Stage 4: Transition to Scale
This innovation has been successfully implemented in three districts (Gulu, Kitgum and Pader) in northern Uganda. Findings on the innovation's large scale effectiveness have been submitted for publication in peer-reviewed scientific journals
Mental Health, HIV and AIDS, Economic Empowerment and 2 MoreSEE ALL
Mental Health, HIV and AIDS, Economic Empowerment, Gender-based Violence and Youth Engagement and ContributionSEE LESS
Funds Raised to Date
Group support psychotherapy addresses the problem of depression. Worldwide, 350 million people are living with depression, 7 out of 10 of those people are living in poverty. And out of those 7, 5 of them do not have access to treatment.
Finding effective treatment for depression in rural areas is very difficult. However, village health workers do visit isolated communities to care for people who live with HIV. So the SEEK-GSP program decided to train those village health workers to recognise and respond to persons with depression by delivering group support psychotherapy (GSP) sessions in the villages.
The SEEK GSP program is working within existing health systems to bring culturally sensitive depression therapies to rural communities which would otherwise be unreachable. The program trains village health workers to identify the symptoms of depression and to deliver GSP sessions to the affected persons . Participants are empowered emotionally, socially, and economically. This innovation is helping people who have depression to access treatment that otherwise wouldn’t have been available.
Mission and Vision
Our Mission and vision is to provide culturally appropriate and cost-effective mental health treatments to save and improve lives of those affected by depression by empowering African communities socially, emotionally and economically. In so doing, the SEEK-GSP program will reduce inequalities between rural and urban areas and also promote decent work and economic growth in rural communities.
The development of GSP involved focus group discussions with community members to identify perceptions of depression, local strategies used to deal with depression, and opinions on what would be the most culturally acceptable components of a group support psychotherapy intervention to alleviate depression symptoms in HIV-aﬀected adults. On the basis of the findings from these two activities, a manual for implementation of the 8-week group support psychotherapy intervention was developed by the investigating team. GSP is delivered in eight sessions held weekly, lasting 2–3 h each. Participants are divided into gender specifc groups of 10–12 participants. Intervention facilitators are of the same gender as the participants, and they deliver the intervention material following a scripted intervention manual.
Participating in GSP sessions leads to acquisition of knowledge and skills that enhance social connections, emotional and social support. Also, participants learn how to cope better with adverse situations and stigma. Practising these new skills leads to a reduction in depression symptoms. The absence of depression improves ability to work and obtain savings and other livelihood assets. The pursuit of livelihoods helps restore the dignity and independence of those affected by depression, thereby leading to a further reduction in stigma, which, in turn, would sustain reduction in depression symptoms and improvement in functioning.
Existing solutions for depression are being rolled out among women only because they are neither attractive nor effective in men. Group support psychotherapy attracts both males and females. Therefore, its integration into existing HIV care platforms may confer additional value, particularly in engaging men in HIV treatment services; thereby improving the health of the entire community. Further, GSP is not only effective against depression in the long term but also reduces post-traumatic stress symptoms, alcohol use, improves ART adherence and viral load suppression and is cost-effective in a primary care setting. GSP has been evaluated using rigorous scientific methods and participants have been followed up for one year and results confirm that the beneficial effects of GSP are sustained in the long term. Detailed results can be found here: https://ssrn.com/abstract=3350557
Planned Goals and Milestones
Currently we are disseminating results from the large scale evaluation and looking for partners to scale up the innovation to more vulnerable populations and other African communities. We have had discussions with potential funding partners e.g. Child Relief International Foundation. We are having discussions with Africa Mental Health Foundation, Kenya University of Witwatersrand, Johannesburg and University of Limpopo, Pretoria in South Africa who have expressed interest in implementing GSP
|New Implemented Countries||Kenya, South Africa|
|Recruit||3 Country Directors, 5 program officers, 30 research assistants, 500 community health workers |
|New Feature||adapt group support psychotherapy for youth (10-18 years)|
The Team Behind the Innovation
Etheldreda Nakimuli-Mpungu, MMED (Psych), PhD. James Okello, MMED Psych, PhD. Ministry of health officials: Dr. Sheila Ndyanabangi (deceased) Dr. Hafsa Lukwata, (now acting National Mental Health Cordinator. Technical advisors include Prof. Seggane Musisi FRCP(c), Prof. Ramin Mojtabai, MD, PhD, Prof. Edward J Mills, PhD, Prof.Jean Nachega, MD, PhD. Implementing partners: The AIDS Support Organization(TASO). Funding partners: MQ Transforming Mental Health and Grand Challenges Canada.