Top

Published in:

01-06-2012 | Brief Report

The Feasibility of Adapted Group-Based Interpersonal Therapy (IPT) for the Treatment of Depression by Community Health Workers Within the Context of Task Shifting in South Africa

Authors: I. Petersen, A. Bhana, K. Baillie, MhaPP Research Programme Consortium

Published in: Community Mental Health Journal | Issue 3/2012

Abstract

Within the context of a large treatment gap for depression and a scarcity of specialist resources, there is a need for task shifting to scale up mental health services to address this gap in South Africa. This study assessed the feasibility of an adapted manualized version of grouped based Interpersonal Therapy (IPT) for use by supervised community health workers through a pilot study on 60 primary health care clinic users screened as having moderate to severe depression. Retention was good and participants in the group-based IPT intervention showed significant reduction in depressive symptoms on completion of the 12-week intervention as well as 24 weeks post baseline compared to the control group. Qualitative process evaluation suggests that improved social support, individual coping skills and improved personal agency assisted in the reduction of depressive symptoms.

MHAPP is a four country study in Africa aimed at mental health policy development and implementation to break the cycle of poverty and mental ill-health (Flisher et al. 2007).

Amberbir, A., Woldemichael, K., Getachew, S., Girma, B., & Deribe, K. (2008). Predictors of adherence to antiretroviral therapy among HIV-infected persons: A prospective study in Southwest Ethiopia. BMC Public Health, 8, 265. doi:10.1186/1471-2458-8-265.PubMedCrossRef

Bana, N., Cambanis, E., Dada, F., Kadwa, Z., Khosa, X., Mbonambi, T., et al. (2009). Adapting Interpersonal Therapy (IPT) for the treatment of depression within the context of task shifting to scale up mental health services for common mental disorders in rural KwaZulu-Natal. Unpublished report, School of Psychology, University of KwaZulu-Natal, South Africa.

Bhagwanjee, A., Parekh, A., Paruk, Z., Petersen, I., & Subedar, H. (1998). Prevalence of minor psychiatric disorders in an adult African rural community in South Africa. Psychological Medicine, 28(5), 1137–1147.PubMedCrossRef

Bolton, P., Bass, J., Neugebeur, R., Verdeli, H., Clougherty, K. F., Wickramaratne, P., et al. (2003). Group interpersonal psychotherapy for depression in rural Uganda: A randomized control trial. JAMA, 289(23), 3117–3124.PubMedCrossRef

Bradshaw, D., Norman, R., & Schneider, M. (2007). A clarion call for action based on refined DALY estimates for South Africa. SAMJ, 97(6), 438–440.PubMed

Brandt, R. (2009). The mental health of people living with HIV/AIDS in Africa: A systematic review. African Journal of AIDS Research, 8(2), 123–133.CrossRef

Clougherty, K. F., Verdeli, L., & Weissman, M. M. (n.d.). Interpersonal therapy adapted for a group in Uganda (IPT-G-U). Unpublished manual.

Department of Health. (1997). National health policy guidelines for improved mental health in South Africa. Pretoria: Directorate for Mental health and Substance Abuse, National Department of Health.

Department of Health. (2004). Mental Health Care Act (17 of 2002). Pretoria: Department of Health.

Evans, D. L., Ten Have, T. R., Douglas, S. D., Gettes, D. R., Morrison, M., Chiappini, M. S., et al. (2002). Association of depression with viral load, CD8 T lymphocytes, and natural killer cells in women with HIV infection. American Journal of Psychiatry, 159, 1752–1759.PubMedCrossRef

Flisher, A. J., Lund, C., Funk, M., Banda, M., Bhana, A., Doku, V., et al. (2007). Mental health policy development and implementation in four African countries. Journal of Health Psychology, 12(3), 505–516.PubMedCrossRef

Kagee, A. (2008). Symptoms of depression and anxiety among a sample of South African patients living with chronic illness. Journal of Health Psychology, 13(4), 547–555.PubMedCrossRef

Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J., et al. (2010). Poverty and common mental disorders in low and middle income countries: A systematic review. Social Science and Medicine, 71(3), 517–528.PubMedCrossRef

Lund, C., Kleintjies, S., Kakuma, R., & Flisher, A. J. (2009). Public sector mental health systems in South Africa: Inter-provincial comparisons and policy implications. Soc Psychiat Epidemiol, 45(3), 393–404.CrossRef

Patel, V., Lund, C., Hatherill, S., Plagerson, S., Corrigall, J., Funk, M., et al. (2010). Mental disorders: equity and social determinants. In E. Blas & A. S. Karup (Eds.), Equity, social determinants and public health programmes (pp. 115–134). Geneva: WHO.

Petersen, I., Bhana, A., Campbell-Hall, V., Mjadu, S., Lund, C., Kleintjies, S., et al. (2009). Planning for district mental health services in South Africa. A situational analysis of a rural district site. Health Policy and Planning, 24(2), 140–150.PubMedCrossRef

Petersen, I., Lund, C., Bhana, A., & Flisher, A. J. (2011). A task-shifting approach to primary mental health care for adults in South Africa: Human resource requirements and costs for rural settings. Health Policy and Planning. doi:10.1093/heapol/czr012.

