In many low and middle income countries (LMIC), Traditional and faith healers provide care for the bulk of patients with severe mental disorders in LMIC because of their abundance, the synchrony of their views with their local communities in regard to the causation and treatment of these disorders, and scarcity of mental health specialists. Even though a desire for collaboration between healers and orthodox health providers is commonly expressed, evidence is lacking about the feasibility of collaboration.
COllaborative Shared care to IMprove Psychosis Outcome (COSIMPO) is an innovative program of work in which primary care providers work collaboratively with traditional and faith healers to provide evidence-based care to patients with psychosis. Following training of both groups, structured engagement activities are implemented involving the provision of clinical support by the primary care providers to the healers. Clinical support, mainly provided at the healers’ facilities, includes direct treatment of patients and educational engagement with the healers to reduce harmful and abusive treatment practices. Indices of collaborative engagement as well as patient outcomes are carefully assessed and compared to care as usual in a randomized controlled design.
Through collaboration, the project aims to test the effectiveness of a shared care program between Traditional/Faith Healers (TFH) and Primary Health Care Providers (PHCPs) in improving the outcome of persons with psychosis.
The innovation includes:
- Development of a manualized collaborative shared care program to improve the management of mental health problems by TFHs, through reduction of harmful practices and abuse of human rights and to facilitate appropriate treatment, consultations and referrals
- Implementation of a randomized controlled evaluation of the program