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BMC Health Services Research
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

Authors: Kamrun Nahar Koly, Jobaida Saba, Enryka Christopher, Anan Nisat Nabela Hossain, Taslima Akter, Zakia Rahman, Helal Uddin Ahmed, Julian Eaton

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Introduction

Bangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service is available. There is limited evidence of the burden of mental health issues and health-seeking behaviour among this population. This study assessed the feasibility of a training intervention for persons with disabilities, where peer support providers provided community-based disability-inclusive mental health services.

Methods

Four stakeholder groups participated in this qualitative study: peer responders (trained persons with disabilities), trainers, representatives of organisations of persons with disabilities and disability-specific organisations, and officials of international and national non-governmental organisations. Two types of qualitative interviews were used to collect data, and thematic analysis techniques were utilised.

Result

Stakeholders perceived the peer responder training programme as acceptable for persons with disabilities to develop themselves as peer support providers, with potential benefits including increased mental health literacy, ensuring accessible mental health services, and improving the well-being of persons with disabilities. Potential challenges included receiving training and delivering services. Increased training duration, more fieldwork, supervision opportunities, and refresher training were recommended to mitigate training challenges. Financial support and formal community recognition were deemed necessary for training delivery.

Conclusion

The peer responder training programme was feasible to ensure accessible mental health services for persons with disabilities, build a workforce to screen for mental health conditions, and provide appropriate referrals. A multi-sectoral collaboration of government and non-governmental institutions is recommended to policy advocates to expand the peer responder training programme in the mainstream mental healthcare system.
Appendix
Available only for authorised users
Footnotes
1
Peer responders who participated in IDIs are denoted by “PR ##, age, type of disability” Trainers are referred to as “Trainer ##, age, profession.” Representative OPDs and DSOs are OPD ##, sex, type of disability and DSO ##, sex, type of disability. CDD and CBM officials are identified as “CBM Official ##, sex, years of experiences in disability sector” and “CDD Official ##, sex,  years of experiences in disability sector”.
 
