One of the key challenges facing mental health professionals and activists working in low and middle income settings is that even when the case for ‘mental health’ has been ‘won’ (and although much needs to be done, the recent inclusion of mental health into international development targets is at least a positive sign), the tricky question remains about how one goes about integrating mental health screening, treatment and care into existing health platforms.
On a very simple, yet illustrative level, how can one develop a tool which busy healthcare providers can use to screen for depression? Many of the existing tools have been validated in high income countries because that’s where most of the interest and research into mental health has historically been. But are such tools relevant to different cultural settings? Wouldn’t there be cultural and linguistic problems and challenges in establishing the meaning of specific terms? What does ‘depressed’ mean across cultures? How relevant is it to ask, in low income settings a classic screening question for depression used in high income countries – ‘Do you have trouble concentrating on things, such as reading the newspaper or watching television?’
In addressing some of these tricky questions, and working with partners King’s College London and the Institute of Human Virology Nigeria, Gede will, in 2016, be testing the validity of (and then adapting) a short screening tool for depression which will be used by HIV-AIDS Adherence Counsellors in Nigeria. Watch this space for further information and insights