Victoria N Mutiso1, Christine W Musyimi1,2, Tahilia J Rebello3, Isaiah Gitonga1, Albert Tele1, Kathleen M Pike3, David M Ndetei4,5. 1. Africa Mental Health Foundation, Nairobi, Kenya. 2. Vrije Universiteit, Amsterdam, The Netherlands. 3. Global Mental Health Program, Columbia University, New York, NY, USA. 4. Africa Mental Health Foundation, Nairobi, Kenya. dmndetei@amhf.or.ke. 5. Department of Psychiatry, University of Nairobi and Founding Director of Africa Mental Health Foundation, Mawensi Road, Off Elgon Road, Mawensi Garden, Nairobi, Kenya. dmndetei@amhf.or.ke.
Abstract
PURPOSE: The objective of this study was to determine the extent of concordance between positive screens for mental disorders by various trained community-based health workers using the WHO mental health Gap Action Programme Intervention Guide (mhGAP-IG) and independently confirmed DSM-IV/ICD-10 diagnoses. METHODS: This was a cross-sectional study conducted in Makueni County, Kenya. 40 nurses/clinical officers, 60 Community Health Workers (CHWs), 51 Faith Healers (FHs), and 59 Traditional Healers (THs) from 20 facilities were trained to screen and refer patients with eight priority mental health conditions using the mhGAP-IG. These referrals, as well as referrals from friends or family members, and self-referrals were assessed using the Mini International Neuropsychiatric Instrument (M.I.N.I.) Plus. Concordance between positive screens and M.I.N.I. Plus diagnoses was investigated. RESULTS: 15,078 community members agreed to participate in screening. Of these 12,170 (81%) screened positive for a mental disorder and were referred to their local clinics/hospitals. 8333 (68.5%) of those who were referred went for independent diagnostic assessment at the nearest facility. Positive predictive values varied with different providers and for different conditions. There was over 80% concordance between the initial screen and the M.I.N.I. Plus diagnoses across the different health providers and across all diagnoses. CONCLUSION: Both formal and informal mental health providers can be trained to successfully and accurately screen for mental health disorders using the mhGAP-IG symptoms. This suggests that community-based non-specialist providers may play a key role in decreasing the mental health treatment gap. Further policy implications are discussed.
PURPOSE: The objective of this study was to determine the extent of concordance between positive screens for mental disorders by various trained community-based health workers using the WHO mental health Gap Action Programme Intervention Guide (mhGAP-IG) and independently confirmed DSM-IV/ICD-10 diagnoses. METHODS: This was a cross-sectional study conducted in Makueni County, Kenya. 40 nurses/clinical officers, 60 Community Health Workers (CHWs), 51 Faith Healers (FHs), and 59 Traditional Healers (THs) from 20 facilities were trained to screen and refer patients with eight priority mental health conditions using the mhGAP-IG. These referrals, as well as referrals from friends or family members, and self-referrals were assessed using the Mini International Neuropsychiatric Instrument (M.I.N.I.) Plus. Concordance between positive screens and M.I.N.I. Plus diagnoses was investigated. RESULTS: 15,078 community members agreed to participate in screening. Of these 12,170 (81%) screened positive for a mental disorder and were referred to their local clinics/hospitals. 8333 (68.5%) of those who were referred went for independent diagnostic assessment at the nearest facility. Positive predictive values varied with different providers and for different conditions. There was over 80% concordance between the initial screen and the M.I.N.I. Plus diagnoses across the different health providers and across all diagnoses. CONCLUSION: Both formal and informal mental health providers can be trained to successfully and accurately screen for mental health disorders using the mhGAP-IG symptoms. This suggests that community-based non-specialist providers may play a key role in decreasing the mental health treatment gap. Further policy implications are discussed.
Authors: D V Sheehan; Y Lecrubier; K H Sheehan; P Amorim; J Janavs; E Weiller; T Hergueta; R Baker; G C Dunbar Journal: J Clin Psychiatry Date: 1998 Impact factor: 4.384
Authors: Victoria N Mutiso; Christine W Musyimi; Tahilia J Rebello; Michael O Ogutu; Ruth Ruhara; Darius Nyamai; Kathleen M Pike; David M Ndetei Journal: Int J Ment Health Syst Date: 2019-08-14
Authors: Victoria N Mutiso; David M Ndetei; Esther N Muia; Rita K Alietsi; Lydia Onsinyo; Frida Kameti; Monicah Masake; Christine Musyimi; Daniel Mamah Journal: BMC Psychiatry Date: 2022-02-16 Impact factor: 3.630
Authors: Victoria N Mutiso; Christine W Musyimi; Isaiah Gitonga; Albert Tele; Romaisa Pervez; Tahilia J Rebello; Kathleen M Pike; David M Ndetei Journal: BMC Health Serv Res Date: 2020-01-20 Impact factor: 2.655
Authors: Fidele Sebera; Peter Dedeken; Jeannine Kayirangwa; Josiane Umwiringirwa; Delphine Kajeneza; Nicole Alves Dos Reis; Tim Leers; Dirk E Teuwen; Paul A J M Boon Journal: Hum Resour Health Date: 2022-01-21