Innovative approach to mental health care in Ethiopia

Professor Clare Pain likes to quote the Ethiopia Amharic saying “der biaber anbessa yaser” which translates as: “together, a spider web will tie a lion.”

Dr. Pain is seeking to tame the lion of mental illness in Ethiopia as part of a team that includes Dr. Dawit Wondimagegn and Dr. Atalay Alem of Ethiopia, and Dr. Paula Ravitz, a professor in the department of psychiatry in the Faculty of Medicine at the University of Toronto.

The group just received a boost to their Biaber Project in the form of a $1 million grant from Grand Challenges Canada, which funds innovative approaches to improving mental health diagnosis and care in developing countries.

“Mental health disorders are a leading cause of suffering and disability everywhere, but the problem is especially acute in the developing world,” says Dr. Peter Singer, professor of surgery in U of T’s Faculty of Medicine and chief executive officer of Grand Challenges Canada.

Globally, close to 450 million people have mental health disorders and more than 75 per cent of those individuals live in developing countries. The World Health Organization says 85 per cent of individuals living in the developing world with serious mental disorders receive no treatment at all.

Domestic violence is a contributing factor to mental health disorders and it has a high occurrence in rural Ethiopian families. The violence can lead to depression, anxiety and suicide and those who suffer mental illness are often severely stigmatized.

"Nine years ago, Ethiopia had just 11 psychiatrists for a country of 84 million people. Today there are 44,” says Dr. Pain, who is also director of Mount Sinai Hospital’s psychological trauma program.

More than 80 per cent of foreign-trained Ethiopian physicians do not return to practice in their home country. Pain is coordinator of the Toronto Addis Ababa Academic Collaboration (TAAAC), which seeks to assist in training professionals in the country, replicating and sustaining advanced training programs over the long term to decrease the need to train abroad.

The Biaber Project will test improved screening for mental health disorders and make treatment available to many who previously could not access care. Ongoing provision of these new psycho-social services will be sustained by embedding training in the professional development programming of mental health and primary health workers in six regions of Ethiopia.

Over the next three years, the Biaber Project will train a network of 300 Ethiopian health workers who will provide culturally sensitive mental health treatment to 15,000 patients in their own communities.