Background: In developing countries with shortage of mental health professionals, paramedics are trained in the delivery of mental health services. Knowledge of the experience of the trained health workers is useful in evaluating output of service and restructuring training package. This study was undertaken to determine the experience of trained primary health care (PHC) workers in mental health service delivery across Ogun State South west Nigeria.
Objective: One of the major challenges of successful integration of mental health into Primary Health Care (PHC) is the lack of adequate knowledge and skills for mental health service delivery by PHC workers in the community. This study is undertaken to evaluate the effectiveness of a mental health training course on the knowledge and mental health practice of PHC workers participating in the Aro Primary Care Mental Health Programme (APCMHP) for Ogun State, Nigeria.
Method:We conducted a quasi-experimental study on eighty (80) PHC workers with a training course locally developed from the WHO mhGAP intervention guide (2010). The course was aimed at improving diagnosis and management of five priority conditions: Psychosis, Depression, Alcohol &Substance abuse, Epilepsy and Other Significant Emotional Complaints (OSEC).Data was collected on socio-demographic characteristics, health practice experience, knowledge and skills to diagnose and treat mental health case vignettes before and after a three day training course.
Results:Of the 80 PHC workers, 90.0% were females and 87.5% of them were nurses. Post-training rate of accurate diagnosis by the PHC workers significantly improved by 12.5% for psychosis(p=0.018), 12.5% for substance abuse(p=0.018), 30.0% for OSEC(p=0.001) while the mean scores for appropriate intervention improved by 114.0% for psychosis(p=0.001), 109.3% for depression(p=0.001), 77.9% for substance abuse(p=0.001), 102.7% for epilepsy(p=0.001) and 91.9% for OSEC(p=0.001). A total of 473 patients were treated in the communities within a period of 12months.
Conclusion:This study shows that mental health training course for PHC workers resulted in improved knowledge and expected mental health practice with greater effect on case management than case recognition. Mental health training of PHC workers is essential for reducing the mental health service gap in Nigeria.
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