RESIDENT: Improving mental health: a process evaluation using qualitative and quantitative analysis of a psychiatry education intervention in Mwanza, Tanzania for medical students
Presenting Author(s): Dr. Jadah Johnson, Dr. Jordan Li, Dr. Susan Poon
Co-Author(s): Dr. Suzanne Black, Dr. E. Charles, Dr. K. Fitch, Dr. Rachel Grimminck, MD, FRCPC, DABPN, Dr. K. Hauli, Dr. Suneina Mohan, Dr. M. Mwita, Dr. Roy Turner, Dr. R. Watterson, Dr. Kimberly Williams, BSc (Pharmacology), MSc (Global Health)
Date and time: 24 Mar 2018 from 15:15 to 15:30
Location: Bluebell
Presenting Author(s) Names: Jadah Johnson, Jordan Li, and Susan Poon
Co-Author(s) Names: Dr. Suzanne Black, Dr. E. Charles, Dr. R. Grimminck, Dr. K. Hauli, Dr. K. Fitch, Dr. R. Watterson, Dr. K. Williams, Dr. Roy Turner, Dr. S. Mohan, and Dr. M. Mwita
Email: jordanhli293@gmail.com
Learning Objectives:
- To define the concept of Global Mental Health and explore current challenges
- To understand stigma and recognize stigma’s implications on mental health education
- To describe a cross-cultural educational intervention and its practical relevance for Canadian resident psychiatrists
Literature References:
Izutsu, T., Tsutsumi, A., Minas, H., Thornicroft, G., Patel, V. (2015). Mental health and wellbeing in the Sustainable Development Goals. Lancet Psychiatry, 2(12), 1052-1054.
Mbatia, J. & Jenkins R., (2010). Development of a Mental Health Policy and System in Tanzania: An Integrated Approach to Achieve Equity. Psychiatric Services, 61(10), 1028-1031.
Patel, V., Chisholm, D., Parikh, R., Charlson, F., Degenhardt, L., Dua, T., Ferrari, A., Hyman, S., Laxminarayan, R., Leevin, C., Lund, C., Medina, M., Petersen, I., Scott, J., Shidhaye, R., Vijayakumar, L., Thornicroft, G., & Whiteford, H. (2014). Addressing the burden of mental, neurological and substance use disorders: key messages form disease control priorities, 3r edition. Lancet, 387(10028), 1672-1685.
PLOS Medicine Editors (2013). The Paradox of Mental Health: Over-Treatment and Under- Recognition. PLoS Medicine, 10(5), e1001456.doi:10.1371/journal.pmed.1001456
Abstract
Background: A psychiatry curriculum was developed for medical students in Mwanza, Tanzania. The two-weeks of teaching was a mixture of didactic lectures, small groups, and review sessions. The intervention was developed based on pedagogy from Canadian undergraduate curriculum, with input from Tanzanian faculty. A process evaluation was done to determine best practices. Study Objectives: 1.) To understand the advantages and barriers to implementation; 2.) To measure the level of satisfaction by those who participated; and 3.) To explore what skills and knowledge are needed for mental health practice. Methods: This study was a cross-sectional design using qualitative and quantitative data collection. Focus groups and surveys were collected from medical students. Stakeholder interviews were collected from faculty. Qualitative data was analyzed using thematic analysis and quantitative using descriptive and frequency distribution. Results: Students appreciated the friendly teacher-student relationship and diverse engaging teaching methods such as small groups and audiovisual materials. Suggestions included increasing review and audiovisual material, cultural and clinical relevance, and culturally acceptable methods of asking questions. Survey results pointed to ways to improve education delivery. Stakeholders identified stigma and poor understanding of the etiology of mental health disorders as huge barriers for the treatment of patients. Discussion: Studies show there is poor knowledge of mental illness and under-prioritization within the health care system which is consistent with themes expressed. Consistent with the literature, both education and exposure reduces stigma. Conclusion: Continued quality improvement is needed to ensure interventions are effective at increasing knowledge and reducing stigma.