Skip to main content Accessibility help
×
Home

Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps

  • C. Echeverri (a1), J. Le Roy (a2), B. Worku (a3) and P. Ventevogel (a4)

Abstract

Background.

In 2015, the United Nations High Commissioner for Refugees started a process of mental health capacity building in refugee primary health care settings in seven countries in Sub-Saharan Africa, ultimately aiming to decrease the treatment gap of mental, neurological and substance use (MNS) conditions in these operations. In 2015 and 2016, a specialized non-governmental organization, the War Trauma Foundation, trained 619 staff with the mental health gap action programme (mhGAP) Humanitarian Intervention Guide (HIG), a tool designed to guide clinical decision making in humanitarian settings.

Methods.

This paper describes the results of a process evaluation of a real-life implementation project by an external consultant, one and a half years after starting the programme.

Results.

The mhGAP-HIG capacity building efforts had various effects contributing to the integration of mental health in refugee primary health care. Facility-and community-based staff reported strengthened capacities to deliver mental health and psychosocial support interventions as well as changes in their attitude towards people suffering from MNS conditions. Service delivery and collaboration amongst different intervention levels improved. The scarcity of specialized staff in these settings was a major barrier, hindering the setting-up of supervision mechanisms.

Conclusion.

Mental health training of non-specialized staff in complex humanitarian settings is feasible and can lead to increased competency of providers. However, capacity building is a ‘process’ and not an ‘event’ and mhGAP trainings are only one element in a spectrum of activities aimed at integrating mental health into general health care. Regular supervision and continuing on-the-job training are in fact critical to ensure sustainability.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Address for correspondence: C. Echeverri, Global Mental Health Consultant, New York, USA. (Email: caro_echeverri@yahoo.fr)

References

Hide All
Budosan, B (2011). Mental health training of primary health care workers: case reports from Sri Lanka, Pakistan and Jordan. Intervention 9, 125136.
Humayun, A, Haq, I, Khan, FR, Azad, N, Khan, MM, Weissbecker, I (2017). Implementing mhGAP training to strengthen existing services for an internally displaced population in Pakistan. Global Mental Health (Camb) 4, e6.
Inter-Agency Standing Committee (2007). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. IASC: Geneva.
Kakuma, R, Minas, H, Van Ginneken, N, Dal Poz, MR, Desiraju, K, Morris, JE, Saxena, S, Scheffler, RM (2011). Human resources for mental health care: current situation and strategies for action. Lancet 378, 16541663.
Kane, JC, Ventevogel, P, Spiegel, P, Bass, JK, Van Ommeren, M, Tol, WA (2014). Mental, neurological, and substance use problems among refugees in primary health care: analysis of the health information system in 90 refugee camps. BMC Medicine 12, 228.
Keynejad, RC, Dua, T, Barbui, C, Thornicroft, G (2018). WHO mental Health Gap Action Programme (mhGAP) intervention guide: a systematic review of evidence from low and middle-income countries. Evidence-based Mental Health 21, 3034.
Saxena, S, Thornicroft, G, Knapp, M, Whiteford, H (2007). Resources for mental health: scarcity, inequity, and inefficiency. Lancet 370, 878889.
Silove, D, Ventevogel, P, Rees, S (2017). The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry 16, 130139.
United Nations High Commissioner For Refugees (2013). Operational Guidance for Mental Health and Psychosocial Support Programming in Refugee Operations. UNHCR: Geneva.
United Nations High Commissioner For Refugees (2015). UNHCR Emergency Handbook, 4th edn, UNHCR: Geneva (https://emergency.unhcr.org/).
Ventevogel, P, Van Ommeren, M, Schilperoord, M, Saxena, S (2015). Improving mental health care in humanitarian emergencies. Bulletin of the World Health Organization, 93, 666666A.
World Health Organization (2008). mhGAP Mental Health Gap Action Programme: Scaling up Care for Mental, Neurological, and Substance Use Disorders. WHO: Geneva.
World Health Organization (2010). Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings. WHO: Geneva.
World Health Organization & United Nations High Commissioner For Refugees (2015). mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical Management of Mental, Neurological and Substance Use Conditions in Humanitarian Emergencies. WHO: Geneva.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed