.

The Kenya beginning is one of 6 innovations in Africa, Asia and Haiti earning scale-up investments, their commander projects carrying proven effective during addressing mental health problems in low-resource countries.

The dual other Africa-based projects, in Uganda and Zimbabwe, for a initial time confederate diagnosis of basin into HIV patients’ care.

Meanwhile, dual Asia-based projects, in Pakistan and Vietnam, will emanate caring for children and youths as good as adults.

And a devise in Haiti is providing cost-effective mental health diagnosis in a land where badly neglected bipolar and other neuropsychiatric disorders consecrate 10% of a health burden.

Grants of CDN $4.1 million by Grand Challenges Canada will be some-more than doubled by a contributions of partners in a 6 projects, formulating a sum investment of $8.7 million.

“The Government is unapproachable to support initiatives such as this that will advantage a many vulnerable. By investing in origination to urge a efficacy of mental health services in building countries, Canada is assisting to accelerate certain change and find solutions to tellurian growth challenges. we strongly trust Canadians can play an critical purpose in origination Canada a personality in growth innovation,” pronounced Canada’s Minister of International Development and La Francophonie, a Honourable Marie-Claude Bibeau.

Says Dr. Peter A. Singer, Chief Executive Officer of Grand Challenges Canada: “People with mental illness in a building universe are too mostly simply abandoned or dark in a dour dark rather than helped. It has been a payoff to support these groundbreaking projects given their inception, to see a convincing justification of their certain impact, and now to assistance scale adult a success of 6 confidant ideas that will urge a health of tens of thousands of people.”

Mental health disorders consecrate 14% of tellurian illness worldwide. But roughly 3 buliding of this weight occurs in low- and middle-income countries, where a necessity of lerned crew and other resources leave huge populations with small or no entrance to mental illness treatment.

Through a Global Mental Health portfolio, Grand Challenges Canada, saved by a Government of Canada, has invested over $39 million to date to rise a Mental Health Innovation Network and saved 70 projects in 26 countries, including 15 vast “transition-to-scale” investments. To date, a portfolio of innovations has reached over 100,000 people, and over 10,000 people have accessed treatment. Given a early theatre of a innovations, a loyal impact will start in a entrance years as a many earnest of these innovations transition to scale.

“Canada is among a world’s heading funders of tellurian mental health innovation,” pronounced Dr. Shekhar Saxena, Director of Mental Health and Substance Abuse during a World Health Organization. “Its caring is assisting to spin a waves in a tellurian mental health challenge, with estimable impact in low and center income countries.”

The appropriation proclamation coincides with Bell Let’s Talk, a Canadian beginning compelling mental health with inhabitant recognition and anti-stigma campaigns.

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Six Scale-Up Global Mental Health Projects

Enlisting African normal healers, faith healers, and village health workers to assistance detect mental illness – Africa Mental Health Foundation (Implementation: Kenya)

Innovative indication enlists normal African healers, faith healers, village workers to assistance detect mental illness; in commander project, about 1,600 people are referred to clinics; 500 are diagnosed with mental illness

Mental health caring indication enlists African normal healers, faith healers and village health workers to assistance detect mental illness. In pilot, about 1600 people were referred to clinics, 500 were diagnosed with mental illness.

A vital new investment will capacitate a Africa Mental Health Foundation (AMHF) to build a mention networks and enhance a formation of mental health into existent open and village health services by training grave (nurses, clinical officers) and spontaneous (traditional healers, faith healers) medical providers.

In Kenya, with a high superiority of mental disorders among a 40 million citizens, there are usually about 500 practicing psychiatrists and psychologists. This necessity of professionals, sum with singular drug supplies, organisation appropriation and stigma, leaves many of those vital with mental illness incompetent to entrance many indispensable diagnosis and treatment.

The AMHF proceed breaks down barriers between a grave and spontaneous sectors, enlivening discourse and training to boost synergy and communication.

Viability of a indication was demonstrated in a explanation of judgment project, saved by Canada’s International Development Research Centre, during that a referrals of people suspected of carrying mental illness rose from nonexistence to 1,593, of that roughly one-third (494, or 31%) were clinically diagnosed with a mental health commotion by lerned medical staff.

The new appropriation will assistance AMHF scale adult from dual to 20 comforts in Makueni County, located between Nairobi and Mombasa. It will rivet and teach some-more than 160 village health workers, normal and faith healers and anticipates identifying 6,000 some-more suspected cases of mental illness. If a same rate of success prevails as in a commander program, roughly 2,000 people will be diagnosed within a year.

