Suicide is Illegal! Challenges and Rewards on the journey to mental health education in Tanzania

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Presenting Author(s): Dr. Rachel Grimminck, MD, FRCPC, DABPN, Dr. Suneina Mohan, Dr. Roy Turner

Co-Author(s): Dr. Suzanne Black, Dr. E. Charles, Dr. K. Hauli, Dr. Jadah Johnson, Dr. Jordan Li, Dr. M. Mwita, Dr. Susan Poon, Dr. R. Watterson, Dr. Kimberly Williams, BSc (Pharmacology), MSc (Global Health)

Date and time: 24 Mar 2018 from 13:50 to 14:10

Location: Hawthorn A  Floor Map

Learning Objectives 

  1. By the end of this session, participants will be able to describe transcultural teaching challenges in Tanzania
  2. By the end of this session, the participant will be aware of practical tools to assist with transcultural teaching
  3. By the end of this session, participants will appreciate the influence of a mental health curriculum on medical student attitudes and behaviours towards mental health and suicide


Literature Reference:

 Kauffman and Mann. Teaching and learning in medical education: How theory can inform practice. Understanding Medical Education: Evidence, Theory and Practice, Second Edition. Edited by Tim Swanwick. © 2014 The Association for the Study of Medical Education. Published 2014 by John Wiley & Sons, Ltd.

Jenkins et al. Prevalence of Psychotic Symptoms and Their Risk Factors in Urban Tanzania. Int. J. Environ. Res. Public Health 2010, 7, 2514-2525

Ngoma et al. Common mental disorders among those attending primary health clinics and traditional healers in urbanTanzania. British Journal of Psychiatry (2003), 183, 349-355

Baig et al.  Assessment of an undergraduate psychiatry course in an African setting. BMC Medical Education 2008, 8:23

Jenkins et al. Common Mental Disorders and Risk Factors in Urban Tanzania.  Int. J. Environ. Res. Public Health 2010, 7, 2543-2558

Saracens et al. Barriers to improvement of mental health services in low-income and middle-income countries.  Lancet 2007; 370: 1164–74

Grand Challenges Canada - Global Mental Health


 The Kolabo project is a partnership between the University of Calgary and the Catholic University of Health and Allied Sciences (CUHAS) in Mwanza Tanzania to strengthen undergraduate and postgraduate medical education.  Prior to the partnership with the University of Calgary, there was one psychiatrist at CUHAS serving a population of 15 million people and there was very limited exposure to psychiatry in undergraduate medical education.  CUHAS has historically focused on traditional areas of medicine including internal medicine and surgical specialties and neglected psychiatric exposure and training.  Stigma within Tanzanian society and the institutional stigma at CUHAS has contributed to fear and avoidance of psychiatry and psychiatric patients.

In fall 2017, a team of 8 psychiatry residents and psychiatrists travelled to Tanzania to deliver a two-week mental health curriculum to almost 300 pre-clerkship and clerkship students.  We introduced novel teaching methodologies to Tanzanian students including small groups and patient presentations.  Mental health stigma especially in the area of suicide is a significant barrier to the delivery of medical education to students.  We evaluated the impact of the curriculum through focus groups, surveys and informal feedback methods.  During this session, we will outline, and present formulations and techniques used to attempt to overcome these challenges.  We will also share stories and present information about the impact on students in response to the curriculum.

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