When it comes to mental health and psychosocial support (MHPSS) services, International Medical Corps is leading the way in Mali, a country that is severely lacking in such programming.
Our MHPSS work in Mali stretches back to 2019, when we first conducted multi-region assessments of the mental health services available and found gaps in service delivery, an absence of qualified or trained personnel, and a lack of appropriate medical supplies and psychotropic medications—in addition to community stigmatization of mental health disorders. Once we received funding two years later, we began working with the Ministry of Health (MoH) and a professor of mental health in Bamako to support five health facilities and one referral hospital. We launched our pilot project in the Timbuktu region using the mhGAP approach, which trains non-MHPSS health workers and community volunteers to deliver a minimum package of MHPSS services. But we also began looking at ways to provide more specialized care.
“Lower-level care can be provided by health workers who are not MHPSS specialists, but for higher levels of care, you need a psychologists or psychiatrists, as well as the capacity for inpatient care and pharmacological treatment,” says Issa Sawadogo, former Field Site Coordinator in Mali, now Director of Country Programs in Nigeria. “The mhGAP approach gives greater priority to lower levels of MHPSS care, but in our pilot intervention, we decided to cover all levels of care.”
The mission deployed a psychiatrist and several psychologists in Timbuktu, in addition to specialized staff members from the MoH and community volunteers, whom we trained in mhGAP. The volunteers went out into their communities to raise awareness of mental health issues and services.
These programs were expanded over the following years to 22 facilities in the Bourem, Gourma Rharous, Mopti and Timbuktu regions. We also worked alongside the MoH to develop a national MHPSS strategy for service delivery.
Today, staff members are implementing four vital MHPSS strategies in Mali. Because MHPSS coverage in the country is still extremely sparse, we are continuing to support the MoH in its efforts to offer MHPSS services within health facilities and referral hospitals. We are also implementing a remote strategy of bringing psychiatrists from referral hospitals into communities where patients may not have a means of getting to the hospital for the higher level of care they need. Our teams are also taking mobile MHPSS units into remote communities without health facilities to provide mental health consultations and other MHPSS activities. At the national level, we are helping the MoH spreading MHPSS policies to other NGOs and health organizations.
The longer MHPSS programs are in place, the more communities understand the important of addressing mental health issues.
“Beneficiaries are very happy with the services,” says Mali Program Director Jean Pierre Diowo. “Now they see that things they thought were caused by demons or evil spells are actually mental health issues that can be addressed through consultations and mental health treatment. Mental health is now a component that is accepted in the country and is a big part of the Ministry of Health’s service to communities.”