Project goals also embody building recognition and combating a tarnish of mental illness within farming communities and, long-term, a village mental health caring indication that can be scaled adult and implemented around Kenya.

Scale-up appropriation includes CDN$660,000 from a Government of Makueni County – a singular joining from an African organisation physique to a mental health program. The bid is also upheld by New York-based Columbia University’s Global Mental Health Program.

Project contact:

Dr. Victoria Mutiso, [email protected]

The Friendship Bench – Zimbabwe AIDS Prevention Project, University of Zimbabwe (Implementation: Zimbabwe)

Low-cost ‘Friendship Bench’ therapy proves effective in pilots during alleviating mental illness symptoms, will extend to 14,000 patients

Friendship Bench lay health workers, famous as “Grandmothers.”

Low-cost therapy proves effective during alleviating depression, other mental illness symptoms; scale-up appropriation will extend to strech 14,000 patients

A technique grown and demonstrated in Zimbabwe to be an inexpensive, effective proceed to assuage basin and other mental illness symptoms among HIV-AIDS and other patients will enhance to strech 14,000 additional people in 2016 interjection to today’s new general investment.

In a 2012 investigate saved by Grand Challenges Canada, a Zimbabwe AIDS Prevention Project assessed a efficacy of a Friendship Bench in a randomized tranquil hearing conducted with over 500 people with basin enrolled during 24 clinics in a collateral city, Harare.

Lay health workers, famous as village ‘Grandmothers,’ broach cognitive behavioural therapy in a safe, gentle sourroundings on wooden benches outward on a sanatorium grounds.

Patients, referred to a benches by clinicians, accept adult to 6 45-minute counselling sessions, including one home revisit and, in some cases, mention to other health or amicable services or to income-generating activities. Specialist support is accessible around mobile phones and tablets.

Assessed after 6 months, a superiority of basin was reduction than 10% among roughly 250 Friendship Bench participants contra roughly one-third in a control organisation of identical size. The full investigate is approaching to be published after this year.

A Cloud-based height grown by a devise organisation serves to confederate training, screening studious referrals and follow-up.

In addition, over 70% of beneficiaries in a new hearing participated in a origination and sale of large, charming shoulder bags (known as “zee bags”), an activity that plays an critical purpose in rebuilding certainty and an event to acquire an income.

Zimbabwe, with 15 million citizens, has only 10 practicing psychiatrists and 15 clinical psychologists.

With assistance from scaling partners, a low-cost, innovative Friendship Bench module will be introduced during 60 primary health caring clinics in Harare and dual beside cities.

Based on serve formula due subsequent year and Zimbabwean Government support, a Friendship Bench module could be finished accessible in each primary caring trickery nationwide.

Project contacts:

Ruth Verhey / Ronald Munjoma +263-4-703-565, [email protected]

Dixon Chibanda, [email protected]

Social, romantic and mercantile empowerment by Group Support Psychotherapy – Makerere University (Implementation: Uganda)

Training village health workers intent in HIV/AIDS caring to strech and support a top series of mental health patients

In Sub-Saharan Africa, one in 3 HIV patients knowledge poignant basin symptoms, famous to meddle with proclivity to take anti-retroviral medications.

In Uganda, critical gains in improving entrance to HIV/AIDS caring though small has been finished to residence a mental health needs of persons vital with HIV. As well, basin among such patients is compounded by other factors such as war, misery and low levels of education, generally in post-conflict settings.

To assistance residence a miss of services, Dr. Etheldreda Nakimuli-Mpungu and colleagues grown an involvement that treats basin by amicable support, that includes training certain coping skills and formulating income-generating abilities.

With Grand Challenges Canada seed funding, a “Group Support Psychotherapy” proceed was evaluated in a trial, a formula published in a biography Lancet HIV final April. The organisation reported that 6 months after a finish of treatment, 85% of GSP participants had recovered from depression, compared to 50% who took partial in a control organisation intervention. Further, Group Support Psychotherapy participants had larger boost in duty levels, amicable support and self-esteem.

With scale-up funding, a organisation will sight 90 veteran health workers and 180 lay health workers intent in HIV/AIDS caring in farming areas of 3 northern Uganda districts to also commend and broach Group Support Psychotherapy for depression. This will urge entrance to a initial line diagnosis for basin and make a smoothness some-more sustainable.

The following outcomes are approaching over a year ahead: 70% of targeted vexed people will knowledge improvements in basin symptoms, increasing self-esteem, amicable support and duty levels; 50% will be economically prolific with increasing provision resources and fewer incapacity days; and 20% will knowledge measurably reduction poverty.

