Guinea
To this end, Abdoulaye SOW and Amadou Lamarana DIALLO described their experience in Guinea. The psychological assistance they have been offering for some twenty years, in collaboration with the La Gerbe mental health centre in Brussels, targets people with neuro-psychiatric pathologies (psychoses, depressions, epilepsies). As we already saw from other workshops, broad-ranging and inclusive support is offered to users and their families, ranging from awareness-raising and active listening to home visits and support for social and sometimes professional reintegration. Patients are seen in collaboration with the Belgian partner, in the context of joint general practitioner-psychiatrist consultations. Once the medical care has been provided, community health workers visit the patients when they have returned home so as to support the families.
"Today the communities we work with are giving more and more credit to modern medicine, showing the benefit of integrating mental health into communities"
Patients returning to their daily environment is often a breaking point for them and their families as new demands arise during this pivotal period: the need for social and professional reintegration, the continuation of treatment, etc. This ambulatory approach has the advantage of preventing non-compliance and some patients relapsing, of (re)finding relatives or guardians for wandering people with mental disorders and, finally, has an effect on the community. Indeed, this method of support has helped to change perceptions and beliefs about mental illness being some sort of evil spell or manifestation. This approach reduces stigma whilst improving the effectiveness of the support offered. Round tables are even organised with traditional practitioners, with whom a system of joint consultations and occasional mutual referrals is in place.
Watch the video of Mr. Abdoulaye Sow and Mr. Amaeou Lamarana Diallo (Guinea)
Côte d'Ivoire
In addition, Alex WON & Boniface Kaba YOU told us about their experience in Côte d'Ivoire. Working in a psychiatric centre located in the heart of a village, they have been working on mental health activities for over twenty years in partnership with psychiatrists from the psychiatric clinic La Borde in France. Again, the support for patients is aimed as much at providing pharmacological and therapeutic treatment as it is at supporting them in their daily lives. However, the centre in question has several unique characteristics that have a definite impact on the evolution and effectiveness of the treatment. Firstly, the centre is not fenced in: it is part of the village and the community has clearly identified this place. Furthermore, the patient arrives at the centre with one or two family members to support him/her, which increases the degree of responsibility of both the patients and their families. This logic of family inclusion extends to therapeutic practices. Indeed, therapeutic spaces and tools have been created with the aim of giving a voice to patients and their relatives to avoid marginalisation and rejection. Patient-family meetings as well as therapeutic clubs following the institutional psychotherapy approach, bringing together patients, families and professionals, are an integral part of the life of the centre.
A technical problem prevented this group’s discussant, Souleymane COULIBALY (Mali), from taking part but he was able to answer participants’ many questions.
Watch the video of Mr. Alex Won and Mr. Boniface Kaba You (Côte d’Ivoire)
The participation of the State, the costs of such experiments, the possible decentralisation of these activities or the qualitative supply of medicines all coincided with examples from other countries. From these exchanges, we saw the distinct similarity of needs but also of practices. Overall, there is widespread integration of mental health into medical, daily and family considerations and support for doing so. The participants initiated a very lively debate, in which one of the most obvious observations was the need to adapt the system to the individual, group, cultural and contextual constraints of the patients and their care teams. In this respect, this observation is perfectly in line with the issues of accessibility of care, efficiency, diversity, and cooperation and organisation between all social and community strata.