Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-14T09:29:36.972Z Has data issue: false hasContentIssue false
  • English
  • Français

Changing patterns of mental health knowledge in rural Kenya after intervention using the WHO mhGAP-Intervention Guide

Published online by Cambridge University Press:  22 October 2018

V. N. Mutiso ,
K. M. Pike ,
C. N. Musyimi ,
T. J. Rebello ,
A. Tele ,
I. Gitonga ,
G. Thornicroft  and
D. M. Ndetei
V. N. Mutiso
Affiliation:
Africa Mental Health Research and Training Foundation, Nairobi, Kenya
K. M. Pike
Affiliation:
Columbia University, Global Mental Health Program, New York, USA
C. N. Musyimi
Affiliation:
Africa Mental Health Research and Training Foundation, Nairobi, Kenya
T. J. Rebello
Affiliation:
Columbia University, Global Mental Health Program, New York, USA
A. Tele
Affiliation:
Africa Mental Health Research and Training Foundation, Nairobi, Kenya
I. Gitonga
Affiliation:
Africa Mental Health Research and Training Foundation, Nairobi, Kenya
G. Thornicroft
Affiliation:
Institute of Psychiatry, King's College London, London, UK
D. M. Ndetei*
Affiliation:
Africa Mental Health Research and Training Foundation, Nairobi, Kenya Department of Psychiatry, University of Nairobi, Nairobi, Kenya
*
Author for correspondence: D. M. Ndetei, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Despite the high prevalence of mental disorders, mental health literacy has been comparatively neglected. People's symptom-management strategies will be influenced by their mental health literacy. This study sought to determine the feasibility of using the World Health Organization mhGAP-Intervention Guide (IG) as an educational tool for one-on-one contact in a clinical setting to increase literacy on the specified mental disorders.

Methods

This study was conducted in 20 health facilities in Makueni County, southeast Kenya which has one of the poorest economies in Kenya. It has no psychiatrist or clinical psychologist. We recruited 3267 participants from a community that had already been exposed to community mental health services. We used Mental Health Knowledge Schedule to measure the changing patterns of mental health knowledge after a period of 3 months, following a training intervention using the WHO mhGAP-IG.

Results

Overall, there was a significant increase in mental health related knowledge [mean range 22.4–23.5 for both post-test and pre-test scores (p < 0.001)]. This increase varied with various socio-demographic characteristics such as sex, marital status, level of education, employment status and wealth index.

Conclusions

mhGAP-IG is a feasible tool to increase mental health literacy in low-resource settings where there are no mental health specialists. Our study lends evidence that the WHO Mental Health Action Plan 2013–2020 and reduction of the treatment gap may be accelerated by the use of mhGAP-IG through improving knowledge about mental illness and potentially subsequent help seeking for early diagnosis and treatment.

