King's College London

NIHR Global Health Research Group on Interventions for Youth with Depression and Anxiety Disorders in African Countries

African Youth in Mind focuses on working with youth and caregivers to adapt and test a stepped care intervention for youth with depression and anxiety, which is tailored to the needs of communities in Ghana and Zimbabwe.

Based on country priorities and context, we will shape the intervention in Ghana for those aged 15-18 enrolled in Ghana’s free senior high school system and in Zimbabwe for youth aged 15-24 in schools, colleges and community health settings including sexual health services. We will then evaluate the clinical and economic benefits of the intervention through running a pilot trial in senior high schools in Ghana and feasibility studies in Zimbabwe. Capacity building is also a key component taking place in Ghana, Zimbabwe, and Malawi.  

Our multidisciplinary group of African and UK researchers will work with youth in Ghana and Zimbabwe to adapt and evaluate a stepped care intervention for youth aged 15 to 24 with depression or anxiety, which is suitable to be delivered through task-shifting to non-specialists.

We have previously shown the acceptability and effectiveness of a stepped-care intervention called the Friendship Bench for working age adults in Zimbabwe. This comprises brief psychological therapy, with the option of adding an antidepressant for those who do not recover. We now wish to adapt this for youth.

In the Formative Phase we will apply a theory-informed participatory approach to adapt the intervention, and develop implementation strategies in Zimbabwe and Ghana. Based on country priorities and context, we will tailor the intervention in Ghana for those aged 15-18 enrolled in Ghana’s free senior high school system and in Zimbabwe for youth aged 15-24 in schools, colleges and community health settings including sexual health services.

In the Implementation Phase, in Zimbabwe, we will run a single-arm study to test feasibility of implementing through community, health and education systems, and assess preliminary outcomes. In Ghana we will run a two arm pilot trial in senior high schools in Navrongo, to test the effectiveness, cost-effectiveness and implementation of our intervention compared to control.

Professor Abas of King’s College London said, “This funding presents a tremendous opportunity to bring together a new dynamic group of researchers to expand the work that we have been undertaking with adults. There is a huge unmet need to provide mental healthcare to young people in African countries. There are many unanswered research questions about what works best to get youth with persistent depression and anxiety back on track with their education and social development, and we look forward to filling some of these gaps”.

Associate Professor Dixon Chibanda, of the University of Zimbabwe and the London School of Hygiene and Tropical Medicine and Director of the African Mental Health Research Initiative (AMARI) said, “This will give us an opportunity to consolidate our collective lessons from the past 10 years as we move towards scaling evidence-based interventions in Zimbabwe and beyond. This work is further strengthened by the formal endorsement of the mental health initiatives in Zimbabwe through the WHO Special Initiative.”

Key partner co-investigators involved:

• Associate Professor Dixon Chibanda (Co-Principal Investigator, University of Zimbabwe)
• Dr Benedict Weobong (Country Lead, University of Ghana)
• Dr Moses Kumwenda (Country Lead, Kamuzu University of Health Sciences, Malawi)
• Dr Jermaine Dambi (University of Zimbabwe)
• Dr Tarisai Bere (University of Zimbabwe)
• Dr Franklin Glozah (University of Ghana)
• Professor Philip Adongo (University of Ghana)
• Dr Dzifa Attah (University of Ghana, Medical School)
• Dr Rosemary Musesengwa (University of Oxford)
• Mr Peter Yaro (BasicNeeds Ghana)
• Dr Abraham Aduro (Navrongo Health Research Centre)
• Mrs Gifty Francisca Ben-Aryee (Ghana Health Service)
• Dr Raymond Aborigo (Navrongo Health Research Centre)
• Ms Karen Webb (The Organization for Public Health Interventions and Development (OPHID))
• Ms Nicola Willis (Zimbabwe)
• Professor Rashida Ferrand (London School of Hygiene and Tropical Medicine)