Mental Health Outcomes of Psychosocial Intervention Among Traditional Health Practitioner Depressed Patients in Kenya
- 399 Downloads
Task-shifting in mental health such as engaging Traditional Health Practitioners (THPs) in appropriate management of mental disorders is crucial in reducing global mental health challenges. This study aims to determine the outcomes of using evidence-based mental health Global Action Programme Intervention guide (mhGAP-IG) to provide psychosocial interventions among depressed patients seeking care from THPs. THPs were trained to deliver psychosocial interventions to their patients screening positive for mild to severe depression on Beck’s Depression Inventory (BDI). Assessments were conducted at 0, 6 and 12 weeks and Analysis of Variance (ANOVA) performed to determine the change in depression scores over the three time period. BDI mean score was 26.52 before intervention and reduced significantly at 6 (13%) and 12 (35%) weeks after intervention. 58 and 78% of patients showed reduction in symptoms of depression at 6 and 12 weeks. It is therefore crucial to engage THPs in the care of patients with depression and the need for inclusion of training packages; and other mental disorders in order to establish and maintain collaboration between THPs and conventional health workers and promote evidence-based care among marginalized populations. Moreover, further research on randomized control trials of mhGAP-IG intervention versus usual care is required.
KeywordsKenya Traditional Health Practitioner Depression Psychosocial intervention mhGAP-IG
This work was supported by Grand Challenges Canada (GCC) (grant number S5_0415-01) to the first author (PhD candidate, Vrije Universiteit) and implemented by Africa Mental Health Foundation under the supervision of the corresponding author. GCC had no role in the study design, data collection, analysis, interpretation, writing of the manuscript or in the decision to submit the manuscript for publication. CWM conceived, designed the study and wrote the protocol; performed data analysis and wrote the first draft of the manuscript. All supervisors (DCH, DMN and JB) were involved in manuscript review and approving the final version of the manuscript. VNM played a key role in coordinating data collection, data entry and cleaning, analysis and interpretation of data and provided critical revisions to the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit the manuscript for publication.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
- Braun, R., C. Catalani, J. Wimbush, and D. Israelski 2013 Community Health Workers and Mobile Technology: A Systematic Review of the Literature. PLoS One 8: 4–9.Google Scholar
- Bruni, A. 2014 Assessing the efficacy of the Mental Health Gap Action Programme (mhGAP) training for non-specialized health workers in Ethiopia: Master’ Project Work in Mental Health Policy and Services.Google Scholar
- Campbell-Hall, V., I. Petersen, A. Bhana, S. Mjadu, V. Hosegood, and A. Flisher 2010 Collaboration Between Traditional Practitioners and Primary Health Care Staff in South Africa_Developing a Workable Partnership for Community Mental Health Services. Transcult Psychiatry 47: 610–628.CrossRefGoogle Scholar
- Gakinya, B.N., J. M. Mburu, C.J. Othieno, A.A. Obondo, and D.M. Ndetei 2014 Knowledge and Practice in the Management of Mental Patients at Mathari Hospital, Kenya in Relation to the Mental Health Act of 1989. International Journal of Research in Nursing 1: 15–20.Google Scholar
- Groth-Marnat G 1990 The Handbook of Psychological Assessment, 2nd ed. New York: Wiley.Google Scholar
- Jenkins, R., D. Kiima, M. Okonji, F. Njenga, J. Kingora, and S. Lock 2010 Integration of Mental Health Into Primary Care and Community Health Working in Kenya: Context, Rationale, Coverage and Sustainability. Mental Health in Family Medicine 7: 37–47.Google Scholar