Keywords

Kenyamental health knowledgerural settingsWHO mhGAP-Intervention Guide
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 13 , October 2019 , pp. 2227 - 2236
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addis, ME and Mahalik, JR (2003) Men, masculinity, and the contexts of help seeking. American Psychologist 58, 5.Google Scholar
Atilola, O (2015) Level of community mental health literacy in sub-Saharan Africa: current studies are limited in number, scope, spread, and cognizance of cultural nuances. Nordic Journal of Psychiatry 69, 93–101.Google Scholar
Bhikha, AG, Farooq, S, Chaudhry, N and Husain, N (2012) A systematic review of explanatory models of illness for psychosis in developing countries. International Review of Psychiatry 24, 450–462.Google Scholar
Campos, L, Dias, P, Duarte, A, Veiga, E, Dias, CC and Palha, F (2018) Is it possible to ‘find space for mental health’ in young people? Effectiveness of a school-based mental health literacy promotion program. International Journal of Environmental Research and Public Health 15, 1426.Google Scholar
Chisholm, K, Patterson, P, Torgerson, C, Turner, E, Jenkinson, D and Birchwood, M (2016) Impact of contact on adolescents’ mental health literacy and stigma: the SchoolSpace cluster randomised controlled trial. BMJ Open 6, e009435.Google Scholar
Clement, S, Schauman, O, Graham, T, Maggioni, F, Evans-Lacko, S, Bezborodovs, N, Morgan, C, Rüsch, N, Brown, JSL and Thornicroft, G (2015) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine 45, 11–27.Google Scholar
Evans-Lacko, S, Little, K, Meltzer, H, Rose, D, Rhydderch, D, Henderson, C and Thornicroft, G (2010) Mental health knowledge schedule. Canadian Journal of Psychiatry 55, 157–165.Google Scholar
Evans-Lacko, S, Rose, D, Little, K, Flach, C, Rhydderch, D, Henderson, C and Thornicroft, G (2011) Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure. Epidemiology and Psychiatric Sciences 20, 263–271.Google Scholar
Evans-Lacko, S, Henderson, C and Thornicroft, G (2013) Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. The British Journal of Psychiatry 55, s51– s57.Google Scholar
Fosu, AK (2015) Growth, inequality and poverty in Sub-Saharan Africa: recent progress in a global context. Oxford Development Studies 43, 44–59.Google Scholar
Galdas, PM, Cheater, F and Marshall, P (2005) Men and health help-seeking behaviour: literature review. Journal of Advanced Nursing 49, 616–623.Google Scholar
Ganasen, KA, Parker, S, Hugo, CJ, Stein, DJ, Emsley, RA and Seedat, S (2008) Mental health literacy: focus on developing countries. African Journal of Psychiatry 11, 23–28.Google Scholar
Government of Makueni County (2017 a) Key indicators: Makueni County. https://knoema.com/atlas/Kenya/Makueni (accessed 22 March 2018).Google Scholar
Government of Makueni County (2017 b) Makueni County: Department of Health Services. https://www.makueni.go.ke/health-services/ (accessed 22 March 2018).Google Scholar
Government of Makueni County (2018) http://www.makueni.go.ke/ (accessed 23 March 2018).Google Scholar
Hanisch, SE, Twomey, CD, Szeto, ACH, Birner, UW, Nowak, D and Sabariego, C (2016) The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review. BMC Psychiatry 16, 1.Google Scholar
Hansson, L, Stjernswärd, S and Svensson, B (2016) Changes in attitudes, intended behaviour, and mental health literacy in the Swedish population 2009–2014: an evaluation of a national antistigma programme. Acta Psychiatrica Scandinavica 134, 71–79.Google Scholar
Henderson, C, Robinson, E, Evans-Lacko, S, Corker, E, Rebollo-Mesa, I, Rose, D and Thornicroft, G (2016) Public knowledge, attitudes, social distance and reported contact regarding people with mental illness 2009–2015. Acta Psychiatrica Scandinavica 134, 23–33.Google Scholar
Howe, LD, Hargreaves, JR and Huttly, SRA (2008) Issues in the construction of wealth indices for the measurement of socio-economic position in low-income countries. Emerging Themes in Epidemiology 5, 3.Google Scholar
Hugo, CJ, Boshoff, DEL, Traut, A, Zungu-Dirwayi, N and Stein, DJ (2003) Community attitudes toward and knowledge of mental illness in South Africa. Social Psychiatry and Psychiatric Epidemiology 38, 715–719.Google Scholar
Judd, F, Cooper, A-M, Fraser, C and Davis, J (2006) Rural suicide – people or place effects? Australian and New Zealand Journal of Psychiatry 40, 208–216.Google Scholar
Li, J, Li, J, Thornicroft, G and Huang, Y (2014) Levels of stigma among community mental health staff in Guangzhou, China. BMC Psychiatry 14, 231.Google Scholar