Literature
1.
Hossain MD, et al. Mental disorders in Bangladesh: a systematic review. BMC Psych. 2014;14(1):1–8.
2.
Nuri NN, et al. Pathways to care of patients with mental health problems in Bangladesh. Int J Ment Heal Syst. 2018;12(1):1–12.
3.
4.
Honey A, Emerson E, Llewellyn G. The mental health of young people with disabilities: impact of social conditions. Soc Psychiatry Psychiatr Epidemiol. 2011;46(1):1–10.PubMedCrossRef
5.
Milner A, et al. Employment status and mental health among persons with and without a disability: evidence from an Australian cohort study. J Epidemiol Community Health. 2014;68(11):1064–71.PubMedCrossRef
6.
Kavanagh AM, et al. Inequalities in socio-economic characteristics and health and wellbeing of men with and without disabilities: a cross-sectional analysis of the baseline wave of the Australian longitudinal study on male health. BMC Public Health. 2016;16(3):23–31.PubMedCentral
7.
Emerson E, et al. Loneliness, social support, social isolation and wellbeing among working age adults with and without disability: cross-sectional study. Disabil Health J. 2021;14(1):100965.PubMedCrossRef
8.
Thompson S. Disability inclusive development situational analysis for Bangladesh; 2020.
9.
Li CM, et al. Hearing impairment associated with depression in US adults, National Health and nutrition examination survey 2005-2010. JAMA Otolaryngol Head Neck Surg. 2014;140(4):293–302.PubMedPubMedCentralCrossRef
10.
Zhong B-L, Xu Y-M, Li Y. Prevalence and unmet need for mental healthcare of major depressive disorder in community-dwelling Chinese people living with vision disability. Front Public Health. 2022;10:900425.PubMedPubMedCentralCrossRef
11.
12.
Munaw MB, Tegegn MT. Visual impairment and psychological distress among adults attending the University of Gondar tertiary eye care and training center, Northwest Ethiopia: a comparative cross-sectional study. PLoS One. 2022;17(2):e0264113.PubMedPubMedCentralCrossRef
13.
van der Aa HP, et al. Major depressive and anxiety disorders in visually impaired older adults. Invest Ophthalmol Vis Sci. 2015;56(2):849–54.PubMedCrossRef
14.
Fellinger J, et al. Mental distress and quality of life in a deaf population. Soc Psychiatry Psychiatr Epidemiol. 2005;40(9):737–42.PubMedCrossRef
15.
16.
17.
Bonsaksen T, Brunes A, Heir T. Post-traumatic stress disorder in people with visual impairment compared with the general population. Int J Environ Res Public Health. 2022;19(2):619.PubMedPubMedCentralCrossRef
18.
Jiang F, et al. The relationship between mental health conditions and hearing loss in low- and middle-income countries. Trop Med Int Health. 2020;25(6):646–59.PubMedCrossRef
19.
Kuvalekar K, et al. Quality of life among persons with physical disability in Udupi taluk: a cross sectional study. J Family Med Prim Care. 2015;4(1):69–73.PubMedPubMedCentralCrossRef
20.
Bell D. Well-being and quality of life: measuring the benefits of culture and sport: a literature review and thinkpiece. Scotish Executive Social Research; 2005.
21.
Brown R, Brown P, Bayer M. A quality of life model: new challenges resulting from a six year study. Quality of life for persons with disabilities. Cambridge: Brookline Book; 1994. p. 56.
22.
Viemerö V, Krause C. Quality of life in individuals with physical disabilities. Psychother Psychosom. 1998;67(6):317–22.PubMedCrossRef
23.
Dalise S, et al. Psycho-social impact of social distancing and isolation due to the COVID-19 containment measures on patients with physical disabilities. Eur J Phys Rehabil Med. 2021;57(1):158–65.ADSPubMedCrossRef
24.
Kavanagh A, et al. Health and healthcare for people with disabilities in the UK during the COVID-19 pandemic. Disabil Health J. 2022;15(1):101171.PubMedCrossRef
25.
Ciciurkaite G, Marquez-Velarde G, Brown RL. Stressors associated with the COVID-19 pandemic, disability, and mental health: considerations from the intermountain west. Stress Health. 2022;38(2):304–17.PubMedCrossRef
26.
World Health Organization. WHO global disability action plan 2014–2021: Better health for all people with disability. World Health Organization; 2015.
27.
Baart J, Taaka F. Barriers to healthcare services for people with disabilities in developing countries: a literature review. DCID. 2017;28(4):26–40.CrossRef
28.
WHO, Community health workers: a strategy to ensure access to primary health care services. 2016.
29.
Bruckner TA, et al. The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ. 2011;89(3):184–94.PubMedCrossRef
30.
Gyee KM, et al. Empowering health workers and leveraging digital technology to improve access to mental health and epilepsy care: a longitudinal quasi-experimental study in Hlaing Thar Yar township. The lancet regional health - Southeast Asia; 2022. p. 5.
31.
Singh OP. Closing treatment gap of mental disorders in India: opportunity in new competency-based medical Council of India curriculum. Indian J Psychiatry. 2018;60(4):375–6.PubMedPubMedCentralCrossRef
32.
