Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes

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dc.contributor.authorSibeko, Goodman
dc.contributor.authorMilligan, Peter D
dc.contributor.authorRoelofse, Marinda
dc.contributor.authorMolefe, Lezel
dc.contributor.authorJonker, Deborah
dc.contributor.authorIpser, Jonathan
dc.contributor.authorLund, Crick
dc.contributor.authorStein, Dan J
dc.date.accessioned2018-07-11T09:31:08Z
dc.date.available2018-07-11T09:31:08Z
dc.date.issued2018-06-14
dc.date.updated2018-06-17T03:36:08Z
dc.description.abstractBackground There is a shortage of trained mental health workers in spite of the significant contribution of psychiatric disorders to the global disease burden. Task shifting, through the delegation of health care tasks to less specialised health workers such as community health workers (CHWs), is a promising approach to address the human resource shortage. CHWs in the Western Cape province of South Africa provide comprehensive chronic support which includes that for mental illness, but have thus far not received standardized mental health training. It is unknown whether a structured mental health training programme would be acceptable and feasible, and result improved knowledge, confidence and attitudes amongst CHWs. Methods We developed and piloted a mental health training programme for CHWs, in line with the UNESCO guidelines; the WHO Mental Health Gap Action Programme and the South African National framework for CHW training. In our quasi-experimental (before-after) cohort intervention study we measured outcomes at the start and end of training included: 1) Mental health knowledge, measured through the use of case vignettes and the Mental Health Knowledge Schedule; 2) confidence, measured with the Mental Health Nurse Clinical Confidence Scale; and 3) attitudes, measured with the Community Attitudes towards the Mentally Ill Scale. Knowledge measures were repeated 3 months later. Acceptability data were obtained from daily evaluation questionnaires and a training evaluation questionnaire, while feasibility was measured by participant attendance at training sessions. Results Fifty-eight CHWs received the training, with most (nā€‰=ā€‰56, 97.0%) attending at least 7 of the 8 sessions. Most participants (nā€‰=ā€‰29, 63.04%) demonstrated significant improvement in knowledge, which was sustained at 3-months. There was significant improvement in confidence, along with changes in attitude, indicating improved benevolence, reduced social restrictiveness, and increased tolerance to rehabilitation of the mentally ill in the community but there was no change in authoritarian attitudes. The training was acceptable and feasible. Conclusions Mental health training was successful in improving knowledge, confidence and attitudes amongst trained CHWs. The training was acceptable and feasible. Further controlled studies are required to evaluate the impact of such training on patient health outcomes. Trial registration PACTR PACTR201610001834198 , Registered 26 October 2016.
dc.identifier.apacitationSibeko, G., Milligan, P. D., Roelofse, M., Molefe, L., Jonker, D., Ipser, J., ... Stein, D. J. (2018). Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/28289en_ZA
dc.identifier.chicagocitationSibeko, Goodman, Peter D Milligan, Marinda Roelofse, Lezel Molefe, Deborah Jonker, Jonathan Ipser, Crick Lund, and Dan J Stein "Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes." <i>BMC Psychiatry</i> (2018) http://hdl.handle.net/11427/28289en_ZA
dc.identifier.citationSibeko, G., Milligan, P. D., Roelofse, M., Molefe, L., Jonker, D., Ipser, J., ... & Stein, D. J. (2018). Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes. BMC psychiatry, 18(1), 191.
dc.identifier.ris TY - Journal Article AU - Sibeko, Goodman AU - Milligan, Peter D AU - Roelofse, Marinda AU - Molefe, Lezel AU - Jonker, Deborah AU - Ipser, Jonathan AU - Lund, Crick AU - Stein, Dan J AB - Background There is a shortage of trained mental health workers in spite of the significant contribution of psychiatric disorders to the global disease burden. Task shifting, through the delegation of health care tasks to less specialised health workers such as community health workers (CHWs), is a promising approach to address the human resource shortage. CHWs in the Western Cape province of South Africa provide comprehensive chronic support which includes that for mental illness, but have thus far not received standardized mental health training. It is unknown whether a structured mental health training programme would be acceptable and feasible, and result improved knowledge, confidence and attitudes amongst CHWs. Methods We developed and piloted a mental health training programme for CHWs, in line with the UNESCO guidelines; the WHO Mental Health Gap Action Programme and the South African National framework for CHW training. In our quasi-experimental (before-after) cohort intervention study we measured outcomes at the start and end of training included: 1) Mental health knowledge, measured through the use of case vignettes and the Mental Health Knowledge Schedule; 2) confidence, measured with the Mental Health Nurse Clinical Confidence Scale; and 3) attitudes, measured with the Community Attitudes towards the Mentally Ill Scale. Knowledge measures were repeated 3 months later. Acceptability data were obtained from daily evaluation questionnaires and a training evaluation questionnaire, while feasibility was measured by participant attendance at training sessions. Results Fifty-eight CHWs received the training, with most (nā€‰=ā€‰56, 97.0%) attending at least 7 of the 8 sessions. Most participants (nā€‰=ā€‰29, 63.04%) demonstrated significant improvement in knowledge, which was sustained at 3-months. There was significant improvement in confidence, along with changes in attitude, indicating improved benevolence, reduced social restrictiveness, and increased tolerance to rehabilitation of the mentally ill in the community but there was no change in authoritarian attitudes. The training was acceptable and feasible. Conclusions Mental health training was successful in improving knowledge, confidence and attitudes amongst trained CHWs. The training was acceptable and feasible. Further controlled studies are required to evaluate the impact of such training on patient health outcomes. Trial registration PACTR PACTR201610001834198 , Registered 26 October 2016. DA - 2018-06-14 DB - OpenUCT DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes TI - Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes UR - http://hdl.handle.net/11427/28289 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12888-018-1772-1
dc.identifier.urihttp://hdl.handle.net/11427/28289
dc.identifier.vancouvercitationSibeko G, Milligan PD, Roelofse M, Molefe L, Jonker D, Ipser J, et al. Piloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes. BMC Psychiatry. 2018; http://hdl.handle.net/11427/28289.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceBMC Psychiatry
dc.source.urihttps://bmcpsychiatry.biomedcentral.com/
dc.subject.otherTask shifting
dc.subject.otherCommunity health workers
dc.subject.otherMental health
dc.subject.otherTraining
dc.titlePiloting a mental health training programme for community health workers in South Africa: an exploration of changes in knowledge, confidence and attitudes
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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