Innovation summary
Depression is the leading cause of disability worldwide. In Africa, 66 million women live with this debilitating illness, and 85% have no access to treatment. Women are affected at twice the rate of men, and African governments typically devote less than 1% of their budgets to providing mental health services. StrongMinds has identified an innovative solution that is both effective and scalable using group interpersonal psychotherapy (IPT-G) to treat depression in response to this crisis. IPT-G is a proven, simple, and cost effective community-based model to treat depression. This cost-effective model is enabling us to rapidly treat tens of thousands of individuals for depression each year.
Utilizing therapy delivered in person or by phone, group members are led through an 8–12-week program that teaches them how to identify their unique triggers, manage their current depression, and prevent future episodes. Together members support one another forming strong social bonds in the process. Following treatment, impact assessments show that more than 80% of clients are depression-free and remain so six months after therapy. These women thrive, economies grow stronger, and communities become more resilient as a result.
Impact summary
- Since first initiating fieldwork in 2014, StrongMinds has treated more than 120,000 women and adolescents for depression in Africa.
- More than 80% of those treated remain depression-free post-therapy.
- These results are sustained six months after the conclusion of treatment
Key drivers
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Lay community health workers who could be trained to deliver services
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Depth of knowledge pertaining to the regions and populations being served
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Expertise in delivering programmatic therapy in a variety of development settings
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A core set of partners with a strategic understanding of program potential
Challenges
- Limited funding
- Lack of awareness of depression as a treatable medical condition
- Dispersed local population
Continuation
StrongMinds seeks to partner strategically with other NGOs to share knowledge and build awareness and ultimately reach underserved populations. We do this by building bridges between Ministries of Health, NGOs, and regional experts to expand our program services.
Partners
StrongMinds works through partners to layer mental health services into existing livelihood, food security, healthcare, and education programs to scale our reach and enhance outcomes for program participants.
StrongMinds is thankful to have generous supporters helping us treat women and adolescents in Africa. Some examples include:
- Cartier Philanthropy
- Effective Altruism
- Grand Challenges Canada
- Mulago Foundation
- Jasmine Social Investments
- The Lucille Foundation
- Butabika National Hospital: Dr. Dorothy Kizza, based at Butabika, provides field expertise to StrongMinds Mental Health Facilitators
- Columbia University: Dr. Helena Verdeli, Associate Professor of Clinical Psychology & Director of the Global Mental Health Lab, is a key partner and advisor
- Medic Mobile: Medic Mobile’s SMS technology cost-effectively improves StrongMinds’ data collection/analysis and improves patient communication
- FXB Uganda: StrongMinds treats depressed women in eastern Uganda before they enter FXB’s poverty alleviation programs
- IRC: A joint pilot to provide depression treatment to refugee women with the goal of scaling the partnership throughout Uganda to treat tens of thousands of female refugees
Evaluation methods
The project is evaluated internally through routine monitoring and evaluation activities, and externally through an independent impact evaluation. The impact evaluation includes a controlled longitudinal cohort study comparing outcomes of women and adolescents with depression receiving treatment in a StrongMinds Therapy Group, with outcomes of women and adolescents with depression who have received no treatment.
StrongMinds uses the Patient Health Questionnaire (PHQ-9) to evaluate individuals with depression immediately pre- and post-intervention, as well as at a 6 month follow-up. The PHQ-9 is contained within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and is endorsed by the World Health Organization for use in the developing world.
Cost of implementation
Impact details
References
1. WHO (2012). Depression Fact Sheet. Geneva: World Health Organisation, Accessed 28 August 2014.
2. WFMH (2012). Depression: a Global Crisis. Occoquan, VA: World Federation for Mental Health.
3. Weissman M, Markowitz J, Klerman G (2000). Comprehensive Guide to Interpersonal Psychotherapy. New York, NY: Basic Books.
4. Bolton P et al. (2003). Group Interpersonal Psychotherapy for Depression in Rural Uganda: A Randomized Controlled Trial. JAMA, 289(23):3117-3124.
5. StrongMinds (2016). Our Impact. Accessed 6 April 2016.
Research
- Depression - WHO | World Health Organization
- Comprehensive Guide to Interpersonal Psychotherapy
- Group Interpersonal Psychotherapy for Depression in Rural Uganda: A Randomized Controlled Trial
- Investing In Mental Health: Evidence for Action
- Psychotherapy: Cost-effectiveness Analysis
- Happiness for the Whole Family
Multimedia
- StrongMinds: Treating Depression at Scale in Africa
- StrongMinds: Treating Depression in Women at Scale in Africa
- NY Times Feature
- StrongMinds Addresses Mental Health in Sub-Saharan Africa
- Celebrating Our Commitment to Innovation for Gender Equality
- Global Mental Health and the Ethics of Happiness
- Building the Ecosystem Around Tele-mental Health
- Western Influence is Impacting Mental Healthcare in Uganda
- Is Therapy Making the World Happier?
- Time to Talk: How Chat Tech Can Drive Social Change
- They Called Me Lazy: Addressing Depression Stigma in Uganda
- 4 Facts You Didn’t Know About Mental Health In Africa
- Top 13 Mental Health Charities Making a Big Impact (2021)
- Taking the Stigma out of Mental Health Services
- IPT: From Humble Origins as “High Contact Therapy” to International Adoption
- Venture Support for Gender Equity
- Embedding a Gender Lens into the Investment Process
- Removing Obstacles to Mental Health Care — Over the Phone
- StrongMinds Overview
- StrongMinds: From Depression to Recovery
- It All Starts with One Woman
- One Woman’s Journey Back to Good Mental Health with StrongMinds