Project Lead(s): Pamela Kaduri, Edmund Kayombo
Due to cultural beliefs and lack of rural medical services,more than 60% of Tanzanians seek mental health care services from widely accessible traditional healers who treat the spiritual causes of psychosis – an easily recognizable and prevalent condition.
Without integrated systems of care, biological symptoms of psychosis may go untreated and reach chronic stages, leading to long-term severe disability.
The pilot study conducted in Pangani district, Tanga, aimed to determine the effectiveness of a mobile phone application for facilitating the collaboration between traditional healers and biomedical professionals, in order to better address psychosis in rural Tanzania.
The project intended to increase the number of patients (both new and follow-up) with mental health problems who are assessed and treated for psychosis at Pangani District Hospital.
The app was comprised of the Psychosis Screening Questionnaire (PSQ), which was culturally adapted and pilot tested by traditional healers and health professionals.
A total of 32 traditional healers and two biomedical professionals participated in the study, and were trained to use the psychosis screening and consulting app.
Individuals accessing care from participating traditional healers underwent a preliminary assessment to determine the nature of their visit.
If the preliminary assessment of observation and/or chief complaints of the patient were associated with mental health issues, the traditional healer assessed the mental state of the patient using the mobile app version of the PSQ.
Individuals with a positive score for any psychotic symptoms, as identified by the PSQ, were referred to Pangani District Hospital to a biomedical professional at the mental health clinic.
The biomedical professional completed the PSQ via the app, made a diagnosis and provided treatment. Patients were then referred back to their traditional healer by the mental health professional during or after biomedical treatment.
The results showed that it is feasible to develop collaboration between traditional healers and biomedical professionals who deal with psychosis, resulting in better health outcomes for patients.
A total of 52 patients were screened by participating traditional healers during the 10 months of data collection.
Of the 52 patients screened, 36 were determined to be positive for psychosis by traditional healers and possessed at least one symptom (69.2%). Of the 36 patients referred to Pangani District Hospital for biomedical treatment, 22 (61.1%) presented at the hospital and were treated by participating biomedical professionals.
The app facilitated dialogue between traditional healers and biomedical staff via text and active calling throughout the study period, indicating the collaborative nature of the developed care plans and holistic approaches to psychosis.
The intervention was successful in helping individuals suffering from psychosis to receive the benefits from both systems of care.
The teams anticipate scaling up the intervention to other regions in Tanzania.
The Mental Health Association of Tanzania (MEHATA), Traditional Healers Associations (CHAWATIATA and SHIWAVIATA) and other NGOs, such as Basic Needs, have expressed interest in partnering with the study team to develop a community engagement plan.
An estimated $1,000,000 will be required to scale up this project to an additional six regions in the country.
Manuscripts were developed for publication.