The innovative model brings together three integrated elements:
- Awareness-building and decreased stigma through a radio-based drama and interactive mobile phone interventions
- School-based mental health literacy and identification of young people with mental disorders for teachers and students alike
- Capacity-building for diagnosis and effective treatment of young people with Depression in community health clinics through competency-oriented training of health providers
Raising Awareness Through Interactive Radio
Interactive Radio Programs
3 stations in Malawi and 1 station in Tanzania broadcast a weekly 30-minute youth radio program with messages about mental health and Depression. This radio program included a syndicated, serialized radio soap opera that delivered messages about mental health, sexual and reproductive health, and substance abuse. Called “Nkhawa Njee” in Malawi and “Positive Mood” in Tanzania, the radio programs have gained immense popularity by using an “edutainment” approach that combines serious issues with entertainment. Mental health exerts participated in program design sessions to ensure accuracy of mental health content, and the radio producers did what they do best—create a program that attracted hundreds of thousands of listeners.
Mobile phone software allowed young people to leave comments and questions for radio hosts or mental health experts, and participate in quizzes and polls intended to assess comprehension of key messages free of charge. Beep for referral service is available, where young people can miss call an automated interactive voice response system free of charge, where they can get information about the closest health facility with a trained mental health provider and the name of that person.
Radio Listener Clubs
To link the programs to school-based mental health literacy interventions, Radio Listener Clubs were
were established in a select number of secondary schools in the target districts of Malawi and Tanzania. Listener club members met weekly to listen to the program together. Following the
radio program, discussions were facilitated by trained peer educators or classroom teachers.
School-based Mental Health Literacy
An adolescent mental health curriculum guide used in Canadian schools (the Guide) was translated and adapted to the local context in Malawi and Tanzania (the African Guide) by mental health experts. The African has 7 modules: 1) Understanding Mental Health and Mental Illness; 2) The Stigma of Mental Illness; 3) Information on Specific Mental Illnesses; 4) Experiences of Mental Illness; 5) Seeking Help and Finding Support; 6) The Importance of Positive Mental Health; and 7) Counseling Treatments for Depression.
Once adapted and translated, teachers in schools in Malawi and Tanzania were trained to integrate the African Guide into their classrooms. Teachers used the African Guide to teach about mental health in the schools and were taught how to identify youth at risk for Depression. Additionally, schools were encouraged to link to local community health care providers to refer students identified as at-risk, and peer educators received training to facilitate peer sessions about mental health as a part of the weekly Radio Listener Clubs.
Health System Capacity Strengthening
A national team of Master Trainers and a number of health care provider trainers have been trained in an Adolescent Depression Identification and Mitigation Program that was adapted for the local context from a program certified in Canada by the Canadian College of Family Practice. In addition, trainers complete a facilitated e-course to enhance learned competencies. Trainers were recruited through the Ministry of Health’s Non-Communicable Disease Department in both countries. They are psychiatric nurses and medical officers, representatives from the Ministry of Health, and trained psychiatrists and psychologist from medical colleges. Trainers provide training and support to community-based health care providers in the diagnosis and effective management of youth with depression.