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mHealth for Mental Health: West Africa

Ghana faces enormous mental health challenges,

including lack of sufficient mental health professionals

and clinical infrastructure, limited access to medication,

and pervasive societal stigma around mental illness.

Ghanaians with mental illness often go undiagnosed,

untreated, or chained and confined for weeks, months

or years at a time in prayer camps.

Locally, no one advocates for the continuation of

abusive practices; stakeholders from all sectors

including government, academia, commerce, and

healthcare are concerned about human rights

violations. Religious leaders, traditional healers, and

those who operate prayer camps that engage in these

controversial practices have expressed openness and willingness to explore more humane approaches. They need alternative tools. 

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The mHealth for Mental Health program at the University of Washington is working with diverse stakeholders in the region (academics, government officials, clinicians, NGOs, traditional and faith healers, people with mental illness and their communities) to develop mobile health tools that leverage multi-media resources (video, audio) to combat stigma, introduce principles of humane care, and alternative strategies for management of mental illness.

 

A Digital Toolkit (M-Healer) to Improve Mental Health Care

Working in close collaboration with researchers at the University of Ghana, our team developed a digital toolkit designed to train traditional and faith healers to deliver brief psychosocial interventions to people with mental illness while also discontinuing their use of practices that may constitute human rights violations. Following a series of prayer camp visits and observations, individual interviews, focus groups, and co-design sessions with healers and prayer camp staff, we produced M-Healer.  Once the prototype was developed, a usability study was conducted with 12 faith healers in Ghana who found the tool to be feasible, acceptable, and usable. Read more here.  

​Combining mHealth and nurse-delivered mental health care

In West Africa, most people suffering from serious mental illnesses like schizophrenia and bipolar disorder receive care from traditional and faith healers in “prayer camps.” Specialized mental health providers are scarce in the region, yet the prevalence of traditional healers and clustering of individuals with serious mental illness within the prayer camps offer opportunities to deliver evidence-based treatment to this population. The BRiTE Center team at University of Washington is collaborating with mental health leaders at the University of Ghana, BasicNeeds-Ghana (a mental health and development advocacy organization), and traditional healers to deliver a package of mental health interventions, strengthened by additional training, support tools, and effective medications in prayer camps.

Our multinational research team has developed a two-level intervention package involving a mobile health program which trains healers to deliver high-quality mental health interventions (M-Healer), and mobile nurses who deliver medications directly to patients at prayer camps. With funding support from the National Institute of Mental Health (Grant # R01MH127531-01A1), we are evaluating the effectiveness of this intervention in multiple prayer camps throughout the region. Read more about this study here: study link

WADMA: Building capacity for digital mental health research in West Africa

Developing and supporting a new generation of digital mental health leaders and innovators in West Africa is vital to improving mental health in the region. The mHealth for Mental Health program at the University of Washington is collaborating with leaders in Ghana and Nigeria to establish the West African Digital Mental Health Alliance (WADMA) – a regional mission-centered network of early-career researchers and trainees with a particular interest in improving mental health through digital interventions. Through WADMA, members will build their network and receive targeted career development in digital mental health research alongside like-minded professionals. WADMA is the first cross-institutional initiative advancing capacity in digital mental health research in the region.

 

Responding to Adolescent Perinatal Depression with Patient-Centered Mobile Health in West Africa

Many factors influence the accessibility of health care facilities by perinatal adolescents. Adolescence has distinct developmental challenges, along with self-stigma (i.e., shame relating to getting pregnant at a young age) and public stigma from health care providers and others in the community that can make accessing these services difficult. Effective, flexible, and convenient-to-access interventions are needed to address the health care needs of pregnant adolescents.

With guidance from Dror Ben-Zeev, this research will build on previous work to scale up efforts for perinatal depression for adolescents in primary care in Nigeria. Lola Kola will lead efforts utilizing user-centered design (UCD) principles to develop a mobile phone application to complement a face-to-face intervention for perinatal adolescents within routine care. Elements from the WHO mhGAP Evidenced-based Guidelines for Management of Perinatal Depression will be also be adapted for this work.