Mental Health Leadership and Advocacy Programme (mhLAP)

Innovation summary

The mental health systems of most low and middle income countries are weak, especially in Sub Saharan Africa. This is mainly due to a lack of policy attention and poor civil society engagement. The consequences of this include a huge treatment gap for mental disorders, poor quality of service, stigma and widespread human rights abuse. The goal of this program is to address this problem in five English speaking West African countries by mobilizing and building the capacity of a broad network of stakeholders to advocate for improved policy attention, contribute to service development and generate public awareness.

The Mental Health Leadership and Advocacy Programme (mhLAP) will develop and mobilize stakeholders groups to advocate for mental health service improvement at both local and national levels, support scale up and improvement of mental health care, and conduct stigma reduction activities.

Impact summary

137 stakeholders have attended the annual mental health training in advocacy skills, mental health leadership and mental health service development over 2010 – 2014
Stakeholders Councils have been established in all five countries

“The mhLAP model of working in multiple countries with minimal set-up cost has been very cost effective. And the greatest benefit seems to have been derived from where partnerships with non-governmental organizations as in Ghana and Sierra Leone were fostered.”

-Tarry Asoka, Independent Health Management Consultant

Innovation details

Developing countries in Africa and other regions share a similar profile of insufficient human resources, poor funding, high unmet need for services and low official prioritization of mental health. This situation is worsened by misconceptions about the causes of mental disorders, stigma and discrimination that frequently result in harmful practices against persons with mental illness. Previous explorations of the required response to these challenges have identified the need for strong leadership and consistent advocacy as potential drivers of the desired change.

The Mental Health Leadership and Advocacy Programme (mhLAP) aims to provide and enhance the acquisition of skills in mental health leadership, service development, advocacy and policy planning and to build partnerships for action to scale up quality mental health service. The specific components of the program includes:

An annual two-week leadership course that is based on current best evidence in the field of public mental health and is designed for the African context.
Formation of Stakeholders Councils in all the participating countries.
Training of trainers in the use of mhGAP-Intervention Guide to scale up mental health service through integration into primary care;
Improvement in mental health service delivery through the use of WHO Quality Rights Tool; and
Implementation of anti-stigma strategies to be developed in the course of the program

Key drivers

Potential Partners Meetings Before Project Commencement

Extensive engagement meetings with potential partners by the Project Director prior to project take-off

Support from Key Project Partners

Technical and administrative support from CBM international and the Nigeria country office

Institutional support from the University of Ibadan

Innovative Project Components to Engage Stakeholders

Establishment of Stakeholders Councils in all the countries. The formation of networks by project trainees

Monitoring Progress in Country Offices

Regular supervisory visits to the country offices from the coordinating center

Challenges

Coordinating Activities Across Countries

Communication and logistical challenges of coordinating activities across the different countries

Lack of Existing Mental Health Policies

Existing lack of policy attention to mental health service in the countries

Continuation

There are ongoing plans to develop a similar leadership program in the Middle East with technical support from the mhLAP.

Partners

Implementing Partners

University of Ibadan (Nigeria)
CBM (International)
BasicNeeds Ghana
Enabling Access to Mental Health in Sierra Leone
World Health Organization - Gambia
International Mental Health Centre, University of Melbourne (Australia)

Funder

The Australian Aid Agency for International Development

Evaluation methods

Participants evaluated the annual workshop on context, relevance and quality of the sessions

The program was evaluated internally midway into the first five years of its existence through a review of the curriculum of the training workshop and assessment of impact in 2012 by sending performance indicators form to the country offices to be completed by the country facilitators.

A comprehensive external and independent evaluation was conducted in the fifth year of project implementation (2014) by an independent evaluation expert. A draft report was submitted to partners.

Cost of implementation

The program has been adjudged as cost-efficient by an independent external evaluator, Tarry Asoka, The unit cost of training per participants at the training course ranged between USD 1,502 and USD 2,100.

Impact details

Between 2010 and 2014, 137 stakeholders, consisting of policy makers, mental health professionals, executives of non-governmental organizations, service users and caregivers have attended the annual mental health training in advocacy skills and mental health service development. Participants have come from Ghana, Kenya, Liberia, Namibia, Niger, Nigeria, Sierra Leone, South Africa and The Gambia.

Stakeholders Councils that have been established in all the participating countries have been very active in raising awareness about mental health issues in their respective countries. At the individual country level, the Councils have been actively involved in the advocacy activities leading to the appointment of a Mental Health Desk Officer at the Federal Ministry of Health in Nigeria, the passing of the Mental Health Act and the establishment of the Mental Health Authority in Ghana, the establishment of a steering committee on Mental Health at the Ministry of Health & Sanitation in Sierra Leone and the Mental Health Unit at the Ministry of Health and Social Welfare in Liberia and The Gambia.³

References

Esan O et al. (2014) Mental health care in Anglophone West Africa. Psychiatric Service. 65(9):1084-7.
Saraceno B et al. (2007) Barriers to improvement of mental health services in low-income and middle-income countries. The Lancet. 370(9593):1164-74.
Abdulmalik J et al. (2014) The Mental Health Leadership and Advocacy Program (mhLAP): a pioneering response to the neglect of mental health in Anglophone West Africa. International Journal Mental Health System. 8(1):5. doi: 10.1186/1752-4458-8-5.

Tools

Multimedia

Nurses not Curses: Witchcraft Beliefs and Mental Health in Sierra Leone

Reports

The mhLAP: a pioneering response to the neglect of mental health in Anglophone West Africa

Comments

These are very good news from

Submitted by Charles Midgett on Tuesday, 23rd February 2016

These are very good news from the society point of view. We need more operations like that.

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Country

Ghana, Gambia, Liberia, Nigeria, Sierra Leone

Affiliated organizations

CBM