33.
Bunn M, et al. Supporting and sustaining nonspecialists to deliver mental health interventions in low- and middle-income countries: an umbrella review. Intervention. 2021;19(2):155–79.CrossRef
34.
35.
Kaplan K, et al. Internet peer support for individuals with psychiatric disabilities: a randomized controlled trial. Soc Sci Med. 2011;72(1):54–62.PubMedCrossRef
36.
Nazari L, et al. Investigating the mediatory role of self-efficacy beliefs in the relationship between self-perception, peer support, and subjective well-being in visually impaired teenagers. Int J Health Sci. 2020;6(4)
37.
Kef S, Deković M. The role of parental and peer support in adolescents well-being: a comparison of adolescents with and without a visual impairment. J Adolesc. 2004;27:453–66.PubMedCrossRef
38.
Rotheram-Borus MJ, et al. Alcohol use, partner violence, and depression: a cluster randomized controlled trial among urban south African mothers over 3 years. Am J Prev Med. 2015;49(5):715–25.PubMedPubMedCentralCrossRef
39.
Bolton P, et al. Group interpersonal psychotherapy for depression in rural Uganda: a randomized controlled trial. JAMA. 2003;289(23):3117–24.PubMedCrossRef
40.
Chinman M, et al. A cluster randomized trial of adding peer specialists to intensive case management teams in the veterans health administration. J Behav Health Serv Res. 2015;42(1):109–21.PubMedPubMedCentralCrossRef
41.
Maddox S, et al. Effects of mental health training on capacity, willingness and engagement in peer-to-peer support in rural New South Wales. Health Promot J Austr. 2022;33(2):451–9.PubMedCrossRef
42.
Reif S, et al. Peer recovery support for individuals with substance use disorders: assessing the evidence. Psychiatr Serv. 2014;65(7):853–61.PubMedCrossRef
43.
Chapin RK, et al. Reclaiming joy: pilot evaluation of a mental health peer support program for older adults who receive Medicaid. Gerontologist. 2013;53(2):345–52.PubMedCrossRef
44.
Byrom N. An evaluation of a peer support intervention for student mental health. J Ment Health. 2018;27(3):240–6.PubMedCrossRef
45.
Fortuna KL, et al. Feasibility, acceptability, and preliminary effectiveness of a peer-delivered and technology supported self-management intervention for older adults with serious mental illness. Psychiatry Q. 2018;89(2):293–305.CrossRef
46.
Whiteman KL, et al. Systematic review of integrated general medical and psychiatric self-management interventions for adults with serious mental illness. Psychiatr Serv. 2016;67(11):1213–25.PubMedPubMedCentralCrossRef
47.
48.
49.
Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23–42.PubMedCrossRef
50.
NDA. Ethical guidance for research with people with disabilities. National Disability Authority Dublin; 2009.
51.
Durham J, Brolan CE, Mukandi B. The convention on the rights of persons with disabilities: a foundation for ethical disability and health research in developing countries. Am J Public Health. 2014;104(11):2037–43.PubMedPubMedCentralCrossRef
52.
53.
Koly K, et al. Mental health and community-based rehabilitation: a qualitative description of the experiences and perspectives of service users and Carers in Bangladesh. Community Ment Health J. 2022;58:52–66.PubMedCrossRef
54.
Mead S, MacNeil C. Peer support: what makes it unique. Int J Psychosoc Rehabil. 2006;10(2):29–37.
55.
56.
Naheed A, et al. Implementing a mental health care program and home-based training for mothers of children with autism spectrum disorder in an urban population in Bangladesh: protocol for a feasibility assessment study. JMIR Res Protoc. 2017;6(12):e8260.PubMedPubMedCentralCrossRef
57.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.PubMedCrossRef
58.
59.
Repper J, Carter T. A review of the literature on peer support in mental health services. J Ment Health. 2011;20(4):392–411.PubMedCrossRef
60.
Penney D. Defining “peer support”: implications for policy, practice, and research. Advocates for Human Potential; 2018. p. 11.
61.
Pathare S, Shields LS. Supported decision-making for persons with mental illness: a review. Public Health Rev. 2012;34(2):1–40.CrossRef
62.
Mahomed F, Stein MA, Patel V. Involuntary mental health treatment in the era of the United Nations convention on the rights of persons with disabilities. PLoS Med. 2018;15(10):e1002679.PubMedPubMedCentralCrossRef
63.
Morrissey F. The United Nations convention on the rights of persons with disabilities: a new approach to decision-making in mental health law. Eur J Health Law. 2012;19(5):423–40.PubMedCrossRef
64.
Mendenhall E, et al. Acceptability and feasibility of using non-specialist health workers to deliver mental health care: stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda. Soc Sci Med. 2014;118:33–42.PubMedPubMedCentralCrossRef
65.
Sangraula M, et al. Feasibility of group problem management plus (PM+) to improve mental health and functioning of adults in earthquake-affected communities in Nepal. Epidemiol Psychiatr Sci. 2020;29:e130.PubMedPubMedCentralCrossRef
