Building a Community Based Mental Health Program for Adolescents in Botswana: Stakeholder Feedback

Brooks, Merrian; Phetogo, Bathusi; Schwennesen, Hannah; Phoi, Onkemetse; Tshume, Ontibile; Matshaba, Mogomotsi; Lowenthal, Elizabeth

doi:10.1007/s10597-021-00915-5

Cited by 8 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent qualitative work with South African primary providers reported a similar set of potential implementation strategies to promote mental health services in primary care, including community outreach, staff supervision, flexible service delivery models, and screening and referral mechanisms [51, 52]. Studies to adapt the Friendship Bench in Botswana, Vietnam and Malawi have all reported challenges with training and supervising younger lay counsellors, intervention fidelity, loss to follow‐up and community stigma, underscoring the importance and relevance of the implementation approaches identified in our research [35, 53–56]. Evidence for implementation strategies to improve the delivery of mental health interventions in resource‐constrained settings is increasing.…”

Section: Discussionmentioning

confidence: 70%

Integrating a mental health intervention into PrEP services for South African young women: a human‐centred implementation research approach to intervention development

Velloza,

Ndimande‐Khoza,

Mills

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

IntroductionAdolescent girls and young women (AGYW) who may benefit from HIV pre‐exposure prophylaxis (PrEP) face high levels of common mental disorders (e.g. depression, anxiety). Common mental disorders can reduce PrEP adherence and increase HIV risk, yet mental health interventions have not been well‐integrated into PrEP delivery.MethodsWe conducted a four‐phase human‐centred design process, from December 2020 to April 2022, to understand mental health challenges among AGYW in Johannesburg, South Africa and barriers to integrated mental health and PrEP services. In the “Discover” phase, we conducted in‐depth interviews with AGYW and key informants (KIs) in Johannesburg. We conducted a rapid qualitative analysis, informed by the Consolidated Framework for Implementation Research (CFIR), to identify facilitators and barriers of integrated mental health and PrEP services and mapped barriers to potential implementation strategies. In the “Design” and “Build” phases, we conducted stakeholder workshops to iteratively adapt an evidence‐based mental health intervention, the Friendship Bench, and refine implementation strategies for South African PrEP delivery settings. In the “Test” phase, we piloted our adapted Friendship Bench package.ResultsInterviews with 70 Discover phase participants (48 AGYW, 22 KIs) revealed the importance of integrated mental health and PrEP services for South African AGYW. Interviewees described barriers and implementation strategies for mental health and PrEP services around the CFIR domains: intervention characteristics (e.g. challenges with AGYW “opening up”); outer Johannesburg setting (e.g. community stigma); inner clinic setting (e.g. judgemental healthcare providers); characteristics of counsellors (e.g. training gaps); and the implementation process (e.g. need for demand creation). The Design and Build workshops included 13 AGYW and 15 KIs. Implementation barriers related to the quality and accessibility of public‐sector clinic services, lay counsellor training, and community education and demand creation activities were prioritized. This led to 12 key Friendship Bench adaptations and the specification of 10 implementation strategies that were acceptable and feasible in initial pilot testing with three AGYW.ConclusionsUsing a human‐centred approach, we identified determinants and potential solutions for integrating mental health interventions within PrEP services for South African AGYW. This design process centred stakeholders’ perspectives, enabling rapid development of an adapted Friendship Bench intervention implementation package.

show abstract

Section: Discussionmentioning

confidence: 70%

Integrating a mental health intervention into PrEP services for South African young women: a human‐centred implementation research approach to intervention development

Velloza,

Ndimande‐Khoza,

Mills

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

show abstract

“…Our quantitative analysis revealed that psychological interventions were the most preferred mental health interventions among young people. Youth participants rated the Friendship Bench problem-solving therapy intervention, which is currently being tested and implemented with adolescents in southern Africa [ 40 , 41 ], as highly acceptable. Our key informants also stressed the need for improved access to standard mental health services that are culturally appropriate.…”

Section: Discussionmentioning

confidence: 99%

A mixed methods analysis of youth mental health intervention feasibility and acceptability in a North American city: Perspectives from Seattle, Washington

