Development of the Training Package
The Aro Primary Care Mental Health Programme for Ogun State (APCMHP) was conceived during the commemoration of World Mental Health Day 2009, a day that was marked by the theme: ‘Mental Health In Primary Care: Enhancing Treatment and Promoting Mental Health.1 Following this, the team began to develop the mhGAP-IG based training package and piloted it with a group of PHC workers in October 2010. The program aimed to equip the PHC workers to assess, diagnose and treat/refer five priority mental health conditions (psychosis, depression, epilepsy, other significant emotional complaints and substance use disorders) using the locally adapted mhGAP intervention guide.
Contents of the Training Package
The training course consists of a one-day plenary introductory lecture on ‘Mental health, and the classification, causes and treatment approaches of mental disorders’, delivered at the Neuropsychiatric hospital Aro Abeokuta, followed by four 2-day zonal training sessions of didactic lectures, video demonstrations, role plays, group exercises and discussions covering the 5 modules of priority mental health conditions.
The zonal trainings were delivered by a group of 3 psychiatrists, 4 psychiatric nurses and a clinical psychologists between September and October 2011, with 20 participants in each zonal training group.
Case record sheets were also designed for each of the five priority conditions, for simplified but detailed documentation of the clinical activities of the trained health workers. The trained health workers receive regular support and supervision from visiting psychiatric nurses, while referred cases are attended to by visiting consultants. Patients requiring immediate attention and hospitalization are referred to the base hospital directly.
Top-up training was provided for the trained health workers in 2013, while additional health workers were trained early 2014 to make up for the attrition in manpower due to high turnover of the PHC health professionals.