The Jamie’s Fund model for developing community mental health care.

We worked with partner hospitals who understood the local need for mental health care and who are keen to work with us.  These hospitals are affiliated to one of two coordinating organisations, the Uganda Catholic and Protestant Medical Bureaux.

Using the World Health Organisation’s Mental Health Gap Action Programme

After an initial visit by Jamie’s Fund Trustees to a hospital, they were invited to send two staff to be trained as Trainers in the well-established World Health Organisation programme, mhGAP*. Training was carried out by a Ugandan team at Butabika, the National Psychiatric Hospital in Kampala and was fully funded by Jamie’s Fund.

When these newly trained Trainers returned home, they were encouraged to organise training for non-specialist clinical staff from their hospital and linked health centres.  This training was delivered by a team of facilitators including them and staff from other hospitals.  The outcome of mhGAP training was that more staff were able to recognise, diagnose and treat people with mental illness or epilepsy appropriately.  mhGAP training courses were funded by Jamie’s Fund

What the mhGAP training has achieved.

The initial Train the Trainer workshop was held in 2018, and trained 22 mental health staff from 11 hospitals. Subsequently they trained a further 223 non-specialist clinical colleagues to identify and treat mental ill health.  This has resulted in many more people with mental illness being appropriately treated and given hope to be able to lead a normal and economically productive life within their community.

Early in 2020, a further mhGAP Train the Trainers workshop was run attended by 18 staff from another 9 hospitals. As the Covid restrictions are gradually being eased in Uganda in the third quarter of 2020, these hospitals were starting to roll out mhGap training to their colleagues and a further 60 clinical staff have been trained so far, with more to come.  Another Training the Trainers workshop took place near the end of 2020.

Increasing knowledge, reducing stigma.

Jamie’s Fund has also developed a one day Community leaders Sensitisation workshop for local leaders such as teachers, religous leaders, policemen, community leaders and informal leaders to learn about the signs and symptoms of mental illness and epilepsy, and importantly that effective treatment is available for these conditions from the hospital or heath centre.  Mental health staff were able to use this in their communities.  The sessions resulted in an increase in referrals, particularly from the police and religious leaders. who were relieved to find that the hospitals coudl help with these disturbed people they didn’t know what to do with.  It has also helped to reduce stigma.

Continuing Professional Development

Jamie’s Fund also funded continuing professional development workshops, to which all the Trainers and other mental health professionals from across Uganda were invited. It was planned that these would be annually, but Covid prevented that. The agenda of the three or four day workshops was driven by the candidates themselves and was delivered by Ugandan mental health professionals supported by others from the UK.  These workshops have been much appreciated both for the training but also for the opportunity to develop mutual support networks.  One participant noted that this was the first professional development she had been offered in the ten years since qualifying.

Developing Jamie’s Fund Support

Apart from mhGAP, we also sponsored a number of nurses to train as psychiatric clinical officers (PCOs).  These were volunteer staff member from hospitals without PCOs. Their training took two or three years depending on previous experience.  PCOs are health professionals at a fairly senior level who are able to prescribe (roughly akin to Nurse Practitioners in the UK.)  As there are few doctors trained in mental-health outside the capital, PCOs play a crucial role in leading the development and delivery of services in a hospital

The National Picture

Jamie’s Fund also collaborated with the national organisations overseeing the not-for-profit hospitals and health centres, and with the Government Ministry of Health Mental Health Lead, to ensure that what we did was in line with Ugandan priorities.

We observed how mental health is beginning to move up the agenda, both nationally and globally. At the heart of our model are local Ugandan staff and trainers and through them Jamie’s Fund enabled mental health services to be delivered at the point of the need.

The Charity, although small, has been able to make a disproportionately large difference with small grants for training, transport and communications to  local hospitals.

*mhGap is a World Health Organisation programme designed to give non-mental health clinicians, particularly in low- and middle-income countries, a good understanding of mental ill health so that they can diagnose and treat many of the more straightforward conditions.