Empowerment training to support service user involvement in mental health system strengthening in rural Ethiopia: a mixed-methods pilot study

Authors

Sisay Abayneh, College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa University, Addis Ababa, Ethiopia. abaynehsisay70@gmail.com.
Heidi Lempp, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, Weston Education Centre 10, Cutcombe Rd., London, SE5 9RJ, UK.
Sauharda Rai, Department of Psychiatry, George Washington University, Washington, DC, USA.
Eshetu Girma, Depatment of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Medhanit Getachew, Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Atalay Alem, College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa University, Addis Ababa, Ethiopia.
Brandon A. Kohrt, Department of Psychiatry, George Washington University, Washington, DC, USA.
Charlotte Hanlon, College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity Building, Addis Ababa University, Addis Ababa, Ethiopia.

Document Type

Journal Article

Publication Date

7-8-2022

Journal

BMC health services research

Volume

22

Issue

1

DOI

10.1186/s12913-022-08290-x

Keywords

Mental health; PhotoVoice; Service user; Sub-Saharan Africa; Training

Abstract

BACKGROUND: Increased service user involvement is recommended to improve weak mental health systems in low-and middle-income countries (LMICs). However, involvement is rarely implemented and interventions to support involvement are sparse. In this study we evaluated the acceptability, feasibility and perceived outcomes of an empowerment and training program for service users and health professionals to facilitate service user involvement in mental health system strengthening in rural Ethiopia. METHODS: REducing Stigma among HealthcAreProvidErs (RESHAPE) is a training curriculum for service users, their caregivers and aspirational health workers, which uses PhotoVoice methodology, to prepare them in participation of mental health systems strengthening in LMICs. We delivered the RESHAPE training augmented with empowerment content developed in Ethiopia. The interactive face-to-face training was delivered to service users and caregivers (over 10 days), and health professionals (1 day) separately. The study was an uncontrolled, convergent mixed-methods design. The quantitative data consisted of process data, satisfaction questionnaire, and a retrospective pre-test survey. Qualitative data included exit and follow-up in-depth interviews with the service users. Descriptive statistics were performed for quantitative data, and qualitative data were thematically analysed. The findings were integrated through triangulation for convergent themes following analysis. RESULTS: Twelve service users, 12 caregivers and 18 health professionals were enrolled, and completed the training. Participants valued the content and delivery process; the standard of the training program met their expectations and participation led to positive gains in understanding about mental illness, stigma, service-user involvement and human rights. The qualitative findings identified positive impacts, including increased self-confidence, sense of empowerment, social - and perceived therapeutic benefits. CONCLUSIONS: We found that the RESHAPE training with added content for Ethiopia, delivered using the PhotoVoice methodology, is feasible, acceptable and of value to develop and implement training programmes which can empower service users to be involved in mental health system strengthening in this setting. Further study to assess the impact on health systems strengthening is warranted.

APA Citation

Abayneh, Sisay; Lempp, Heidi; Rai, Sauharda; Girma, Eshetu; Getachew, Medhanit; Alem, Atalay; Kohrt, Brandon A.; and Hanlon, Charlotte, "Empowerment training to support service user involvement in mental health system strengthening in rural Ethiopia: a mixed-methods pilot study" (2022). GW Authored Works. Paper 1335.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1335

Department

Psychiatry and Behavioral Sciences