Plagerson, S., Patel, V., Harpham, T., Kielmann, K., & Mathee, A. (2010). Does money matter for mental health? Evidence from the Child Support Grants in Johannesburg, South Africa. Global Public Health. doi:10.1080/17441692.2010.516267.

Rahman, A. (2007). Challenges and opportunities in developing a psychological intervention for perinatal depression in rural Pakistan—a multimethod study. Archives of Women’s Mental Health, 10(5), 211–219.PubMedCrossRef

Rahman, A., Malik, A., Sikander, S., Roberts, C., & Creed, F. (2008). Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: A cluster-randomised control trial. Lancet, 372, 902–909.PubMedCrossRef

Rumble, S., Swartz, L., Parry, C., & Zwarenstein, M. (1996). Prevalence of psychiatric morbidity in the adult population of a rural South African village. Psychological Medicine, 26(5), 997–1007.PubMedCrossRef

Saraceno, S., Van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., et al. (2007). Barriers to improvement of mental health services in low and middle-income countries. Lancet, 370, 1164–1174.PubMedCrossRef

Sawyer, S., Ngwenya, N., Memela, Z., Petersen, I., Subedar, H., & Parekh, A. (1996). Training and resource manual for community care givers. Unpublished manual, Department of Psychology, University of Durban-Westville.

Seedat, S., Stein, D. J., Herman, A., Kessler, R., Sonnega, J., Heeringa, S., et al. (2008). Twelve-month treatment of psychiatric disorders in the South African Stress and Health Study (World Mental Health Survey Initiative). Social Psychiatry and Psychiatric Epidemiology, 43(11), 889–897.PubMedCrossRef

Shrier, L. A., Harris, S. K., & Beardslee, W. R. (2002). Temporal associations between depressive symptoms and self-reported sexually transmitted disease among adolescents. Archives of Pediatric Adolescent Medicine, 156, 599–606.

Tanser, F., Hosegood, V., Barnighausen, T., Herbst, K., Nyirenda, M., Muhwaya, W., et al. (2008). Cohort profile: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey. International Journal of Epidemiology, 37, 956–962.PubMedCrossRef

UNAIDS. (2008). South Africa. Country situation analysis. Retrieved April 2010, from http://www.unaids.org/en/CountryResponses/Countries/south_africa.asp.

Verdeli, H., Clougherty, K., Bolton, P., Speelman, L., Lincoln, N., Bass, J., et al. (2003). Adapting group interpersonal psychotherapy for a developing country: Experience in rural Uganda. World Psychiatry, 2, 114–120.PubMed

Ward, C., Flisher, A., Zissis, C., Muller, M., & Lombard, C. (2003). Reliability of the Beck Depression Inventory and the Self-Rating Anxiety Scale in a sample of South African adolescents. Journal of Child and Adolescent Mental Health, 15(2), 73–75.CrossRef

Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.

WHO. (1994). User’s guide to the Self-Reporting Questionnaire (SRQ). Geneva: World Health Organization.

WHO, & WONCA. (2008). Integrating mental health into primary care: A global perspective. Geneva: WHO and WONCA.

Wilfrey, D. E., Roy Mackenzie, K., Robinson Welch, R., & Weissman, M. M. (2000). Interpersonal psychotherapy for group. New York: Basic Books.

Williams, D. R., Herman, A., Stein, D. J., Heeringa, P. B., Moomal, H., & Kessler, R. C. (2008). Twelve month mental disorders in South Africa: Prevalence, service use and demographic correlates in the population-based South African Stress and Health Study. Psychological Medicine, 38(2), 211–220.PubMedCrossRef

Title: The Feasibility of Adapted Group-Based Interpersonal Therapy (IPT) for the Treatment of Depression by Community Health Workers Within the Context of Task Shifting in South Africa
Authors: I. Petersen
A. Bhana
K. Baillie
MhaPP Research Programme Consortium
Publication date: 01-06-2012
Publisher: Springer US
Published in: Community Mental Health Journal / Issue 3/2012
Print ISSN: 0010-3853
Electronic ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-011-9429-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Feasibility of Adapted Group-Based Interpersonal Therapy (IPT) for the Treatment of Depression by Community Health Workers Within the Context of Task Shifting in South Africa

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2012

Supported Housing and Supported Independent Living in the Netherlands, with a Comparison with England

Community Mental Health Centres Initiated by the South-Eastern Europe Stability Pact: Evaluation in Seven Countries

Lay Diagnoses and Views on Causes, Coping Strategies, and Treatment for Schizophrenia

Mental Health Status and Related Characteristics of Chinese Male Rural–Urban Migrant Workers

The Pathway of Internalizing and Externalizing Problems from Childhood to Adolescence: A Prospective Study from Age 7 to 14–16 in Korea

The Cost of Generalized Anxiety Disorder in Primary Care Settings: Results of the ANCORA Study