Mensa-Kwao,

Sub Cuc,

Concepcion

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

In March 2021, the Governor of Washington declared a youth mental health crisis. State data revealed high rates of youth suicide and inadequate access to services. This study aims to ascertain the kinds of support across the mental health care continuum recommended by young people and key stakeholders who could assist with implementation in Seattle. We interviewed 15 key informants to identify the contextual, structural, and individual-level factors that increase the risk of poor mental health and deter access to care among youth. We complimented these data with a 25-item survey of 117 participants in King County to assess the feasibility and acceptability of interventions for youth mental health. We conducted a deductive thematic qualitative analysis of the interviews and performed descriptive analyses of the quantitative data, using t-tests and χ2 tests to summarize and compare participant characteristics stratified by age group. Qualitative informants attributed challenges to youth mental health to social isolation and relational problems. Example interventions included creating environments that increase belonging and implementation of culturally congruent mental health services. Quantitative study participants rated all evidence-based mental health interventions presented as highly acceptable. However, youth preferred interventions promoting social connectedness, peer support, and holistic approaches to care, while non-youth preferred interventions focused on suicide, and substance abuse prevention. Key informants and survey participants identified schools as the most important setting for mental health interventions. There were no significant differences among quantitative outcomes. Our findings highlight the need for interventions that reduce isolation and increase social connectedness to support youth mental health. As the city designs youth responsive interventions, schools and digital platforms should be prioritized. Engaging multiple stakeholders, particularly young people, tackling cultural stigma surrounding mental health, and improving access to safe community spaces are important considerations for youth mental health interventions.

show abstract

“…This strong therapeutic alliance was a core finding of our analyses and highlights the importance of supporting and training NPYLC to do this well and in a sustainable way. Safe Haven's adaptation from older adult lay counsellors to NPYLC was a direct response to key stakeholder feedback (Brooks, Phetogo, et al, 2022). The cultural and contextual considerations noted by the community and professional stakeholder group seem to resonate with the youth who had experiences with the NPYLC showing a direct connection between community guidance and acceptability and feasibility with the target youth.…”

Section: Discussionmentioning

confidence: 99%

“…NPYLC close in age (18-35 years) to youth clients were determined by stakeholders to be potentially more effective than older adults in delivering therapy-based lay counsellor interventions because of cultural divides between generations (Brooks, Phetogo, et al, 2022). The NPYLC for Safe Haven were recruited by community leaders who worked with youth in other community capacities using a word-of-mouth referral method GARRIOTT ET AL.…”

Section: Safe Haven Interventionmentioning

confidence: 99%

“…The Safe Haven intervention is a near peer youth lay counsellor (NPYLC) led intervention that was adapted from the Friendship Bench (Broström et al, 2021; Chibanda et al, 2015), to meet the mental health needs of YLWH in Botswana. It was created to address the gap in youth‐friendly mental health services and build upon our formative research on culturally appropriate youth‐friendly mental health services in Botswana (Brooks, Phetogo, et al, 2022; Brooks, Willis, et al, 2022). This study examines the attitudes and impressions of YLWH in Botswana, who participated in Safe Haven.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Youth perspectives of working with near peer youth lay counsellors: The Safe Haven Pilot

Garriott

Gulubane

Poku

et al. 2023

Journal Community Psychology

Self Cite

View full text Add to dashboard Cite

Youth living with HIV (YLWH) have higher rates of common mental disorders (CMDs) when compared with HIV‐negative youth. We adapted the Friendship Bench to create a problem solving‐based counselling intervention in Botswana delivered by near peer youth lay counsellors for YLWH called Safe Haven. In August 2020, and from June to August 2021, we conducted 22 semistructured interviews with youth aged 13–25 years with mild‐to‐moderate symptoms of CMDs. Two independent coders carried out an inductive thematic analysis of the transcribed interviews with discrepancies discussed to consensus. Safe Haven was seen as largely acceptable among the youth. Youth felt Safe Haven was a place where they had freedom of expression and could receive practical advice from well‐trained and approachable counsellors. Trained youth lay peer counsellors show promise to meet the mental health needs of mild and moderately symptomatic youth, where mental health professionals are in short supply.

show abstract

Building a Community Based Mental Health Program for Adolescents in Botswana: Stakeholder Feedback

Cited by 8 publications

References 25 publications

Integrating a mental health intervention into PrEP services for South African young women: a human‐centred implementation research approach to intervention development

Integrating a mental health intervention into PrEP services for South African young women: a human‐centred implementation research approach to intervention development

A mixed methods analysis of youth mental health intervention feasibility and acceptability in a North American city: Perspectives from Seattle, Washington

Youth perspectives of working with near peer youth lay counsellors: The Safe Haven Pilot

Contact Info

Product

Resources

About