Course

Mental Health: Resources for Community Health Workers

Welcome to the Mental Health Resources for Community Health Workers. These consist of:

   1. Mental Health: a Guide for Community Health Workers

The guide is especially appropriate for settings where the provision of medical, diagnostic and support services is sparse or lacking. It covers adult and child mental health problems, as well as childhood developmental disorders. It includes information and guidance on dealing with mental health crises and emergencies and identifying mental health and developmental problems, together with simple intervention strategies, including suggestions for parents and family members to use themselves. It outlines strategies for Community Health Workers to employ in promoting mental health and in raising their community’s awareness of mental health problems.

  2. Five training videos on childhood developmental problems

Each of these videos models a health worker interviewing the mother of a child with a developmental disorder.  Two of the videos focus on autism, two on intellectual disability (ID), while the fifth video focuses on the social and mental health problems that may develop for the mother of a child with ID.  The aim of the videos is to offer health workers models of good interview practice for the early detection of developmental problems, and for supportive counselling and problem solving.  

Background to the resources

These resources were first developed for use in Ethiopia where primary health care is delivered by Health Extension Workers (HEWs). In 2011, the Open University launched the HEAT (Health Education and Training) programme in which a team of academics from The Open University (OU) worked with Ethiopian health experts to develop a series of 13 modules covering a range of health issues.  One of them, Non-Communicable Diseases, Emergency Care and Mental Health, included material on adult mental health, and a brief discussion of childhood mental health and developmental problems.

In 2012, the charity Autism Speaks funded a team from the Open University’s (OU) Life, Health and Chemical Sciences Department and the Department of Psychiatry at Addis Ababa University (AAU) to research the knowledge, attitudes and current practice of rural HEWs on a range of adult mental health problems, and with a particular focus on childhood mental health and developmental problems. This research*, led by Dr Rosa Hoekstra at The Open University, now at King’s College London, revealed a need for more training in early detection, particularly in children (1), and specific support in tackling the stigma that may lead to affected individuals being concealed by their families, or to families with an affected individual being excluded by their community (2, 3).

In response to these research findings the team from the OU and AAU, with the Ethiopian Federal Ministry of Health, produced the original version of the mental health guide and filmed the five short scenarios modelling a HEW interviewing mothers of children with autism or intellectual disability. In an evaluation, the research team found that these training materials had beneficial effects in countering HEWs’ negative beliefs about, and desire for social distance from autistic children (4).

Although the resources were developed with Ethiopia in mind, most of the information and guidance can be readily used or adapted for use in other settings. The version of the Mental Health Guide offered here (version 1.2) is a selective revision of the original, prepared for an international audience by Dr Ilona Roth. Terms, practices and demographics which are specific to or specially relevant to Ethiopia are explained in brief footnotes throughout the guide.  

As Open Educational Resources, the Guide is free to download, use and adapt within a Creative Commons Attribution-NonCommercial-ShareAlike Licence https://creativecommons.org/licenses/by-nc-sa/2.0/uk/ 

Word: Mental Health: a Guide for Community Health Workers

Training videos on childhood developmental problems (Amharic and Amharic with English subtitles)

(1) Tilahun D, Hanlon C, Araya M, Davey B, Hoekstra RA, Fekadu, A, (2017) Training needs and perspectives of community health workers in relation to integrating child mental health care into primary health care in a rural setting in sub-Saharan Africa: a mixed methods study. International Journal of Mental Health Systems 11:15 DOI: https://doi.org/10.1186/s13033-017-0121-y

(2) Tekola B, Baheretibeb Y, Roth I, Tilahun D, Fekadu A, Hanlon C, Hoekstra RA, (2016) Challenges and opportunities to improve autism services in low-income countries: lessons from a situational analysis in Ethiopia. Global Mental Health vol.3 (e21) DOI: https://doi.org/10.1017/gmh.2016.17

(3) Tilahun D, Hanlon C, Fekadu A, Tekola B, Baheretibeb Y, Hoekstra RA, (2016) Stigma, explanatory models and unmet needs of caregivers of children with developmental disorders in a low-income African country: a cross-sectional facility-based survey. BMC Health Services Research 16:152 DOI: https://doi.org/10.1186/s12913-016-1383-9

(4) Tilahun D, Fekadu A, Tekola B, Araya M, Roth I, Davey B, Hanlon C, Hoekstra RA (2017) 'Ethiopian community health workers’ beliefs and attitudes towards children with autism: impact of a brief training intervention.' AUTISM (first published September 25 2017) DOI: https://doi.org/10.1177/1362361317730298; Open Access: http://oro.open.ac.uk/52292/ 

*The HEAT+ project funded by Autism Speaks (grant no. 7770), with PRIME and The Open University