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

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...

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Detalles Bibliográficos
Autores principales: Echeverri, C., Le Roy, J., Worku, B., Ventevogel, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128042/
https://www.ncbi.nlm.nih.gov/pubmed/30202535
http://dx.doi.org/10.1017/gmh.2018.19
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author Echeverri, C.
Le Roy, J.
Worku, B.
Ventevogel, P.
author_facet Echeverri, C.
Le Roy, J.
Worku, B.
Ventevogel, P.
author_sort Echeverri, C.
collection PubMed
description 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.
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spelling pubmed-61280422018-09-10 Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps Echeverri, C. Le Roy, J. Worku, B. Ventevogel, P. Glob Ment Health (Camb) Original Research Paper 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. Cambridge University Press 2018-08-28 /pmc/articles/PMC6128042/ /pubmed/30202535 http://dx.doi.org/10.1017/gmh.2018.19 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by/4.0/ 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.
spellingShingle Original Research Paper
Echeverri, C.
Le Roy, J.
Worku, B.
Ventevogel, P.
Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title_full Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title_fullStr Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title_full_unstemmed Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title_short Mental health capacity building in refugee primary health care settings in Sub-Saharan Africa: impact, challenges and gaps
title_sort mental health capacity building in refugee primary health care settings in sub-saharan africa: impact, challenges and gaps
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128042/
https://www.ncbi.nlm.nih.gov/pubmed/30202535
http://dx.doi.org/10.1017/gmh.2018.19
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