Scaled adult around a north and other areas of Uganda with high HIV prevalence, adult to 325,000 people could knowledge Group Support Psychotherapy caring and over 65,000 could knowledge poignant improvements in basin and functioning by 2030.

The core devise organisation is comprised of heading academics and researchers from a universities of Makerere and Ottawa, as good as Dr. Sheila Ndyanabangi, a pivotal mental health process builder during a Ministry of Health in Uganda.

Partner appropriation of $450,000 will be supposing by UK-based gift MQ: Transforming Mental Health, that promotes investigate to urge a impact of mental health treatment, irradiate causes of mental illnesses, and support a best and many innovative researchers and suspicion leaders of a future. Dr. Etheldreda Nakimuli-Mpungu is a new leader of MQ’s Fellows Award, one of 11 recipients in a past 3 years and a initial from a low- or middle-income country.

Project contacts:

Etheldreda Nakimuli-Mpungu, [email protected]

Neil Balmer, [email protected]

“Frugal Innovations” for compelling mental health among adults and children – Centre for Applied Research in Mental Health and Addictions / Simon Fraser University (Implementation: Vietnam)

Making a many of wanting resources by “frugal innovations”: Training village health workers to yield stress and basin and providing telephone-based coaching and support to families of children with behavioural difficulties

Making a many of wanting resources: Simon Fraser University-led devise trains village health workers to assistance patients cope with stress and depression, and provides telephone-based coaching and support to families of children with behavioural difficulties

Mental health disorders, of that ethanol abuse, basin and stress are a many prevalent, consecrate one-sixth (16%) of a illness weight in Vietnam, surpassing a tellurian average. The accessibility of lerned mental health professionals, however, falls distant subsequent that of other countries.

In a 2011 study, Vietnam ranked final among 144 low- and middle-income countries on a accessibility of mental health care, with 1.7 psychiatrists and 11.5 psychosocial caring providers per 100,000 population.

A devise led by a Centre for Applied Research in Mental Health and Addictions (CARMHA) during Simon Fraser University’s Faculty of Health Sciences devise helps to fill this use opening in dual low-cost ways: Training village health workers to yield adults pang from stress and depression, and providing telephone-based coaching and support to families of children with behavioral difficulties.

A two-year commander investigate in dual provinces of Vietnam successfully demonstrated a approach, screening roughly 1,300 people, of that 127 now accept diagnosis for basin – some-more than 3 times a series approaching – and pre/post diagnosis evaluations uncover statistically-significant decreases in symptoms.

Building on that success, a adult basin module will be scaled adult and rolled out in 32 communities opposite 9 provinces in Vietnam. It is approaching that roughly 4,250 people with basin will entrance services, of that 1,280 will knowledge improvements in a subsequent year.

Whereas a commander devise focused only on adult depression, a scaled-up devise will embody a child and family-focused component. Materials for a stretch coaching indication called “Strongest Families” have been blending and translated for Vietnamese use, and a 25 family commander investigate is underway.

The organisation will weigh a Strongest Families indication in 9 provinces, with 5 coaches providing support to an estimated 740 children and kin over 3 years.

Project contact:

Elliot Goldner, [email protected]

Centre for Applied Research in Mental Health and Addictions / Simon Fraser University

Creating Family Networks (FaNs) for children with developmental disorders – Human Development Research Foundation (Implementation: Pakistan)

Task-shifting from health workers to relatives, neighbours: Family Networks for Kids (FaNs) creates a absolute network of new recruits to caring for youths with developmental disorders

Task-shifting from health workers to relatives, neighbours: In Pakistan, a Family Networks for Kids (FaNs) devise creates a absolute web of new recruits to caring for youths with developmental disorders

In Pakistan, developmental disorders including egghead disabilities and autism impact over 7% of children – 13.2 million in sum – roughly all of them untreated due to discrimination, bad recognition of a medical need among family members and front line health-providers, and a miss of dilettante services generally outward of civic centres.

The Human Development Research Foundation (HDRF), one of Pakistan’s many active growth and health organizations, designed a Family Networks for Kids (FaNs) to assistance kin commend and assistance their children cope with mental illness challenges.

The programs organizes and trains family volunteers – called “champions” – to yield assistance to their possess children and to those within their network of 5 to 7 families.

Champions yield training and caring around a tablet-based, Avatar-assisted Cascade Training (ACT) complement that contains interactive, discerning modules with story-telling avatars formed on a World Health Organization’s (WHO) mental health Gap Action Plan (mhGAP).

