Three innovative mental health projects in Africa and India

“ A taboo subject ”. Many people working in mental health agree that this field is severely underfunded, particularly in low- and middle-income countries, which often results in insufficient access to care and treatment.

According to the World Health Organization, the rate of mental health workers in these countries can be as low as 2 for every 100,000 inhabitants, compared with over 70 in high-income countries. “This is in stark contrast with needs, given that one in every ten people is estimated to need mental health care at any one time,” emphasizes the WHO.

In Africa, only one country in five has a mental health policy, and the majority allocate less than 1% of their health care budget to treating mental disorders. For example, Kenya has just one mental health specialist for every million inhabitants. According to Tom Osborn, co-founder and CEO of the Shamiri Institute: "Kenyan youths often face barriers in accessing help due to structural and systemic issues.” These barriers often deter some people from accessing treatment.

The lack of available care is exacerbated by the stigma around mental health issues, which are viewed as taboo in certain cultures or a sign of weakness. “Stigma surrounding mental health further prevents people from seeking help,” says Osborn.

Marie-Alix de Putter, President of the Bluemind Foundation, paints a similar picture: “In Africa, 135 million people are living with mental health problems.” She advocates “destigmatizing mental health and ensuring that treatment can be accessed by everyone in Africa.” In response to this issue, she launched the Heal By Hair project in Côte d’Ivoire with the aim of training hairdressers in mental health, to help them recognize the early signs of mental health issues.

During this pilot project, which ran from April 2022 to July 2023, the team trialled its training modules in collaboration with mental health specialists, delivering training sessions to 200 hairdressers. The results were encouraging, leading to improved perceptions of “customers of trained hairdressers, who were significantly more optimistic, energetic and at ease than the customers of hairdressers who had not received training.”

The Bluemind Foundation has now partnered with a research team to further demonstrate the impact of this program. FID is financing this new phase, which is essential to convince public authorities that this approach is beneficial.

The Anansi program developed by the Shamiri Institute, whose CEO is Tom Osborn, aims to remove barriers to mental health care, specifically among young Kenyans aged between 18 and 22. The model developed is based on the results of an impact study, and recommends a three-level health care protocol for middle and high school students. The goal is to treat each young person according to their individual needs, and offer group therapy sessions led by peer therapists trained by the institute.

The institute will use FID funding to conduct a large-scale impact evaluation involving 25,000 low-income young people, and determine whether the Anansi program can sever the link between poverty and inequality, because, as Tom Osborn says, “Poverty increases the risk of developing mental health problems, as being born in a low-resource environment exposes you to stressors that cause mental health problems.”

In 2024, the Shamiri Institute has already helped 102,000 young people across seven districts in Kenya, and therefore, has achieved its goal of raising awareness among 100,000 young people a year.

In India, people also face various obstacles which limit their access to mental health care. There are only 0.3 psychiatrists for every 100,000 inhabitants in the country, compared with 23 in France. Moreover, there is a lack of awareness around depression which often means that symptoms go unidentified.

A study conducted in the country found that between 10% and 24% of adults have experienced some form of depression (Angelucci and Bennett, 2023). As a result, the DAI Research and Advisory Services organization is now offering to trial Self Help Plus in India, a program developed by the WHO to reduce psychological distress and prevent the onset of mental disorders. As part of this program, mental health specialists and doctors provide training to non-professional facilitators who can then run group sessions themselves. This method makes up for the lack of trained professionals and provides support to people dealing with these conditions.

While this approach has proven effective in specific contexts, it had not yet been tested in India. With funding from FID, this program will now be implemented on a small scale in India, so that any necessary adjustments can be made before its wider roll-out is considered.