Published on June 29th, 2016 | from CAMH
Findings from Cell phones and Psychosis: Mobile apps used to holistically address psychosis in Tanzania
By Sireesha Bobbili, Special Advisor/Project Coordinator, Office of Transformative Global Health, Institute of Mental Health Policy Research and Erin Lee, Communications Specialist, Office of Transformative Global Health, Institute of Mental Health Policy Research, CAMH
Early 2016 marked the completion of our 18 month project in rural Tanzania that sought to test the effectiveness of a mobile app for facilitating the collaboration between traditional healers and biomedical professionals to better address psychosis. We worked with Dr. Pamela Kaduri, a psychiatrist at Muhimbili University of Health and Allied Sciences (MUHAS) in Tanzania to develop this pilot project funded by Grand Challenges Canada.
In Tanzania, psychosis is a condition that affects approximately four per cent of the population. The traditional belief system contributes to how mental illness, particularly psychosis, is perceived.
We found that the cause of mental illness is often attributed to witchcraft or supernatural causes. As a result of these cultural beliefs as well as a lack of rural biomedical services, over 60 per cent of Tanzanians seek mental health care from traditional healers. Without an integrated model of care, biological symptoms are left untreated and can reach chronic stages, leading to severe and long-term disability. Check out our previous blog to learn more about the early stages of the project.
Built partnerships with various agencies
The initial months of this project were spent developing partnerships. By means of several meetings and site visits to Pangani District Hospital, relationships were built with administrators, staff and the District Medical Officer, Dr. Elisey Magiri. On the use of an app to integrate the two models of care, Dr. Magiri said, “I hope to this, the interaction between those three groups, patients, traditional healers and biomedical staff, to help the patient to be attended in a proper way. We will get them a holistic treatment approach.”
Relationships were also built with CHAWATIATA, a traditional healer organization. Mohamedi Hatibu, the traditional healing coordinator, said, “The project is good and the patient will benefit from it because the patient will be diagnosed and then if it is the illness [psychosis], the patient will be referred to the hospital for further treatment.” (translated from Kiswahili)
Noxyt Software Solutions, a local Tanzanian programming company, was brought on board to develop the app.
Developed a mobile app
We worked closely with Noxyt Software Solutions to develop the psychosis screening and consultation app used by traditional healers and biomedical professionals.
Here are some of its features:
- Screening tool: contains the mobile culturally adapted version of the Psychosis Screening Questionnaire (PSQ).
- Communication tool: discussion capabilities via text or phone between traditional healers and biomedical professionals.
- Data collection tool: patient profiles were created and information was entered, accessed and stored by providers from both systems of care.
The development process was highly collaborative. The prototype was tested with both traditional healers and biomedical professionals for user-friendliness and cultural compatibility.
Trained traditional healers and biomedical professionals
Traditional healers working in Pangani district who met the inclusion criteria were invited to participate in a three-day orientation from February 4th-6th, 2015. The orientation included an overview of the study, training about mental illness from both perspectives (traditional and biomedical), cell phone distribution, and training on how to use the app.During the orientation, providers participated in interactive lectures, group activities and vignettes regarding psychotic disorders. After the training, participants were required to demonstrate proficiency by using the app to screen patients, share patient information with other professionals, create collaborative plans of care and provide referrals.
We were extremely pleased to find a number of positive improvements after completing the 18-month study.
- We found an increase in the proportion of traditional healers who possessed a high level of knowledge about the biological symptoms of mental illness.
- The acceptability of the app by traditional healers was also high. We found that 100 per centhad a clear and consistent perception that mobile phones, and the app in particular, could be successfully used to screen mentally ill patients.
- 69 per cent of the traditional healers used the mobile app successfully by developing patient profiles, screening and consulting with biomedical professionals.
- Of the patients who were referred to Pangani District hospital, 61 per centpresented at the hospital and were treated by participating biomedical professionals. This finding was of particular importance as it confirmed the crucial role that the app played in providing holistic treatment for individuals affected by psychosis.
We’re thrilled to have completed our pilot study resulting in positive improvements for traditional healers, mental health professionals and individuals affected by mental illness. Looking ahead, we hope to garner additional funds to build on these findings and expanding this initiative to other regions. Tanzania’s Ministry of Health and Social Welfare is motivated by the promising research findings and are supportive of scaling up the initiative to six new regions across Tanzania.
Stay tuned, we will be releasing a follow-up video which recaps the entire project in the upcoming weeks!
For more detailed information on the project, contact firstname.lastname@example.org or visit our Mental Health Innovation Network page
For updates on other projects from the Office of Transformative Global Health, follow @akwatukhenti