Partnership brings model for mental health recovery to Kenya

Starting next month, one Western faculty member will begin a cooperative program to bring a North American practice for improving mental health to the African Republic of Kenya.

Dr. Arlene MacDougall, a psychiatrist and researcher with Western’s Department of Psychiatry in the Schulich School of Medicine & Dentistry, is teaming up with colleagues from the University of Toronto, Queen’s University and the Africa Mental Health Foundation to establish a social enterprise business in the community of Machakos, located an hour southeast of Nairobi, to help locals suffering from mental illnesses.

“Essentially, there are no psychosocial treatment programs available in the area,” MacDougall said. “The aim is developing a new model for recovery from severe mental illnesses, like schizophrenia and mood disorders like bipolar.”

The project, called Community REcovery Achieved Through Entrepreneurship (CREATE) will develop a business tailored to mesh with the Kenyan economy that will employ people with mental illnesses. The business will then provide employees with the tools and social support they need to begin recovery and reintegration into society.

This kind of business is tried and tested in North America.

Impact Junk Solutions (IJS) Inc. is one such business that operates in London. The business is designed to assist people with mental illness in acquiring a permanent job by understanding that their health issues might otherwise hinder them from doing so and supporting them throughout.

CREATE brings this same understanding to Machakos, but the investigative team knows some changes will have to be made.

While businesses like IJS, cafés and bakeries are effective in North America, for the business and its employees to thrive in Kenya, a business must be developed that works with Machakos’ agricultural market-based economy, MacDougall said.

While mental-health improvement is the main goal of the project, MacDougall said the business must be successful in order for its employees to benefit. Further, the success of the business and treatment go hand-in-hand, as the sense of self-worth derived from gainful employment is itself a form of treatment.

“The goal isn’t profit, but to improve health and focus on social outcome. But it does have to be sustainable. This is a real job; it’s not a sheltered workplace at the hospital. Workers will be hired, trained, paid and expected to perform,” MacDougall said.

The team hopes to have the Machakos business running by summer of this year, at which point they will evaluate its progress and efficacy until early 2016. Researchers will begin by determining the participants’ goals and tracking them as they work, with an emphasis placed on how employees utilize time before and after the program is initiated. Following this proof of concept phase, the team will be eligible for more grant money.

The initial grant of $112,000 comes from the Government of Canada’s Grand Challenges Canada ‘Stars in Global Health’ fund.

While the team is faced with a daunting task, MacDougall says she and her partners fully believe in the necessity of the project. The end goal of CREATE is to have their social enterprise business run solely by the Machakos community, and the team is prepared to work hard towards that end.

“I’m hopeful. I think it’s very exciting. From discussions with our partners on the ground it seems this is needed,” she said.

While Canadians have woken up in recent years to the significant issues faced by those with mental illnesses, the stigmatization faced by their counterparts in low-income countries can be worse in many ways. MacDougall and the CREATE team hope to change the way people view this issue.

“Stigma is quite significant and people are often marginalized from their families and communities,” she said. “Their identity is not just their illness.”