Training Mental Health Workers in Afghanistan

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Training Mental Health Workers in Afghanistan
By Dr. Siamah M. Qureshi Consultant
Psychologist Mental Health Resource Center
Peshawar Pakistan Visiting Psychologist
Fountain House Lahore Visiting Psychologist
Horizon Peshawar
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AFGHANISTAN

• Traumatized Country
• Afghans
• Displaced
• Poverty

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In Afghanistan

• Minimum Psychiatric Facility
• Nonavailability of trained Mental Health
  Professionals

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Common Psychiatric Problems

• Depression
• PTSD
• As observed from various clinic attendance in
  NWFP Pakistan as well as based on study findings
  inside Afghanistan by Prof. Khalid A. Mufti.

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AIMS OBJECTIVES

• Giving Training to
• Medical Professionals
• Nurses
• Paramedics
• Social workers
• Teachers
• Volunteers

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Methodology

• Workshops
• In Afghanistan 4
• In Pakistan 8
• ___________________
• Total 12

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Workshops Addressed

• Trauma Psychology
• Management of Anxiety and Depression
• Research Methodology

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Participants(459)

• Male 268
• Female 191

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COLLABORATION

• In Pakistan
• MHRC
• Horizon
• Lahore Mental Health Association
• IN Afghanistan
• IBNESINA
• HEALTH NET INTERNATIONAL
• Special thanks
• University of Missouri
• WPA
• Khyber Medical College Peshawar.

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Planning

• IN AFGHANISTAN
• A Pakistani team visited lead by Prof Khalid A.
  Mufti and Coordinated by Dr. Farida H. Saifi at
• Kabul
• Jalalabad

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Resource Persons Visited Afghanistan

• No. of Resource persons 05
• Consultant Psychiatrists 03
• Prof. Khalid A. Mufti
• Dr. Munir Ahmad Dawar
• Dr. Mian Mohammad Iqbal
• Psychiatric Social Worker 01
• Mr. Asad Haroon
• Mental Health Media Specialist 01
• Dr. Farida H. Saifi

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Planning

• In Pakistan Training was given at
• Pesahwar
• Lahore
• Akora Khattak Refugee Camp
• Islamabad

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Faculty In Lahore

• Prof. Haroon Rashid Chaudhry
• Dr. Fariha N. Piracha
• Prof. Muhammad Afzal Chaudhry
• Mr. Usman Rasheed Chaudhry
• Prof. Azhar Ali Rizvi

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CURRICULUM

• Curriculum was carefully considered depending on
  the need assessment done prior to course.
• During Planning visit several interviews were
  carried out for the preparation of curriculum

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Need Assessment based on before execution of
training

• Primary Health care physicians 32
• Internal Physicians 02
• Nurses 14
• Paramedics 12
• Volunteers 56
• Media People (Electronic/Print) 06
• Doctors already working in Mental
• Health Institution 02

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• Teachers 67
• Staff from Ministry of Primary 04
• Health
• Families of Mentally Ill patients 100
• Through letters addressed to Prof. Mufti and
  Communication through BBC Mental Health
• Pashto Service
• And through Interviews Health Care Facilities
  Jalalabad and Ghani Khail.

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Curriculum

• MODULE I
• SLEEP SLEEP DISORDERS
• BEREAVEMENT
• GENERALIZED ANXIETY DISORDERS
• OBSESSIVE COMPULSIVE DISORDER
• PANIC DISORDER
• POST-TRAUMATIC STRESS DISORDER
• DEPRESSIVE DISORDER

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MODULE II

• Severe Mental Illnesses
• ACUTE PSYCHOTIC DISORDERS,
• CHRONIC PSYCHOTIC DISORDERS
• DELIRIUM
• DEMENTIA
• BIPOLAR DISORDER 

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MODULE III

• Mental Retardation
• Epilepsy
• Pervasive Developmental Disorders

MODULE IV

• Mental Health Promotion
• Communication
• Stress
• Mental Health Worldwide

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MODULE V

• Substance Abuse
• Psychopharmacology
• Psychotherapies
• Doctor- patient relationship

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Training Venue

• Peshawar
• Community Mental Health Service Horizon Peshawar
• Mental Health Resource Centre
• Akora Khattak Refugees Camp.
• Dept. of Psychiatry Khyber Teaching Hospital
• Small Mental Health Awareness Centre in
  Timbarpura, Village near Peshawar organized by
  local residence, courtesy Horizon.

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Training Venue

• Islamabad
• Dept. of Psychiatry, Pakistan Institute of
  Medical Sciences by
• Prof Rizwan Taj

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Training Venue Lahore

• Rotation of the one key member for 6 weeks
• Lahore
• Psychiatric Teaching Units
• Psychiatric / Epilepsy Clinic
• Fountain House-Rehab Facility
• Schools of Special Education
• Drug Addiction Units

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Outcome

• Evaluation
• Pretest Evaluation Courses 7 14
• Inside Afghanistan
• Post Test Evaluation courses 82 86
• inside Afghanistan

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Outcome Pakistan
Evaluation Pretest Evaluation Courses 12
18 In Peshawar Post Test Evaluation courses
83 88 In Peshawar
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Outcome Pakistan

• Evaluation
• Pretest Evaluation Courses 16 20
• In Lahore
• Post Test Evaluation courses 85 90
• In Lahore

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Incentives

• All these trained people were awarded
  certificates as Mater trainers to Impart training
  inside Afghanistan.

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Follow-up

• A follow-up evaluation after six months was done
  by Dr. Farida Saifi inside Afghanistan and found
  that 10 of the trainers actually involved in the
  training.
• Rest of the required population almost 90 of
  them practicing Mental Health Delivery in the
  primary health care setting.

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Follow-up

• While only 30 General Physicians involved in
  Mental Health service delivery.
• One year follow up through a visit by Mr. Asad
  Haroon and Major Dagarwal found 14 trainer
  involved in training and 76 involved in Mental
  Health Care service delivery. (decreased in
  Primary Health Care was lost of jobs or leaving
  the jobs)

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Follow-up

• Follow-up contact through e mail, telephone, or
  postal mails
• Only 40 of the people maintain this contact for
  continued education to MHRC Peshawar and Lahore.

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Conclusion

• A Rewarding and Successful experience
• The need to replicate and sustain this activity
  this desire, but due to lack of funds the
  activity is limited by the MHRC

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Funding Resource

• Horizon Peshawar
• Fountain House Lahore

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Thank You