Under the study, Task Shifting In Mental Health: Innovative Approaches funded by Global Health Research Initiative (GHRI) and headed by Dr. Victoria Mutiso of Africa Mental Health Foundation (AMHF), the team has trained faith and traditional healers, community based health workers and health facility personnel to perform basic psychiatric tasks, such as identifying symptoms, diagnosing conditions, and most importantly, referring patients to mental health services.

In a period of one year, traditional and faith healers have already made 727 referrals in both the urban and rural experimental sites of Kibwezi and Kangemi indicating an upward trend in the number of clients referred by informal workers and treated with mental illness. Preliminary results for the year under review (2011-2012) indicate that out of these referrals made, a total 280 clients were identified to be having a mental illness at the health facilities and are on treatment.

“This indicates the critical role that lay health workers can play in improving access to mental health services in Kenya,” said Teddy Aswani, the Programs officer. ‘This is a positive indicator to the use of non psychiatric health workers and informal health workers in increasing the uptake of psychiatric services in the community,’ he added.

Is training these resource persons an effective way to expand mental health services coverage to vulnerable populations across the country? “This has been long overdue; task shifting in mental health is the way to go. “AMHF saw these actors as potential points of access to reach people suffering from mental illness, since they are already known and accepted by the community,” said Dr. Victoria,” says Dr. Victoria.

Results also show an upward increase in the number of self-referral cases during the year under review in the rural and urban setting at 29 and 34 respectively. This can be indicative of reduced stigma in the study sites as a result of increased community sensitization, awareness and mobilization by the informal health workers.

Prof David Ndetei, Director of Africa Mental Health Foundation said that these efforts need more support from stakeholders. “We have to continue looking at other options to go along with training of psychiatrists and other graduate mental health workers and task-shifting is ideal,” he said adding that with the huge treatment gap in Kenya, where there are currently 78 psychiatrists for a population of over 40 million, training more psychiatrists cannot be the only solution.
The approach of task shifting was launched by the World Health Organization in collaboration with the Office of the United States Global AIDS Coordinator to expand the pool of human resources for health in the area of HIV/AIDS. It is a process of delegation whereby tasks are moved, where appropriate, to less specialized health workers. By reorganizing the workforce in this way, task shifting can make more efficient use of the human resources currently available.

The approach of task-shifting has not been tried in mental health services. It is in the effort of borrowing this approach that AMHF adopted it into the area of mental health service delivery to be tried in a low income country such as Kenya.
This is the first study carried out in Kenya to determine how effective task shifting can be in the delivery of mental health services. Co-principal investigators include Prof David Ndetei; Chris Rakuom the Chief Nursing Officer Kenya; Dr. Lincoln Khasakhala and Anne Mbwayo both Research Fellows at Africa Mental Health Foundation.