66.
Muke SS, et al. Acceptability and feasibility of digital technology for training community health workers to deliver brief psychological treatment for depression in rural India. Asian J Psychiatr. 2019;45:99–106.PubMedPubMedCentralCrossRef
67.
Naheed A, et al. Feasibility of a school-based mental health program implementation to improve the status of depression and quality of life of mothers of children with autism spectrum disorders in urban Bangladesh: MENTHOL study. Global Mental Health. 2022;9:146–56.PubMedPubMedCentralCrossRef
68.
Tekola B, et al. Adapting and pre-testing the World Health Organization's caregiver skills training programme for autism and other developmental disorders in a very low-resource setting: findings from Ethiopia. Autism. 2020;24(1):51–63.PubMedCrossRef
69.
Armstrong G, et al. A mental health training program for community health workers in India: impact on knowledge and attitudes. Int J Ment Heal Syst. 2011;5(1):17.CrossRef
70.
Caulfield A, et al. WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers. BMJ Open. 2019;9(1):e024059.PubMedPubMedCentralCrossRef
71.
Barnett ML, et al. Mobilizing community health workers to address mental health disparities for underserved populations: a systematic review. Admin Pol Ment Health. 2018;45(2):195–211.CrossRef
72.
Greenspan JA, et al. Sources of community health worker motivation: a qualitative study in Morogoro region, Tanzania. Hum Resour Health. 2013;11(1):52.PubMedPubMedCentralCrossRef
73.
Liana L, Windarwati HD. The effectivity role of community mental health worker for rehabilitation of mental health illness: a systematic review. Int J Health Sci. 2021;11:100709.
74.
Shidhaye R, et al. The effect of VISHRAM, a grass-roots community-based mental health programme, on the treatment gap for depression in rural communities in India: a population-based study. Lancet Psychiatry. 2017;4(2):128–35.PubMedCrossRef
75.
Beales A, Wilson J. Peer support – the what, why, who, how and now. J Ment Health Train Educ Pract. 2015;10(5):314–24.CrossRef
76.
77.
Angdembe M, et al. Situational analysis to inform development of primary care and community-based mental health services for severe mental disorders in Nepal. Int J Ment Heal Syst. 2017;11(1):69.CrossRef
78.
Endale T, et al. Barriers and drivers to capacity-building in global mental health projects. Int J Ment Heal Syst. 2020;14(1):89.CrossRef
79.
80.
Devkota G, et al. Factors affecting utilization of mental health services from primary health care (PHC) facilities of western hilly district of Nepal. PLoS One. 2021;16(4):e0250694.PubMedPubMedCentralCrossRef
81.
82.
Maart S, Jelsma J. Disability and access to health care - a community based descriptive study. Disabil Rehabil. 2014;36(18):1489–93.PubMedCrossRef
83.
Kibria G, et al. Barriers to healthcare services for persons with disabilities in Bangladesh amid the COVID-19 pandemic. Public Health Pract (Oxf). 2020;1:100027.PubMedCrossRef
84.
World Health Organization, Disability and health. 2021.
85.
Prytherch H, et al. Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania. BMC Health Serv Res. 2013;13(1):1–15.CrossRef
86.
Papageorgiou A, Loke YK, Fromage M. Communication skills training for mental health professionals working with people with severe mental illness. Cochrane Database Syst Rev. 2017;6(6):Cd010006.PubMed
87.
Mistry SK, et al. Community health workers can provide psycho-social support to the people during COVID-19 and beyond in low- and middle- income countries. Front Public Health. 2021;9:666753.PubMedPubMedCentralCrossRef
88.
Kissinger A, et al. Don’t change who we are but give us a chance: confronting the potential of community health worker certification for workforce recognition and exclusion. Arch Public Health. 2022;80(1):61.PubMedPubMedCentralCrossRef
89.
Koly KN, et al. Educational and training interventions aimed at healthcare Workers in the Detection and Management of people with mental health conditions in south and South-East Asia: a systematic review. Front Psychiatry. 2021;12:741328.PubMedPubMedCentralCrossRef
90.
91.
Koly KN, et al. Exploring the potential of delivering mental health care services using digital technologies in Bangladesh: a qualitative analysis. Internet Interv. 2022;29:100544.PubMedPubMedCentralCrossRef
92.
Bucci S, Schwannauer M, Berry N. The digital revolution and its impact on mental health care. Psychol Psychother Theory Res Pract. 2019;92(2):277–97.CrossRef
93.
Berry N, Lobban F, Bucci S. A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems. BMC Psychiatry. 2019;19(1):1–13.CrossRef
Metadata
Title
Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh
Authors
Kamrun Nahar Koly
Jobaida Saba
Enryka Christopher
Anan Nisat Nabela Hossain
Taslima Akter
Zakia Rahman
Helal Uddin Ahmed
Julian Eaton
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10742-5

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