On Tuesday, May 9th 2018, Gede Foundation hosted Dr Mayston from King’s College, London to deliver a Theory of Change seminar focusing on ways to integrate mental health into HIV care and support, using the Theory of Change (ToC) model to identify key issues. There were 20 participants ranging from mental health experts as well as HIV/AIDS organisations. Participants represented the following organisations: Society for Community Development (SCD), Organisation for Positive Productivity (OPP), Heartland Alliance International Nigeria, Karu Behavioural Medicine Unit, Federal Medical Centre (FMC), AIDS Healthcare Foundation (AHF), National Primary Healthcare Development Agency (NPHCDA), Brain Specialist Hospital, Presidential Committee for the North East Initiative (PCNI) and the Institute for Human Virology, Nigeria (IHVN). 

It was an opportunity for participants to review the results from the earlier ToC seminar that was held at Gede Foundation in January 2017. Our regular readers will recall that the ToC in 2017 sought to, i) review the evidence base related to integrated mental healthcare for people with HIV, ii) better understand the barriers and facilitators to designing and implementing effective integrated care in the Nigerian setting, and, iii) share these ideas among people with interest in this area, with a view towards carrying out future collaborative work/service development. Theory of Change is defined as “a way to understand how, why and to what extent change happens.”

During the course of the seminar, Dr. Mayston asked participants to think of an overall impact so as to map out the Theory of Change process. Participants agreed on greater involvement of mental health professionals in the care of PLWHA, care that is patient-centred, improved quality of care, improved HIV and mental health outcomes. The map is accessible here.

At the end of the seminar, it was agreed that if integration of mental healthcare into HIV is to be practical, there are changes that need to be made to the existing structure. Healthcare workers who were present noted that they may not be fully equipped to care for someone whose mental and physical health is challenged as as they had yet to be trained to screen and treat such conditions and the medical training given to facility doctors at the community level had very little in the way of psychiatry/psychology. The challenge is integrating mental health screening, treatment and referral expertise into the very busy lives of frontline health care workers. Participants also agreed on how to go about treatment depending on the severity of the mental health disorder when an individual is first diagnosed. 

Participants agreed on the road map as articulated and that this will form the basis of Gede’s forthcoming engagement with Government agencies and grant applications.