Livingston, JD, Milne, T, Fang, ML and Amari, E (2012) The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction 107, 39–50.Google Scholar
Martensson, G, Jacobsson, JW and Engstrom, M (2014) Mental health nursing staff's attitudes towards mental illness: an analysis of related factors. Journal of Psychiatric and Mental Health Nursing 21, 782–788.Google Scholar
Mehta, N, Clement, S, Marcus, E, Stona, A-C, Bezborodovs, N, Evans-Lacko, S, Palacios, J, Docherty, M, Barley, E, Rose, D, Koschorke, M, Shidhaye, R, Henderson, C and Thornicroft, G (2015) Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. The British Journal of Psychiatry 207, 377–384.Google Scholar
Mendenhall, E, Kohrt, BA, Norris, SA, Ndetei, D and Prabhakaran, D (2017) Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. The Lancet 389, 951–963.Google Scholar
Morrison, AB, Conway, ARA and Chein, JM (2014) Primacy and recency effects as indices of the focus of attention. Frontiers in Human Neuroscience 8, 6.Google Scholar
Mutiso, VN, Musyimi, CW, Nayak, SS, Musau, AM, Rebello, T, Nandoya, E, Tele, AK, Pike, K and Ndetei, DM (2017) Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya. International Journal of Social Psychiatry 63, 508–517.Google Scholar
Mutiso, VN, Musyimi, CW, Rebello, TJ, Gitonga, I, Tele, A, Pike, KM and Ndetei, DM (2018 a) Patterns of concordances in mhGAP-IG screening and DSM-IV/ICD10 diagnoses by trained community service providers in Kenya: a pilot cross-sectional study. Social Psychiatry and Psychiatric Epidemiology, 1–11.Google Scholar
Mutiso, VN, Pike, K, Musyimi, CW, Rebello, TJ, Tele, A, Gitonga, I, Thornicroft, G and Ndetei, DM (2018 b) Feasibility of WHO mhGAP-intervention guide in reducing experienced discrimination in people with mental disorders: a pilot study in a rural Kenyan setting. Epidemiology and Psychiatric Sciences, 1–12.Google Scholar
Ndetei, DM, Pizzo, M, Khasakhala, LI, Maru, HM, Mutiso, VN, Ongecha-Owuor, FA and Kokonya, DA (2009) Perceived economic and behavioural effects of the mentally ill on their relatives in Kenya: a case study of the Mathari Hospital: original article. African Journal of Psychiatry 12, 293–299.Google Scholar
Patel, V, Chisholm, D, Parikh, R, Charlson, FJ, Degenhardt, L, Dua, T, Ferrari, AJ, Hyman, S, Laxminarayan, R and Levin, C (2016) Addressing the burden of mental, neurological, and substance use disorders: key messages from disease control priorities. The Lancet 387, 1672–1685.Google Scholar
Peluso Éde, TP and Blay, SL (2008) Public perception of alcohol dependence. Revista Brasileira de Psiquiatria 30, 19–24.Google Scholar
Pescosolido, BA, Martin, JK, Long, JS, Medina, TR, Phelan, JC and Link, BG (2010) ‘A disease like any other’? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry 167, 1321Google Scholar
Review, World Population (2018) Kenya Population 2018. http://worldpopulationreview.com/countries/kenya-population/ (accessed 26 March 2018).Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R and Dunbar, GC (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry 59(suppl. 2), 22–33–57.Google Scholar
Smits, J and Steendijk, R (2015) The international wealth index (IWI). Social Indicators Research 122, 65–85.Google Scholar
Spedding, MF, Stein, DJ, Naledi, T and Sorsdahl, K (2018) Pregnant women's mental health literacy and perceptions of perinatal mental disorders in the Western Cape, South Africa. Mental Health & Prevention 11, 16–23.Google Scholar
Thornicroft, G, Mehta, N, Clement, S, Evans-Lacko, S, Doherty, M, Rose, D, Koschorke, M, Shidhaye, R, O'Reilly, C and Henderson, C (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet 387, 1123–1132.Google Scholar
van Heyningen, T, Honikman, S, Tomlinson, M, Field, S and Myer, L (2018) Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women. PLoS ONE 13, e0193697.Google Scholar
Van Vliet, IM and de Beurs, E (2007) The MINI-International Neuropsychiatric Interview. A brief structured diagnostic psychiatric interview for DSM-IV en ICD-10 psychiatric disorders]. Tijdschrift Voor Psychiatrie 49, 393–397.Google Scholar
Vyas, S and Kumaranayake, L (2006) Constructing socio-economic status indices: how to use principal components analysis. Health Policy and Planning 21, 459–468.Google Scholar
World Health Organization (2010) mhGAP Intervention Guide for Mental, Neurological and Substance use Disorders in non-Specialized Health Settings. Geneva: Oxford University Press, pp. 1–121.Google Scholar