The Sunday Mail
Roselyne Sachiti in Nairobi Kenya
Mental health challenges and substance abuse continue to stalk communities in Zimbabwe and many parts of sub Saharan Africa.
With the continent also battling to close treatment gaps, substance abuse seems to grow each day.
In Zimbabwe, substance abuse especially by the youth has become a thorn in the flesh of communities already burdened by other social challenges.
Apart from Government interventions, researchers, too, have been working tirelessly to find solutions to this growing scourge.
At the launch of DELTAS Africa II on Tuesday in Nairobi Kenya, Zimbabwe’s African Mental Health Research Initiative (AMARI), was for the second time awarded a grant that seeks to further build mental health research, capacity building and collaborations.
The second phase of DELTAS Africa is implemented by the Science for Africa Foundation (SFA Foundation) with support from Wellcome and the UK Foreign, Commonwealth & Development Office (FCDO).
AMARI is a consortium of four African universities namely; Addis Ababa University, College of Medicine – University of Malawi, University of Cape Town and University of Zimbabwe.
In an interview with The Sunday Mail at the second phase launch, AMARI Director Professor Dixon Chibanda said DELTAS II gives them an opportunity to use the lessons from DELTAS I to implement interventions and address challenges being faced.
“One of the challenges we face in Africa is the absence of appropriate screening tools for different conditions. If people are suffering from a mental disorder, first and foremost you want to identify them correctly so you need the tools to do so.
“Secondly, you want to be able to equip people to use those tools. In our part of the world because of the challenges that we face in what we call the huge treatment gap, we do not have enough psychiatrists. I am a psychiatrist in Zimbabwe. At the moment we have few psychiatrists which is hardly enough to address these problems,” noted Prof Chibanda.
According to Prof Chibanda, it is important to think outside the box when it comes to interventions especially around issues of substance abuse. He called for collective efforts in addressing the challenges adding DELTAS II is an opportunity to intensify collaborations.
“We cannot expect psychiatrists to address all these problems like the issues of substance abuse which are a huge problem in Zimbabwe at the moment.
“DELTAS II enables us to equip ordinary people in communities to be able to intervene to address the problem. We are looking at task shifting or task sharing or collaborative care models, which equip ordinary people like teachers, policemen, community members with the skills and tools they need to adequately identify students facing problems and intervene before you have a problem,” he revealed.
With regards to substance use, Prof Chibanda said this was not the time to take on a punitive approach.
“For example when students are caught smoking marijuana or doing other things, they should not be expelled. Our approach should be to put in place systems that enable us to capture them before they go on to do those things.
“This is where AMARI comes in. AMARI has the science behind. Moving to AMARI II or DELTAS II, we not only have the science but we have the people to do all those things,” added Prof Chibanda.
He said with Zimbabwe’s education system training thousands of teachers every year, and the country’s police force present everywhere, both can be equipped with skills.
“Imagine if we could equip these people with scientific evidence on how to identify and intervene when we have these problems. We will quickly narrow that care gap. Unfortunately, the general tendency is to think that when kids are doing drugs, they should be only treated by psychiatrists. Communities can contribute towards making a difference.”
He said communities can come in at different levels.
For example, Prof Chibanda added, at a very practical level, school teachers can be equipped to screen and intervene if they are taught how to use evidence- based screening tools.
He said it takes less than three days to learn how to use these tools.
“They can use and administer these tools when teaching students in classrooms. They can easily see that this child is likely to have a problem. This one is going to have a problem if we do not do anything.”
This he said, could help teachers to immediately identify kids with possible problems.
“With the interventions that we have developed over the years, they intervene and sit down with that child, use different psychological modalities to address these problems.
“Because they are using screening tools that are validated, they can refer before a child reaches a certain stage where we are saying a child needs to be expelled. This is what we are trying to achieve with DELTAS II. It’s all evidence based, it’s all about the science,” he added.
Prof Chibanda said only empirical observations can help to truly make a difference.
He said there has been inclusion of students to provide peer counselling through initiatives like the Friendship Bench.
“It’s not perfect, it’s work in progress, but that is another entry point. There are other people in this space who are working on evidence based interventions but definitely young people can be trained.”
He revealed that the Friendship Bench has a number of memorandums of understanding (MOUs) with some leading universities in Zimbabwe where every year, they train students with the basic skills of being able to reach out to their peers.
“We do this by equipping them with skills to provide therapy online. We are aware that young people spend time on social media platforms like Whatsapp. We can also provide the same evidence based services through mobile phones.”
Prof Chibanda added that what is missing is the scaling up of interventions.
“We need to make sure that it’s not just a few universities but every university, school and police station. That way we are going to nip things in the bud because if a problem is at community level, the likely solution is going to come from community level. This notion of sending a child to a doctor when caught doing drugs is an outdated way of thinking in terms of intervention because a lot of the problems that lead to substance abuse are so called social determinants of health.”
These, he said, can be an unstable background, family issues, poverty and many others.
He added that a lot of those issues in terms of resolving them, best resources and the best elements of wisdom come from people who are already in those communities.
DELTAS Africa I, was a US$100 million investment that was implemented over 2015-2022. This programme awarded multimillion dollar grants to 11 consortia, AMARI included, headed by world class senior researchers from eight African countries and spanning 54 lead and partner institutions from across West, East and Southern Africa.
The implementation of DELTAS Africa I informed further refinements and improvement of the second phase of DELTAS Africa, particularly the 2018 mid-term assessment report. DELTAS Africa II focuses more on balancing equity and inclusion for example; across the continent by encouraging collaboration amongst networks of researchers that are relatively well-resourced and those who are poorly resourced; improved gender equity and diversity; and multidisciplinary and cross-disciplinary research including social science and humanities.
The inclusion of social sciences seeks to redress the dearth of social science research on the continent and the need for contextually relevant social science and humanities research outputs. These are essential for effective and efficient policy formulation and implementation of African social and public health policy.