Mental Health OPD

Dr. Jibril Handuleh, MBBSAmoud University teaching hospital

Al-Hayat medical center

Background

• Borama had no dedicated mental health service before May 2011.

• Mental health OPD started service on May 3rd 2011 with three days Saturdays, Wednesdays and Thursdays.

Mental health OPD• It was a part of mental

health project Amoud mental health project supported financially by the Tropical health and education trust (THET).

• Academic assistance was offered by Institute of psychiatry - King’s College London in partnership with Amoud University.

• It was a pilot phase of 6 months to introduce mental health service in Borama. By December 2011, it met all of its target goals.

• It is run by one of the doctors in the hospital and a nurse.

Benefits of the OPD service

• Within a year it led to the construction of mental health ward in Borama hospital.

• Borama population got access to mental health care both in hospital and in the community setting.

• Our OPD is free of charge for clients.

• Students of Amoud University got bed side teaching site on Psychiatry as a part of their undergraduate training.

• Social workers referred cases to the service. • School children and maternal mental health

service is offered. The first in the country.• Regular follow ups and talking therapy

sessions for clients.

• The OPD serves not only clients in Borama but also have patients from Ethiopia and Djibouti.

• The number of cases of the OPD Service for a year is over 500 clients.

• The OPD service also offers patient leaflets.• Room is equipped enough to do physical

exam.• We have good documentation system.

Scope of work- The first of its kind in Somali context

• Mental health disorders• Neurological service including epilepsy ,

movement disorders etc. Some consultation liaison work with hospitals and clinicians particularly on neurosis.

• Childhood behavioral disorders • School teen mental health service• Perinatal psychiatry service

• Forensic support for Borama prison- King’s College London Forensic psychiatrists

• Counseling service on Khat• Community Psychiatry support for social

workers/traditional workers• student mentoring on mental health in the

OPD.

Partnerships

• Amoud University • King’s health partners• Peace-ware Somaliland• Somali Swedish Research Association • Borama community

Mental health disorders-Borama 2011 community reach

out

Presentations

• Case presentations were done in different conferences on mental health locally and internationally.

• Examples include• The annual institute of psychiatry academic meeting

on behavioral psychiatry in January 2012 as international case presentation. Post cast can be downloaded at http://dl.dropbox.com/u/21419522/SW_somalia_edit2.mp3

• Annual CME session at Al-Hayat in December 2011.

Future plans

• Dedicated childhood behavioral and adolescent clinic in partnership with KTSP.

• Khat Clinic • Psychotherapy service • Training for primary care physicians and nurses

in the region on mental health using the WHO MH Gap. MMH was done last year.

• These activities are planned in next few months.

Example of our success

• These two sisters and their healthy caretaker brother came to the OPD service in October 2011.

• They had schizophrenia and no care for them for 17 years being chained at a hut in Fardolaguxidh, midway between Borama and Djibouti.

• The two sisters were brought in by women who saw them for assessment.

• Volunteer women rented home for them and offered costs for medications.

• OPD service supported with follow ups and consultations to the supporting brother and social workers.

• The message reached so far places and so many other patients received care.

• Patients are doing well, fully integrated into community.

• They cook food, eat well and communicate well.

• Social workers and their relatives support them with life.

• OPD service offer one a month follow up.

ACKNOWLEGEMENT

• Amoud University schools of health sciences • Al-Hayat Hospital• King’s Health Partners • Tropical Health and Educational Trust (THET)• Peace-ware Somaliland