TPC-Journal-V6-Issue1

1 Melissa Luke, NCC, is an Associate Professor at Syracuse University. J. Scott Hinkle, NCC, is the Editor of The Professional Counselor . Wendi Schweiger, NCC, is Vice President at NBCC International, Greensboro, NC. Donna Henderson, NCC, is a Professor at Wake Forest University. Equal authorship is intended. This article is dedicated to Professor Kenneth Hamwaka, Executive Director of the Guidance, Counselling and Youth Development Centre for Africa and Vice Chancellor of the Africa University of Guidance, Counselling and Youth Development. Correspondence can be addressed to Scott Hinkle, 3 Terrace Way, Greensboro, NC 27403, hinkle@nbcc.org . Melissa Luke, J. Scott Hinkle, Wendi Schweiger, Donna Henderson Mental Health Facilitator (MHF) Service Implementation in Schools in Malawi, Africa: A Strategy for Increasing Community Human Resources The Mental Health Facilitator (MHF) program utilizes a population-based curriculum and has been implemented in Malawi for the past seven years. This article reports findings from an ethnographic study that explored how 40 MHF stakeholders have experienced the MHF program. This transdisciplinary program is a 30-hour training in community mental health that focuses on fundamental helping skills; identification of stress, distress and mental disorders; and appropriate community referral and follow- up. Results indicated four interrelated themes representing participants’ beliefs about their experiences with the training, including the curriculum’s responsiveness to the Malawian context, the availability and limitations of resources, the processes involved, and a variety of identified outcomes. Implications for community implementation and future directions are identified. Keywords: Mental Health Facilitator, MHF, mental disorders, Malawi, ethnographic study Mental health research supports the notion that better care management is achieved when people receive education, training and support to carry out the role of informal caregivers (World Fellowship for Schizophrenia and Allied Disorders, 2006). Although the prevalence of mental disorders in Africa is a significant health problem (Jenkins et al., 2010), treatment remains a low priority (Bird et al., 2011; Jacob et al., 2007), placed at the bottom of the public health care agenda. Mental health patients of all ages and their families are too often invisible, voiceless and living at the margins of society, and they are rarely mobilized to advocate for themselves (Saraceno et al., 2007). In Africa, mental health receives less attention due to a plethora of problems with communicable diseases and malnutrition (Gureje & Alem, 2000). Moreover, the contribution of mental distress to morbidity, as well as mortality, largely goes underappreciated (Jenkins et al., 2010). Skeen, Lund, Kleintjes, Flisher, and the MHaPP Research Programme Consortium (2010) have reported: “Mental health is a crucial public health and development issue in sub-Saharan Africa” (p. 624). At least half of all African countries have no community-based mental health services, and almost as many have no integration of mental health into primary care or training facilities for primary care staff in the treatment of mental health (World Health Organization [WHO], 2005). In low-income countries like Malawi, essential psychotropic medications are not available, and resources for mental health training and care are largely lacking (Becker & Kleinman, 2013; WHO, 2004). Challenging the negative perception of mental disorders, reducing their prevalence The Professional Counselor Volume 6, Issue 1, Pages 1–21 http://tpcjournal.nbcc.org © 2015 NBCC, Inc. and Affiliates doi:10.15241/ml.6.1.1