Wireless phone-based record supports a module in many other ways as well. Initially, family members dial into an Interactive Voice Response (IVR) complement to answer questions that assistance brand a child expected to have a developmental disorder, shortening a need to transport to a alloy or to wait for a health worker’s visit.

With a CDN$768,000 Grand Challenges Canada extend in 2012, a investigate of FaNs within a farming race of 30,000 people successfully grown technology-assisted identification, training and intervention-delivery solutions, lerned 17 family champions, screened over 2,500 children and identified 70 influenced families.

A study, published in a biography Pediatrics, compared a phone complement with a house-to-house consult regulating a same questions and found it successfully identified 92 out of 109 (84.4%) children underneath 10 years aged with developmental disorders. The cost of screening per child: US $7.00 door-to-door vs. $0.07 regulating a phone system.

After a interventions, a investigate showed clinically suggestive improvements in participating child tellurian incapacity scores, bargain and communication, removing around/mobility, self-care, rendezvous in propagandize and non-school activities, appearance in society, and reduction stigma.

With a transition-to-scale funding, HDRF will hurl out a module to sight 300 champions and shade some-more than 27,000 families for developmental disorders, with expectations that 3,000 children and teenagers will be treated and helped to urge functioning with fewer romantic and behavioural problems.

An HDRF partner, Autism Speaks, shares with a World Health Organization an seductiveness in a roll-out of this task-shifting indication – training kin and family members rather than lay health workers. HDRF is also collaborating with World Vision Pakistan (WVP) and Pakistan’s Federal Ministry of National Health Services (MOH), that will closely follow outcomes to consider a model’s feasibility for wider adoption.

Project contacts:

Usman Hamdani, [email protected]

Andy Shih, [email protected]

Promoting a community-based mental health indication in farming Haiti and building a inhabitant scale-up devise – Zanmi Lasante (Implementation: Haiti)

Novel indication helps strech those many in need while organisation helps develop, account a inhabitant mental health devise in Haiti

An epilepsy studious in Haiti with her internal medical worker. Novel devise helps strech those many in need while operative to assistance Haiti rise a inhabitant mental health caring devise Neuropsychiatric disorders, such as bipolar disorders consecrate 10% of a altogether illness weight in Haiti though mostly go undiagnosed or untreated.

The mental health infrastructure in Haiti consists of a singular psychiatric sanatorium and health centre in Port au Prince – collateral of a nation with 10.3 million citizens.

Building on knowledge regulating community-based approaches to yield diseases such as HIV and tuberculosis, Zanmi Lasante – one of Haiti’s largest non-governmental health caring providers – grown a “5×5 Model” to assistance people pang depression, bipolar disorder, psychosis, epilepsy, as good as child and youth disorders.

Mental health services are delivered by veteran and lay workers in a existent open health complement lerned and supervised opposite 4 mental health caring pathways. The indication is being integrated into a services supposing during 11 open primary caring comforts portion 1.3 million people and co-managed by Zanmi Lasante in partnership with a Ministère de la Santé Publique et de la Population and a Ministry of Health.

In a three-year explanation of judgment project, roughly 10,000 people perceived mental health diagnosis during 11 sites – 1,935 with depression, 1,360 with epilepsy and 1,004 with suicidal thoughts. Of these, an estimated one third have already gifted softened clinical outcomes as a outcome of certain diagnosis and treatment.

During a 15-month transition-to-scale, Zanmi Lasante will labour and strengthen a model, yield refresher mental health caring training to 100 staff, and urge monitoring and analysis and organisation systems. The classification anticipates treating another 3,500 patients.

Another elemental goal: growth of a inhabitant mental health devise for Haiti formed on a model, assisted by collaborators, including a Pan-American Health Organization.

Project contacts:

Eddy Eustache, [email protected]

Giuseppe Raviola, [email protected]

Alexandra Rose, [email protected]


About Grand Challenges Canada

Grand Challenges Canada is dedicated to ancillary Bold Ideas with Big Impact in tellurian health. We are saved by a Government of Canada and we support innovators in low- and middle-income countries and Canada. The confidant ideas we support confederate scholarship and technology, amicable and business origination to find tolerable solutions to health hurdles – we call this Integrated Innovation. Grand Challenges Canada focuses on innovator-defined hurdles by a Stars in Global Health module and on targeted hurdles in a Saving Lives during Birth, Saving Brains and Global Mental Health programs. Grand Challenges Canada works closely with Canada’s International Development Research Centre (IDRC), a Canadian Institutes of Health Research (CIHR) andGlobal Affairs Canada to catalyze scale, sustainability and impact. We have a dynamic concentration on results, and on saving and improving lives.

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