In Tanzania, families who care for loved ones with mental illnesses may feel they quite literally have no place to turn. There are just three mental health providers for every 1 million residents, making professional intervention for mental health disorders rare or even impossible.
“The reality is that it’s families who are providing most of the care,” says Joy Noel Baumgartner, an associate professor of global health who leads DGHI’s mental health research group.
But in some low-resource settings, necessity is seeding innovation. Recognizing that giant gaps in mental health access aren’t going away any time soon, Baumgartner and other mental health researchers are increasingly testing interventions that rely more on families and trusted allies of people with mental disorders.
In one such study, Baumgartner and colleagues at Tanzania’s Muhimbili University of Health and Allied Sciences are providing psychosocial education to caregivers of adults with schizophrenia. Caregivers and their family members attend sessions to learn about the disorder, dealing with stigma, how to recognize symptoms of acute episodes, and how to set positive goals for recovery.
“We had people in the study who have not been functional in many years,” says Praxeda Swai, a medical specialist at Muhimbili National Hospital who helped run the psychoeducation program. “But within a few weeks, almost all had really changed in a lot of aspects of their recovery.”
Similar experiments are underway in South Africa, where DGHI assistant professor Lauren Franz is training caregivers of children with autism spectrum disorder in evidence-based techniques to improve social engagement. And in Kenya, Eve Puffer, an assistant professor of global health and clinical psychologist, is teaching village elders to use family therapy with community members who have experienced intimate partner violence. Other studies are helping family members and peers intervene in cases of depression and anxiety.
But scarcity isn’t the only reason to welcome more family-based interventions in mental health. Baumgartner notes that there is significant evidence that family and peer support is effective wherever it is applied, even in countries with more mental health resources.
