Strengthening mental health systems in Zambia

Abstract

Background: Studies in mental health care for low resource settings indicate that providing services at primary care level would significantly improve provision and utilisation of mental health services. Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community. This study aimed to explore the barriers to the use of mental health services in Zambia, suggesting health systems thinking approaches to solving these challenges. Methods: Primary data were collected through individual interviews from 12 participants; primary caregivers, health workers from public health institutions that treat mental health conditions and policymakers and implementers. The digitally recorded responses were transcribed and analysed using thematic analysis. Results: Key barriers to care included inadequate funding, few human resources, poor infrastructure and stigma. Barriers to care at policy, facility and individual or community level could be alleviated by strengthening the mental health system. Engagement of community health workers and increasing efforts to sensitise the community about mental health would prove beneficial. Conclusions: Strengthening the community health systems for mental health could improve access and increase utilisation of services.

Conceptualization, detection, and management of psychological distress and mental health conditions among people with tuberculosis in Zambia: a qualitative study with stakeholders’ and TB health workers

“…Although there is some literature that suggests TB infection [ 5 ] and TB medication can lead to neuropsychiatric complications in TB patients, these complications are rare; a global meta-analysis calculated a pooled estimate of 1.1% (95% CI 0.2–2.1) for central nervous system related adverse drug reactions in TB patients [ 25 ]. Our findings reveal that this conceptualisation of mental health conditions was inundated with stigmatizing undertones affirming the work of other studies exploring the attitudes towards mental health conditions in Zambia [ 16 , 21 , 26 , 27 ].…”

Prevalence and correlates of suicidal behaviour among a national population-based sample of adults in Zambia

“… 27 One way of improving the access rate of treatment for suicidal behaviour and/or depression is by improving or expanding primary mental healthcare. 37 , 38 A study among primary healthcare workers in Zambia showed that their ability to detect mental health problem early was limited and that additional in-service training was needed to improve their service delivery. 39 Apart from primary healthcare screening for depression and suicidal ideation, for people not consulting primary care, community-level case-finding strategies may increase detection and management.…”

Construct validity and internal consistency of the revised Mental Health Literacy Scale in South African and Zambian contexts

“…In sub‐Saharan Africa, primary healthcare (PHC) workers play a significant role in delivering and promoting mental health care in their respective societies (Atilola, 2016 ; Munakampe, 2020 ; Mwape et al., 2012 ), but they lack knowledge on mental health‐related issues and hold negative stereotypes towards mentally sick persons (Kapungwe et al., 2011 ; Mwape et al., 2010 ). These negative attitudes, knowledge, beliefs and recognition of mental health issues (Jorm et al., 1997 ; O’Connor et al., 2014 ) may also reflect PHC workers’ poor MHL (Atilola, 2016 ).…”