The innovation connects two models of care for treating psychosis through a specialized mobile application (app). This innovation aims to:
- Improve diagnosis and management of psychosis
- Increase referrals and facilitate early diagnosis
- Develop shared treatment plans
- Reduce stigma
Phase 1: Building Partnerships
The project team recruited professionals from Pangani District hospital as the biomedical participants in the study. This includes one medical doctor and three psychiatric nurses who work as a team to treat mental illness on a daily basis. This is the only primary health care facility with outpatient mental health services in the Tanga region. A traditional healer from CHAWATIATA traditional healer organization, acted as the liaison in recruiting other traditional healers.
Phase 2: Mobile Application Development
Noxyt Software Solution Company, a Tanzanian programming group, was hired to develop the mobile screening and consultation app. A Kiswahili version of The Psychosis Screening Questionnaire (PSQ) was adapted and included in the app to screen patients with psychosis. The app enables PSQ scores to be shared between traditional healers and biomedical professionals in order to facilitate cross referrals and to prioritize next steps. Both practitioners were consulted in PSQ adaptation and the app development process to ensure it is culturally relevant and user friendly.
Phase 3: Training of Traditional Healers and Biomedical Professionals
Traditional healers and biomedical professionals participated in a week long training course that covered the following:
- an overview of the study
- an overview of clinical, biomedical and spiritual and intuitive aspects of psychosis
- group work on techniques for treating mental illness
- case studies on depressive psychosis, bipolar and schizophrenia
- training on how to use the app to screen for psychosis and refer patients between the two systems of care
Phase 4: Implementation: Screening, Referral and Treatment of patients
Individuals seeking care from participating traditional healers will undergo a preliminary assessment, this involves a prescreening checklist to identify symptoms of mental illness. If the checklist criteria is met, the healer will administer the first portion of the mobile-adapted Psychosis Screening Questionnaire (PSQ). The first portion of the PSQ assessment involves a series of questions that the traditional healer is trained to answer. Based on this score, the traditional healer may refer the patient for further screening and possible biomedical treatment at Pangani District Hospital. Biomedical professionals will be able to access the patient’s file and administer the second portion of the PSQ assessment via the app. A diagnosis is made by the biomedical professional and the treatment plan is determined. Once the biomedical treatment is administered, the patient is re-referred to the traditional healer for complementary treatment. Biomedical professionals and the traditional healers have the option of discussing their treatment plans via chat or text.