Project Lead(s): Dawit Gebreamalk
Severe mental health problems (such as schizophrenia and bipolar disorder) are conditions associated with significant levels of morbidity and mortality, and the prevalence of these conditions in Ethiopia is estimated to be 1 to 1.5% in the community.
Ethiopia has an estimated population of 85 million but only 44 psychiatrists.
The treatment gap for severe mental health problems in Ethiopia is 1 in 10, meaning only one out of ten patients with a severe mental illness will access modern mental health services.
In addition to a lack of modern mental health services, most Ethiopians prefer to go to a traditional healer because it better fits their belief system. As a result, much of the burden of treating mental illness falls to these traditional healers.
The aim of the project was to create a shared care model, where psychiatrists and other mental health professionals would work with and under the guidance of traditional healers, to transform the way mental health care is delivered in a traditional society.
The model is named ‘The Debrelibanos model’ and involves training priests at churches/monasteries who administer holy water to identify difficult behaviour, which is amenable to treatment with medication.
Building on a pilot project conducted with the religious community and a focus group conducted with traditional healers, the model was extended to 20 holy water treatment sites in Addis Ababa.
Due to the way care was administered through the priests, it was impossible to conduct a randomized controlled trial as initially planned.
However, the results of the project showed that it is feasible to develop collaboration between traditional healers and biomedical professionals, resulting in better health outcomes in patients.
There were three key achievements of the project:
1. Establishing a shared care model of collaboration between mental health professionals and priests administering holy water treatment in 20 sites of holy water treatment – ten priests were trained to identify behaviour that is amenable to modification with medication
2. Establishing a partnership between the Ethiopian Orthodox Church charity organization and the project to work together to expand the model
3. Improving patients’ lives, as a result of treatment provided through the project – 100 patients were treated in the study.
The primary investigator plans to apply for Transition To Scale Phase II funding.
Scale-up efforts will include: continuing to work with the 20 established units and documenting progress; formalizing a partnership with the Ethiopian Orthodox Church charity organization, which has promised full partnership up to funding the existing project; working with the traditional medicine unit at the Ministry of Health to promote and secure policy favouring such collaboration; expanding to 20 sites in each of the five regions, leading to 100 sites in three years.