Mental Health for Young People in Addis Ababa´s High Schools – LMU Delegation initiates a new CIHLMU Project in Ethiopia
The Grand Palace Hotel in Addis Ababa, Ethiopia, 1st of October, 2022: The scent of roasted coffee beans finds its way up to the 8th floor of the building, where experts of mental and public health gather around a large table and reflect upon their joint project ”Mental Health for Young People in Addis Ababa´s High Schools“.
The atmosphere is vibrant and reflective, team spirit fills the room. Eshetu Girma, Professor for Public Health at Addis Ababa University and Principal Investigator of this CIHLMU One Health project, brought local and international colleagues together for a joint vision: The empowerment of mental well-being and de-stigmatization of mental health problems among young people in his country.
Around the table: Dr. Surafel Worku, psychiatrist at St. Paul´s Hospital in Addis Ababa and responsible for the Outpatient Department for Child and Adolescent Psychiatry, Yohannes Gebreegziabhere, mental health professional and current PhD candidate at Addis Ababa University, Finina Abebe, Master of Public Health and part of Girma´s research team, Sandra Dehning, German child and adolescent psychiatrist and LMU researcher, affiliated to the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy of LMU hospital in Munich, and Andrea Jobst, psychiatrist at the Department of Psychiatry and Psychotherapy of LMU hospital in Munich and board member of the subdivision of Global Mental Health at the Center for International Health ( CIHLMU ).
During a 2-day workshop and a 4-day visit, the experts commonly initiated a pilot project for Addis Ababa´s high schools and set the ground stone for a stronger collaboration concerning young people`s mental health. They extensively discussed sociocultural aspects of prevention and treatment strategies for young people, reflected upon cultural adaptions of existing interventions and optional treatment pathways in the local health care system. Within the pilot project, mental health professionals will teach school nurses and health extension workers about mental health in young people, who subsequently will provide an awareness and anti-stigma intervention for students at a selection of Addis Ababa´s high schools. Scientific evaluation of the program is led by Finina Abebe and makes use of an e-mobile application for digital data collection, an innovative and new tool in Ethiopia.
The project is funded by the German Academic Exchange Service (DAAD) via the CIHLMU One Health projects, which are enabling researchers from low- and middle- income countries to receive their own project funding and thereby realize innovative research and teaching ideas. By doing so, the CIHLMU empowers global research teams to set up their own agendas with the overarching goal to improve health care systems in low- and middle-income countries.
For the current one-health project, Girma and his colleagues chose an anti-stigma intervention as first step towards a broader improvement of mental health problems among youth. Stigma against people with mental health problems is one major barrier for adequate treatment access in Ethiopia and other African countries and delays or inhibits adequate and early treatment. Eshetu Girma has engaged in stigma research since his PhD at CIHLMU in 2014 in Munich. He confirmed the high stigma against people with mental health problems in his country. Cultural beliefs, i.e., spiritual, devil or witchcraft affirmations or assumptions of guilt, are common among the Ethiopian society and enhance stigma habits. People with mental illness and disability are often kept away by their families and excluded from society. Likewise, family and relatives face social rejection and prejudices. Anti-stigma campaigns, therefore, may enhance help-seeking behavior and get people into treatment. However, prevention, support, treatment and rehabilitation opportunities for mental health problems, supply of medication and sufficient treatment pathways remain scarce in the country and entail a major challenge for the health care system.
At St. Pauls´ Hospital in Addis Ababa, Surafel Worku is now responsible for the establishment of a new (and the first) ward for child and adolescent psychiatry in the country. The hospital’s administration has already assigned rooms for that purpose to the Department of Psychiatry. The new ward will directly enclose to the pediatric ward in the large hospital building. It provides light flooded space for the treatment and support of children and adolescents with mental health problems. This new ward is another milestone for the improvement of the mental health care system in Ethiopia, where over 60% of the population is under the age of 24, but child and adolescent psychiatry still in its early stages. A special focus will be the support and education of parents and care-givers, who carry most of the burden due to the lack of a secondary support system for children. Over the last months, Surafel Worku achieved success using WHO care-givers training over its outpatient department. Jobst, Dehning and Worku agreed on a further cooperation and clinical partnership between St. Paul´s hospital and LMU, Departments of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy and of Psychiatry and Psychotherapy, with the joint vision of a humanistic psychiatry where patients equally participate in medical decision making.
On the final day of their meeting, the colleagues leave the Grand Palace Hotel with the experience of an exchange at eye level, of mutual transcultural learning and with the sense of an aspiring global mental health village. It was raining that day in Addis, the aircraft that brings back the LMU experts to Germany takes off from Bole International airport through a cloudy sky. The future of global mental health, however, is already getting a tiny bit brighter.
Andrea Jobst & Sandra Dehning