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Shared learning from the global mental health portfolio
1
How to train service providers
"We've taken an approach, right from the beginning of educating the educators... We've had sustainability in mind... and it's been really difficult to work that way because there's been a sense of wanting to do it for them and we've had to constantly hold back." Innovator, Africa
Results
Barriers to successful training
Lack of behaviour change
Training alone does not change behaviour - need ongoing supervision
Core metrics forms only
System may not allow practitioner to implement skills after training
Weak health systems
Need realistic expectations over what practioners can achieve within constraints
Task limitations
Drivers of successful training
How to detect mental disorders
Responsiveness
Actively engage trainees, incorporate their expertise, adapt to setting
Involve specialists in design of training programmes
Educational expertise
Skills-focussed training, role play, on the job training
Experiential learning
Develop local staff as trainers for sustainability
Train the trainer
Train all staff in a setting to ensure coverage
Training coverage
Methods
Aim |
To synthesize challenges, lessons, results and impact from the 50 GCC global mental health projects
How to promote wellbeing
Qualitative analysis
Aim: Challenges to implementation and solutions to overcome them
Data sources:
Progress reports to GCC
14 qualitative interviews with innovators
Quanitative analysis
Methods
Process
Harnessing knowledge and experience of innovators allows us to:
- Core metrics forms
- Latest RMAF
- GCC progress reports
Core metrics reporting form
How to treat mental health problems
Create the "GCC global mental health consortium"
Anticipate and avoid common mistakes
Share strategies for successful innovation
Form working groups to analyze data for each challenge
Target resources and support to make the most impact
Publish results as a series of papers, with a capstone paper on overall impact
Barriers to service delivery fidelity
Drivers of innovation fidelity
Multiple organisations
Different teams have different priorities and interpret innovation in different ways
Core ingredients
Innovations defined by key processes rather than precise details
Manuals, protocols
Clear guidelines facilitate implementation that is true to the evidence base
In some settings or with some sub groups, the innovation may not work as intended
Need for adaptation
Monitor fidelity through observation, M&E and accreditation schemes
Evaluate fidelity
"All the strong [branches] have this really strong 'can-do', 'unstoppable-ness', if I can use that word... Bascially peple who just keep going, in the face of the most extraordinary oppostion, difficulties... We call them 'fire souls'."
Innovator, international
Shared learning from the Global Mental Health portfolio
Mary De Silva | Georgia Lockwood Estrin | Grace Ryan Shamaila Usmani | Tessa Roberts | Agnes Becker
Capstone paper: what is the overall impact of the portfolio of projects? What is promising for scale up and what should be set aside? What key areas need further research?
Shamaila Usmani
How to train service providers to deliver quality innovations
KIDS, Kenya
Aims
To build life skills, promote well-being and prevent mental illness in children
Children from 23 schools in the eastern part of Kenya are trained by qualified consultants with expertise in psychosocial intervention
Innovation
Each school has 3 established peer clubs of 25 - 65 members; children meet weekly to plan school and community activities. Activities relate to health, personal development, arts or agriculture
Increased parent-teacher contact and sensitization of parents to increase involvement in children's school work.
Primary health care workers trained to provide mental health services (adaptation and adoption of mhGAP guidelines)
96 teachers, 5740 children, 5700 guardians/parents accessed promotional activities through the school mental health program.
Impact
Children have improved leadership and communication skills, and have shown an increase in academic performance
What innovations are effective at improving outcomes
How to engage stakeholders
to invest in mental health
How to effectively scale up mental health innovations
How to train service providers to deliver quality innovations
How to ensure adequate supervision and quality improvement
Georgia Lockwood-Estrin
Farm Radio, Malawi and Tanzania
Create demand for adolescent mental health services
Aims
Improve knowledge, attitudes and health seeking behaviours among youth
Innovation
3 stations in Malawi and 2 in Tanzania broadcast a weekly 30-minute youth radio program (soap opera) with messages about mental health and depression.
Radio listener clubs established in every school. Every week they listen to the program and have a discussion facilitated by trained peer educators.
Integration of mental health curriculum into secondary schools; and training primary healthcare providers on detection and treatment of adolescent depression
Impact
Estimated >400,000 regular listeners in Malawi who will have heard the show.
>15,000 facebook likes for their program.
mhin@lshtm.ac.uk
www.mhinnovation.net
What innovations are effective at improving outcomes
What innovations are effective at promoting wellbeing
How to generate demand for mental health services
How to accurately detect mental health problems