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Better mental health and wellbeing for young people

A healthcare worker, conducts a virtual counselling session with a sex worker at Alive Medical Services in Kampala, Uganda.

Key information

  • Organisation: Alive Medical Services (AMS)
  • Country: Uganda
  • Region: East Africa
  • Stage of innovation: Stage 3: Pilot
  • Start date: October 2020
  • End date: June 2021
  • Type of innovation: Service innovation: new or improved service
  • Budget: 60,000 USD
  • Funder: SIDA through the Swedish Embassy in Kampala, managed by Frontline AIDS

Summary of intervention

Adolescence is a time of tremendous emotional upheaval and change — it is estimated that 50% of mental issues begin during this time. For young people in Uganda, gender-based violence (GBV) often further impacts mental health, and the relationship between poor mental health and adherence to medications means young people living with HIV (YPLHIV) risk defaulting on antiretroviral treatment. They often lack confidence to seek support, and health care workers may not have the skills to identify mental health issues or make relevant referrals.

Under the sexual and reproductive health and rights (SRHR) Umbrella project, AMS has mainstreamed mental health and GBV into SRHR and HIV services for YPLHIV. Activities included facility-based mental health workshops for YPLHIV, their caregivers and families; home visits and peer-led community learning activities, and training for health care workers. The aim was to increase awareness of GBV and its effects on mental health; prevent and respond to GBV and mental health issues; reduce levels of depression; improve ART adherence, and boost communication skills and self-esteem.

An end-of-project evaluation showed improved mental health and psychosocial well-being among YPLHIV. Health care workers reported new skills in identifying and screening for mental health, as well as improved counselling skills, which they intend to cascade to colleagues. Parents and caregivers felt better able to communicate with their children, and both caregivers and adolescents reported increased confidence and self-esteem. Barriers to adherence and ART retention were broken down, improving viral loads for YPLHIV

learnings

  • Learning confirmed linkages between poverty, mental health and GBV, and a need for economic empowerment activities.
  • Capacity-building for health care workers proved to be an effective way to strengthen integration of GBV into SRHR services.
  • Bringing caregivers and young people together improved relationships. Some participants struggled in English and requested training materials, visual aids and IEC materials in local languages.

next steps

AMS is incorporating this learning and building on this project through its Year 6 Innovation grant, which has a strong focus on economic empowerment. Future plans will promote integration of mental health services in routine care and treatment for adolescents and YPLHIV using family and peer-led interventions as well as empowering medical workers with counselling and communication skills.

sustainability

To enhance sustainability the project needs to involve more peer educators, community health workers, and facility health workers to continue to achieve impact.

For more information on the SRHR Umbrella Grant, click HERE.