5.4 Mental Health Pocket Guide and training videos
Continuing their research in rural areas, the team found that stigma is common, including among HEWs themselves (Tilahun et al., 2016; 2017). Stigma may be directed at the autistic individual and their family, or experienced by the family without the specific actions of others – for instance, a family may feel shame or guilt at their child’s slow and atypical development. In the majority of cases where autism remains undiagnosed and the label itself is unfamiliar, stigma may arise nonetheless because a child’s slow development and unusual behaviour marks them out as different. Certain traditional beliefs may have a stigmatising effect: children may be thought possessed by a spirit, and parents may believe they are being punished for a sin. One HEW gave the following account:
I have got one child in our survey; he does not talk. His parents were hiding information about him. They thought that this type of disease is cured through traditional or spiritual means. They said [his illness was] due to spirit possession – likift – because someone had given him some potion. When I saw the child he was very pale and […] chained.
The research demonstrated that the HEWs would benefit from more targeted training (Tilahun et al., 2017). In response, the team produced a guide to autism, intellectual disability and other child and adult mental health problems, including tips on supporting parents and families. In addition, the team produced five interview training videos for autism and intellectual disability.
Versions of these materials now form a free OpenLearn Create resources pack on mental health, available on this page: Mental Health: Resources for Community Health Workers [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .
Ongoing initiatives in Ethiopia include the development of a culturally appropriate diagnostic instrument, and the trial of an intervention that can be implemented by parents with their children.