Developing mental health education for health volunteers in a township in South Africa

Abstract

South Africa like many countries is moving towards a system of community care for people with mental health problems. This is set against a backdrop of under-resourced and overburdened services. These problems are particularly apparent in the township communities. The aim of this study was to devise an education programme for South African volunteer health workers using principles adapted from the UK evidence base for psychosocial intervention (PSI) and to evaluate the impact of the education programme on community volunteer health workers' knowledge about mental health issues. A stakeholder consultation exercise was held to explore: the context of South African services; the transferability of the UK evidence base and educational strategies to South Africa; and to inform the design of an educational programme. Evaluation of the community volunteer educational programme was undertaken using pre- and post-education focus groups. Twenty-one volunteers working with mentally ill people in the community from one township attended a three-day, six module course. After the course, volunteers: were able to articulate a greater range of aetiological and contributing factors to the development of mental health problems, including stress vulnerability and traditional belief frameworks; could describe a more humanistic model of mental health identification; identified a wider range of both formal and informal helping strategies; were more aware of the negative impact of interpersonal behaviours for people with mental health problems. Volunteer involvement has been confined to communicable diseases in South Africa. Volunteers educated about mental health care could assist in the South African policy of ‘horizontal’ integration of services into primary care from their current ‘vertical’, specialist-orientated structures.