COMMUNITY MENTAL HEALTH DEVELOPMENT in The GAMBIA

1
COMMUNITY MENTAL HEALTH DEVELOPMENT in The GAMBIA
Supporting traditional healers to provide
treatment and care of people with mental illness
in partnership with Health Services and NGOs
2
THE CONTEXT
GNI per capita Rank 192 /206
International Poverty Levels (1998 National
Household Survey) below 1US 60 below
2US 83

• 118,000 people affected by mental disorders
• 27,000 severe mental disorders
• Treatment gap for severe mental disorder almost
  90

• Few human resources
• Very limited access to mental health services
  outside of the Greater Banjul area
• Cultural beliefs witchcraft

3
COMMUNITY MENTAL HEALTH Primary objective

• To improve access to care and community
  reintegration for people with mental disability
• Traditional healers supporting treatment and
  care
• NGOs supporting small scale farming activities
• Self sufficiency for nutritional needs
• Contribution to household economy
• Promoting independence and autonomy

4
THE PILOT PROJECT Bakindiki Village Treatment
Program (2001)

• Training of 4 traditional healers
• Medications to treat epilepsy
• Use of traditional healers understanding of
  mental illness
• Improvements in patient's condition - no need
  for restraints
• Challenge to traditional beliefs
• Program extended to patients with psychosis
• Today, 300 people have been treated through the
  programme
• Majority are independent, living and working in
  the community
• Program now running in five other villages

5
MAIN PROJECT ACTIVITIES

• Traditional healers identified and engaged
• Health workers trained to provide training,
  support and supervision to traditional healers
• Traditional healers trained to deliver effective
  and 'humane', treatment
• Rehabilitation NGOs train traditional healers
  to set up small scale farming activities
• Health workers provide regular follow-up
  supervision and support

6
SCALING UP SUCCESS INNOVATION
People with Severe Mental Disorders receiving Care
15,000
10,000
Traditional Healers with Mental Health Training
90
90
60
Health Workers with Mental Health Training
76
3,000
44
60
12
Treatment gap for People with Severe Mental
Disorders in the Gambia
12
45
0
Pilot Project
By Year 2
By Year 5
Baseline Situation
7
CONCLUSION