Sitting with others: mental health self-help groups in northern Ghana

Abstract

BackgroundOver the past four decades, there has been increasing interest in Self-Help Groups, by mental health services users and caregivers, alike. Research in high-income countries suggests that participation in SHGs is associated with decreased use of inpatient facilities, improved social functioning among service users, and decreased caregiver burden. The formation of SHGs has become an important component of mental health programmes operated by non-governmental organisations (NGOs) in low-income countries. However, there has been relatively little research examining the benefits of SHGs in this context.MethodsQualitative research with 18 SHGs, five local non-governmental organisations, community mental health nurses, administrators in Ghana Health Services, and discussions with BasicNeeds staff.ResultsSHGs have the potential to serve as key components of community mental health programmes in low-resource settings. The strongest evidence concerns how SHGs provide a range of supports, e.g., social, financial, and practical, to service users and caregivers. The groups also appear to foster greater acceptance of service users by their families and by communities at large. Membership in SHGs appears to be associated with more consistent treatment and better outcomes for those who are ill.DiscussionThis study highlights the need for longitudinal qualitative and quantitative evaluations of the effect of SHGs on clinical, social and economic outcomes of service users and their carers.ConclusionsThe organisation of SHGs appears to be associated with positive outcomes for service users and caregivers. However, there is a need to better understand how SHGs operate and the challenges they face.

Mental health, poverty and development

“…Also key to human rights promotion and protection is the strengthening of civil society in the area of mental health, particularly through provision of mutual support and self help. Self-help groups can serve as key components of community mental health programs in low-resource settings, providing social and financial services, and practical support to individuals and families; they are also associated with better health outcomes (Cohen et al, 2012).…”

Grupos de Ajuda Mútua para Cuidadores: Informais de pessoas com demência: no sentido de um helping ethos comunitário

“…Algumas evidências de estudos de caráter quantiqualitativo sugerem uma associação entre a frequência de GAM e uma melhoria no funcionamento social e familiar, e na perceção de apoio social disponível por parte dos usuários destes serviços (CHIEN et al, 2004;CASTELEIN et al, 2008;COHEN et al, 2012). Nos GAMs analisados neste estudo, o sentimento de atendimento e apoio experimentado pelos seus participantes endossa o valor desta intervenção na comunidade, fazendo eco do preconizado por estudos anteriores sobre os benefícios desta intervenção (GRECO et al, 1999).…”

“…Apesar de não ser possível apurar neste estudo estas dimensões para cada um dos participantes, nem tampouco analisar os benefícios individuais em termos de recurso a serviços ou em termos de saúde mental pela natureza descritiva e exploratória da abordagem realizada, importa evidenciar que a investigação tem demonstrado uma associação entre a frequência de um GAM e a redução da taxa de utilização de instalações de internamento (BURTI et al, 2005), bem como uma utilização mais ajustada de serviços de saúde (CHIEN et al, 2007). A literatura aponta, ainda, para o ajustamento psicológico positivo do cuidador (CHIEN et al, 2007;CHIEN et al, 2008;FALCÃO;BUCHER-MALUSCHKE, 2009) e a diminuição da sobrecarga e melhoria do bem-estar psicológico (CHIEN et al, 2006;CHIEN et al, 2008;CHIEN et al, 2011;COHEN et al, 2012), com redução dos níveis de preocupação, depressão major e sentimento de incapacidade (LUCKSTED et al, 2008). Todos estes benefícios serão importantes focos de análise numa investigação longitudinal dos cuidadores que integram os GAMs aqui considerados.…”

A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

“…Third, our treatment packages did not contain important components that are standard in High-Income Countries such as occupational therapy or self-help groups. Self-help groups in LMICs can assist patients and carers to improve social and economic hardships and reduce exclusion and stigmatization in the community [49]. Another challenge that was not addressed in our pilot project is the reintegration of patients into productive life.…”