DIALOGUE TO EMPOWER TRADITIONAL AND FAITH HEALERS TO DELIVER EVIDENCE-BASED PSYCHOSOCIAL INTERVENTIONS TO REDUCE TREATMENT GAP IN KENYA (DIALOGUE)
KEY STUDY FINDINGS
DIALOGUE has shown that traditional and faith healers (the clergy) and formal health care workers can collaborate successfully in providing mental health services to patients in rural communities with limited access to specialist care. The study also proved that trained traditional and faith healers can effectively screen and refer complicated cases of depression to primary health care settings.
- Majority of practitioners showed interest in collaborating with each other and mistrust was alleviated leading to referral of patients from the healers to clinicians. This was made possible through a series of independent discussions with traditional healers, faith healers and clinicians which identified existing barriers to collaboration and potential Mistrust and lack of respect were identified as key barriers among the practitioners causing referral gaps.
- 100 traditional and faith healers were trained on depression screening and providing psychosocial interventions using the Mental Health Global Action Programme Intervention Guide (mhGAP-IG).
- Trained traditional and faith healers screened a total of 1515 and 2566 patients respectively over a period of 3 months. The prevalence of depression among the stated screened patients was 22.9%, with 1 out of every 3 of them having suicidal behaviour.
- Trained traditional and faith healers referred 50 patients they had screened positive for mental illness to health centres where 46% of these patients were correctly identified to have depression on confirmation of diagnosis by a mental health professional.
- There was a 12% and 34% improvement in symptoms of depression at 6 weeks and 12 weeks (3 months) respectively. 257 (76.9%) patients showed resolution of depression symptoms at 3 months post intervention, a percentage expected at 6 months using stepped care approach (a psycho educational group intervention, structured and systematic follow-up, and drug treatment for patients with severe depression) and more than four times the percentage expected at 3 months using usual care in primary health care settings (antidepressant medication or referral for specialty treatment) (Araya et al., 2003). Therefore, traditional and faith healers’ mhGAP-IG based intervention accelerated patient recovery.
- To facilitate dialogue between the two sectors; formal (conventional health care workers) and informal (traditional and faith healers) sectors towards synergy in the provision of mental health services.
- To train the informal sector on the use of mhGAP-IG to provide psychosocial services for depression and the need to refer cases not responding to treatment to formal sector.
- To determine accuracy of depression diagnosis made by the informal sector after training on mhGAP-IG for depression.
- To determine the effectiveness of training traditional and faith healers on mhGAP-IG