Mini Review
Volume 12 Issue 9 - 2020
Bridging the Gap on Early Identification and Treatment of Mental, Neurological and Substance Use Disorders in Sub-Saharan Africa
Justus Uchenna Onu1*, Sunday O Oriji1, Theclar Ogochukwu Iyidobi2, Francis C Chinawa3 and Jude U Ohaeri4
1Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
2Department of Psychological Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
3Department of Psychology, Godfrey Okoye University, Thinkers Corner, Enugu, Nigeria
4Department of Psychological Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
*Corresponding Author: Justus Uchenna Onu, Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nnewi Campus, Anambra State, Nigeria.
Received: May 25, 2020; Published: September 30, 2020




Abstract

Although communicable diseases remain a priority in sub-Saharan Africa (SSA), the demographic, epidemiologic, and nutritional transitions occurring in the region is expected to change the narrative to non-communicable diseases. Mental, neurological, and substance (MNS) use disorders contribute substantially to the Global Burden of Disease (GBD) worldwide, with MNS accounting for about 350 million Disability-Adjusted Life Years (DALYs) lost per annum in Sub-Saharan Africa. This picture is made bleaker by the huge treatment gap in the Sub-region with over 90% of persons with MNS disorders lacking access to optimal health care services. The Mental Health Gap Action Program (mhGAP) was designed to bridge this gap in treatment. However, after over a decade it was first launched, access to optimal care for MNS disorders is still lacking in most SSA countries despite some positive efforts. The authors opine that bridging the treatment gap for MNS disorders will require the following: forging a common terminology for MNS disorders in the SSA countries for a comprehensive policy, integration of mental health services into existing health care services (e.g. primary health care, HIV/AIDS and maternal and child health care services), the use of mobile phone or other application-based technology and leveraging on the informal health care systems (e.g. traditional and faith-based healers) to deliver some level of care to persons with MNS disorders.

Keywords: Sub-Saharan Africa (SSA); Mental, neurological, and substance (MNS); Global Burden of Disease (GBD); Disability-Adjusted Life Years (DALYs); Mental Health Gap Action Program (mhGAP)

References

  1. World Health Organization. “Mental Health Gap Action Programme: Scaling up Care for Mental, Neurological and Substance use Disorders”. Geneva: WHO (2008).
  2. Whiteford HA., et al. “The Global Burden of Mental, Neurological and Substance Use Disorders: An analysis from the Global Burden of Disease study”. PLoS ONE 10.2 (2010): E0116820. 
  3. Charlson FJ., et al. “Mental and substance use in sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years”. PLoS ONE 9.10 (2014): e110208.
  4. World Health Organization. “The World Health Report: Burden of Mental and Behavioral Disorders”. World Health Organization, Geneva (2014).
  5. World Health Organization. “Substance abuse overview”. World Health Organization Regional Office for Africa, Brazzaville (2016). 
  6. Silberberg D and Katabira E. “Neurological disorders”. In: Disease and mortality in sub-Saharan Africa. 2nd Edition, Washington DC (2006).
  7. Jansen S., et al. “The “treatment gap” in global mental health reconsidered: sociotherapy for collective trauma in Rwanda”. European Journal of Psychotraumatology 6 (2015): 28706.
  8. Patel V., et al. “Reducing the treatment gap for mental disorders: a WPA survey”. World Psychiatry 9 (2010): 169-176.
  9. World Health Organization. “The global atlas of the health workforce”. World Health Organization, Geneva (2018). 
  10. World Health Organization. “Global Health Observatory Data”. World Health Organization (2016). 
  11. Uwakwe R. “Mental health service and access in Nigeria: A short overview”. International Journal of Global Social Work 2 (2018): 103.
  12. Burvill PW. “Looking beyond the 1:10,000 ratio of psychiatrists to population”. Australian and New Zealand Journal of Psychiatry 26.2 (1992): 265-269.
  13. Atlas. “Country resources for neurological disorders”. World Health Organization and World Federation of Neurology (2004): 1-59.
  14. Preux PM and Druet-Cabanac M. “Epidemiology and Aetiology of Epilepsy in sub-Saharan Africa”. Lancet Neurology 4 (2005): 21-31.
  15. Bower JH and Zenebe G. “Neurologic services in the nations of Africa”. Neurology 64 (2005): 412-415.
  16. African Union. “African summit on HIV/AIDS and other related infectious diseases”. Abuja, Nigeria: AU (2001).
  17. Eaton J., et al. “Scale up services for mental health in low-income and middle-income countries”. The Lancet 378.9802 (2011): 1592-1603.
  18. Gater R., et al. “Pathways to psychiatric care in Eastern Europe”. British Journal of Psychiatry 186 (2005): 529-535. 
  19. Lasebikan VO., et al. “Social network as a determinant of pathway to mental health sciences utilization among psychotic patients in Nigerian hospital”. Annals of African Medicine 11 (2012): 12-20.
  20. World Health Organization. Country profile of Nigeria mental health atlas of the World Health Organization. Geneva: WHO (2011): 348-351.
  21. Scheffler RM., et al. “Forecasting the global shortage of physicians: an economic- and needs-based approach”. Bulletin of the World Health Organization 86.7 (2008): 516-523.
  22. Kohn R., et al. “The treatment gap in mental health care”. Bulletin of the World Health Organization 82.11 (2004): 858-866.
  23. Abdulmalik J., et al. “Country contexualization of the Mental Health Gap Action Programme Intervention Guide: a case study from Nigeria”. PLoS ONE 10.8 (2013): E1001501.
  24. Institute of Medicine and National Academy of Sciences. “Mental, Neurological, and Substance use Disorders in Sub-Saharan Africa: Reducing the Treatment Gap, Improving Quality of Care: summary of the workshop by the institute of Medicine and the Uganda National Academy of sciences. Washington, DC: The Academies Press (2010).
  25. Bitta MA., et al. “Priority mental, neurological and substance use disorders in rural Kenya: Traditional health practitioners’ and primary health care workers, perspectives”. PLoS ONE 14.7 (2019): E0220034. 
  26. Global System for Mobile Communication. “The mobile economy sub-Saharan Africa”. GMSA (2019). 
  27. Anthony K. “The use and role of technology in counselling and psychotherapy. In: Technology in counselling and psychotherapy. Palgrave, London (2011). 
  28. Duarte AC and Thomas SA. “The use of phone technology in out-patient populations: a systematic review”. Open Nursing Journal 10 (2016): 45-58.
  29. Uwakwe R and Otakpor A. “Public mental health-using the Mental Health Gap Action Program to put all hands to the pumps”. Frontiers in Public Health 2.33 (2014): 1-5.
Citation: Justus Uchenna Onu., et al. “Bridging the Gap on Early Identification and Treatment of Mental, Neurological and Substance Use Disorders in Sub-Saharan Africa”. EC Neurology 12.9 (2020): 11-16.

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