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Evaluation of a home treatment approach to schizophrenia in rural Pakistan: the SOUL Programme

Published online by Cambridge University Press:  01 September 2022

S. Raja ,
F. Soomro ,
B. Junejo ,
R. Wagan  and
S.S. Afghan
S. Raja*
Affiliation:
John Radcliffe Hospital, Neurology, Oxford, United Kingdom
F. Soomro
Affiliation:
Shaheed Mohtarma Benazir Bhutto Medical University, Psychiatry, Larkana, Pakistan
B. Junejo
Affiliation:
Shaheed Mohtarma Benazir Bhutto Medical University, Psychiatry, Larkana, Pakistan
R. Wagan
Affiliation:
Shaheed Mohtarma Benazir Bhutto Medical University, Psychiatry, Larkana, Pakistan
S.S. Afghan
Affiliation:
Dorothy Pattison Hospital, Adult Mental Health, Walsall, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

Psychiatric services in LEDCs face a tripartite challenge: (i) limited financial capital; (ii) scarcity of professionals; (iii) restrictive health beliefs. Inevitably, services developed for the first-world are ill-suited here. Psychiatric services must be designed from the ground up: inspired by but not a replica of best practices in the developed world. The SOUL project in Larkana, Pakistan provides home based assessment by a psychiatrist and fortnightly treatment by a mobile nursing team for schizophrenic patients. Psychoeducation of carers and the community as well as facilitation of work for patients are core aims. This mixed-methods study evaluates the experiences of primary stakeholders - patients and their carers.

Objectives

1.Are patients and carers satisfied with the care received? 2.Has SOUL been successful in changing health beliefs? 3.How could the programme be improved?

Methods

The principal investigator accompanied the team for 4-weeks. Purposive sampling was employed. Satisfaction was assessed quantitatively using the likert based PSQ-18 questionnaire. Thereafter, qualitative data was gathered using semi-structured interviews and analysed using a grounded theory approach. A total of 27 interviews were conducted before data saturation.

Results

100% of interviewees answered ’Satisfied’ or ’Very’ Satisfied to all elements of the PSQ-18. Above all, stakeholders valued that treatment was free and highly accessible (home visits), promoting treatment adherence. They felt psychoeducation events significantly reduced community stigma and made families more likely to seek psychiatrists over faith healers. Provision of respite care was suggested as a future improvement.

Conclusions

SOUL is highly valued by stakeholders and offers an excellent example of LEDC psychiatric care.

Disclosure

No significant relationships.

Keywords

schizophréniaOutreachMixed MethodsLEDC
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S613
Creative Commons
Creative Common License - CCCreative Common License - BY
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.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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