ONGOING WORK

The undergraduate and postgraduate courses in Mental Health are run at the College of Medicine’s main campus in Blantyre. Established in 1991, the College is the country's only medical school and is part of the University of Malawi. The intake to the medical school is now around 100 per year, all courses are taught in English and students receive an internationally recognised medical qualification.

The Department of Mental Health is headed by Dr Kazione Kulisewa, a Malawian consultant psychiatrist who was himself supported through his training by SMMHEP.  The department's teaching is supported by SMMHEP’s volunteer lecturers. The department aims to increase its size and capacity, expanding the number of lecturers and its research output, while building up a critical mass of postgraduate mental health clinicians and researchers.

All organisations and persons featured in the film gave full permission for their images to be published.


Undergraduate Psychiatry Teaching

The general psychiatry course is taught to 4th year students over a five-week period with an exam at the end of week six. There are four rotations every academic year.

The course includes lectures at the College, together with clinical teaching at  Zomba Mental Hospital and in the outpatient clinic at Queen Elizabeth Central Hospital in Blantyre. Teaching methods include problem-based learning, tutorials and case-based teaching in acute outpatient and inpatient settings. A Malawian clinical psychologist and a visiting psychology lecturer deliver teaching on psychotherapy, mental wellbeing and the cultural aspects of mental health.

Twice a year, a Learning Disabilities and Child and Adolescent Psychiatry course is taught to 4th year students over a one-week period. It includes a lecture series, small group work, problem-based learning, discussions, a film night and site visits to children’s charities.

Out Patient Clinics, Queen Elizabeth Hospital, Blantyre

Three mornings a week, the Head of Department and SMMHEP volunteers run an outpatient walk-in clinic with two psychiatric nurses. The remainder of the week, the clinic is staffed by psychiatric nurses. Each week, the clinic treats between 100 and 150 patients and when necessary, admits patients to Zomba Mental Hospital. The Head of Department and SMMHEP volunteers also organize training sessions for the nurses and security personnel and conduct clinical audits.


Postgraduate Psychiatry Teaching

Students
Undergraduates on a school visit to teach local students about mental health as part of their Psychiatry rotation.

The postgraduate training is a four-year course of seminars and clinical training, leading to a Master of Medicine  (M.Med) degree. Trainees spend two years in Malawi, supervised by members of the Department of Mental Health and sit Part One of their M.Med exams. They then  continue their training in psychiatric subspecialties at the University of Cape Town, under the supervision of Dr Peter Milligan.  So far, three consultant psychiatrists have beensupported through their training by SMMHEP and other psychiatric trainees are currently in training.


E-learning project

The e-learning project aims to build capacity and ensure a sustainable, mental health workforce. Online learning materials are currently being developed for both undergraduate and postgraduate students. They will also be available to clinical officers, psychiatric nurses and other mental health professionals. Undergraduate resources include interactive problem-based learning scenarios, powerpoint lectures with voice-overs and links to online information. Postgraduate materials are designed to support psychiatry training, so that Malawi will be able to train its own mental health specialists in the future.


Consolidating Psychiatry Capacity Development in Malawi and Zambia (CPMZ) - 2018 - 2020

This project supports

(1) The undergraduate teaching at the Malawi College of Medicine. Volunteer psychiatrists stay in Malawi for three to six weeks and provide mental health training to medical students.

(2) The work to standardize e-learning materials for use in Zambia and Malawi.

(3) Work to strengthen the training environments for psychiatrists and other mental health workers in Malawi and Zambia.  This involves setting up a Quality Improvement Partnership between services in Malawi and Zambia through workshops in clinical governance and quality improvement, curriculum development and teaching methods. Workshops were held in July 2019 in Lusaka and in February 2020 at Zomba, where the Quality Improvement teams from Chainama Psychiatric Hospital in Zambia and Zomba Mental Hospital, met to share data on the QI programmes set up under this project.  Delegates from both countries also came to Edinburgh, Scotland for Quality Improvement Training and project planning in April 2019.


COMPLETED PROJECTS

Enhancing Mental Health Training in the Districts of Malawi

Adopting a key recommendation of the WHO mhGAP programme, this three year long community-based project was a trainer-of-trainers scheme to strengthen the mental health skills and substance misuse expertise of Malawi’s primary health care workers. Operating in five  Districts, the project trained more than four hundred clinicians working in primary care, helping to narrow the very wide gap between the services urgently needed in Malawi and those that were available. The project was funded by the Scottish Government. The project concluded in 2016.

2 publications were were recently published about this work:

  1. Ahrens, J., Kokota, D., Mafuta, C. et al. Implementing an mhGAP-based training and supervision package to improve healthcare workers’ competencies and access to mental health care in Malawi. Int J Ment Health Syst 14, 11 (2020). https://doi.org/10.1186/s13033-020-00345-y
  2. Kokota, D., Lund, C., Ahrens, J. et al. Evaluation of mhGAP training for primary healthcare workers in Mulanje, Malawi: a quasi-experimental and time series study. Int J Ment Health Syst 14, 3 (2020). https://doi.org/10.1186/s13033-020-0337-0


Improving Clinical Standards and Teaching at Zomba Mental Hospital

This project arose from Dr Selena Gleadow Ware's work at  Zomba Mental Hospital, while she was a SMMHEP- supported lecturer at the College of Medicine. She held regular case-discussions and taught non-medical staff as well as medical students, working with hospital staff to improve clinical standards.  With nursing staff on the female wards, she particularly focused on developing a baby-friendly service for breast-feeding mothers. The project concluded in 2015.