Delivered by lay health workers to groups of patients, the treatment involves eight sessions of therapy delivered in eight weeks with each focusing on a different topics where the first session is introductory and the last focusing on livelihood skills for those involved.
A psychiatrist at Makerere University has urged the Ministry of
Health to adopt group mental healthcare also known as group support
psychotherapy for people living with HIV that develop depression.
Dr Etheldreda Nakiwala Mpuungu who has reached more than 1,000 people living
with HIV and depression in her continuous study to test its efficacy says
participants involved in group treatment recovered from the mental illness six
months later and remained free two years after treatment.
//Cue in: “Five years down…
Cue out: “…Up to two
Nakiwala says that she started testing her treatment innovation in 2012 having
realized that the country has only a few health workers that specialize in
mental health and yet a lot of people who live with HIV were presenting late to
big health facilities with mental health complications and yet some never get
to seek care at all.
Figures globally already show that depression rates are higher among those
living with HIV than the general population.
According to figures by the United Nations Joint Programme on
HIV/AIDS (UNAIDS), the prevalence of depression and other mental health
disorders among people living with HIV in sub-Saharan Africa is estimated
between 13 and 78%.
However even as figures point to a problem, in many countries including Uganda,
screening for depression is not done at HIV clinics. All they do is basic
counselling. This treatment, Nakiwala says comes in handy.
Delivered by lay health workers to groups of patients, the treatment involves
eight sessions of therapy delivered in eight weeks with each focusing on different
topics where the first session is introductory and the last focusing on
livelihood skills for those involved.
Initially, they involved 109 participants in Kitgum district, grew them to 574
but went on increasing the numbers and expanding to different districts having
realized that those involved didn’t only get cured but they also adhered more
to the HIV medications and improved economically.
They also compared the outcomes of care with a control arm where
the other group were only given HIV related information and counselling. So far
more than 1,000 people have been followed using this therapy in 30 HIV clinics
in three Northern Uganda districts including Gulu and Pader.
She says in one of the sessions where participants have to share with
colleagues and health workers their experiences many sufferers revealed having
suicidal thoughts after testing positive. Others revealed also battling
post-traumatic stress disorders, falling into over-consumption of alcohol and
some losing interest in their sources of livelihood.
///Cue in: “Treating depression improved…
Cue out: “…To have depression”. //
She says they allowed people to suggest the kind of treatment sessions they
wanted and that’s how they added livelihood skills even as it wasn’t part of
the original treatment plan.
The original sessions included education patients about depression
and equipping them with coping skills.