- Kohn, R., S. Saxena, I. Levav, and B. Saraceno 2004 The Treatment Gap in Mental Health Care. Bulletin of the World health Organization 82(11): 858–866.Google Scholar
- Makueni County 2013 First County Integrated Development Plan 2013–2017.Google Scholar
- Mbwayo, A., D. Ndetei, V. Mutiso, and L. Khasakhala 2013 Traditional Healers and Provision of Mental Health Services in Cosmopolitan Informal Settlements in Nairobi, Kenya. African Journal of Psychiatry 16: 134–140.Google Scholar
- Mhame, P., K. Busia, and O. Kasilo 2010 Clinical Practices of African Traditional Medicine. African Health Monitor 13: 1881–1907.Google Scholar
- Musyimi, C.W., V.N. Mutiso, A.M. Musau, L.K. Matoke, and D.M. Ndetei 2015 Prevalence and Determinants of Depression Among Patients Under the Care of Traditional Health Practitioners in a Kenyan Setting: Policy Implications. Transcultural Psychiatry (in press).Google Scholar
- Musyimi, C.W., V.N. Mutiso, E.S. Nandoya, and D.M. Ndetei 2016 Forming a Joint Dialogue Among Faith Healers, Traditional Healers and Formal Health Workers in Mental Health in a Kenyan Setting: Towards Common Grounds. Journal of Ethnobiology and Ethnomedicine. doi: 10.1186/s13002-015-0075-6.Google Scholar
- National Coordinating Agency for Population and Development, Ministry of Health, Central Bureau of Statistics, O.M. 2005 Kenya Service Provision Assessment Survey 2004. Central Bureau of Statistics (CBS), Nairobi.Google Scholar
- Niekerk, M. A. van Dladla, N. Gumbi, L. Monareng, and W. Thwala 2014 Perceptions of the Traditional Health Practitioner’s Role in the Management of Mental Health Care Users and Occupation: A Pilot Study [WWW Document]. South African Journal of Occupational Therapy 44 (1): 20–24. URL http://www.scielo.org.za/scielo.php?pid=S2310-38332014000100005&script=sci_arttext, accessed January 18, 2016.
- Ochieng, B.M., E. Akunja, N. Edwards, D. Mombo, L. Marende, and D.C.O. Kaseje 2014 Perceptions of Health Stakeholders on Task Shifting and Motivation of Community Health Workers in Different Socio Demographic Contexts in Kenya (Nomadic, Peri-urban and Rural Agrarian). BMC Health Services Research 14: 1–13.CrossRefGoogle Scholar
- Phang, C., M. Midin, and S.A. Aziz 2010 Prevalence and Experience of Contact with Traditional Healers among Patients with First-Episode Psychosis in Hospital Kuala Lumpur [WWW Document]. Malaysian Journal of Psychiatry 19 (2). URL https://www.researchgate.net/publication/257853716_Prevalence_and_Experience_of_Contact_with_Traditional_Healers_Among_Patients_with_First-Episode_Psychosis_in_Hospital_Kuala_Lumpur, accessed January 25, 2016.
- Read, U.M., E. Adiibokah, and S. Nyame 2009 Local Suffering and the Global Discourse of Mental Health and Human Rights: An Ethnographic Study of Responses to Mental Illness in Rural Ghana [WWW Document]. Globalization and Health. doi: 10.1186/1744-8603-5-13.
- Robertson B 2006 Does the Evidence Support Collaboration Between Psychiatry and Traditional Healers? Findings from Three South African Studies: Review Article. South African Psychiatry Review 9: 87–90.Google Scholar
- Simpson, S., R. Corney, P. Fitzgerald, and J. Beecham 2003 A Randomised Controlled Trial to Evaluate the Effectiveness and Costs of Psychodynamic Counselling with GP Patients with Chronic Depression. Psychological Bulletin 33: 229–239.Google Scholar
- World Health Organization (WHO) 2008 The Global Burden of Disease: 2004 Update, Department of Health Statistics and Informatics in the Information, Evidence and Research Cluster of WHO.Google Scholar
- World Health Organization (WHO) 2010 Mental Health Gap Action Programme: mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings. World Health Organization, Geneva, pp. 1–65.Google Scholar