Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme
Abstract Aim HOPE (National Institute for Health and Care Research Global Health Research Group on Homelessness and Mental Health in Africa) aims to develop and evaluate interventions that address the unmet needs of people who are homeless and have severe mental illness (SMI) living in three African...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796025000186/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850148793144573952 |
|---|---|
| author | Charlotte Hanlon Caroline Smartt Victoria N. Mutiso Peter Yaro Eleni Misganaw Ursula Read Rosie Mayston Ribka Birhanu Phyllis Dako-Gyeke David M. Ndetei Laura Asher Julie Repper Julian Eaton Kia–Chong Chua Abebaw Fekadu Ruth Tsigebrhan Cecilia Ashaley Fofo Kimberly Kariuki Sauharda Rai Sisay Abayneh Caroline Reindorf Amissah Amma Mpomaa Boadu Priscilla Makau Agitu Tadesse Philip Timms Martin Prince Graham Thornicroft Brandon Kohrt Atalay Alem |
| author_facet | Charlotte Hanlon Caroline Smartt Victoria N. Mutiso Peter Yaro Eleni Misganaw Ursula Read Rosie Mayston Ribka Birhanu Phyllis Dako-Gyeke David M. Ndetei Laura Asher Julie Repper Julian Eaton Kia–Chong Chua Abebaw Fekadu Ruth Tsigebrhan Cecilia Ashaley Fofo Kimberly Kariuki Sauharda Rai Sisay Abayneh Caroline Reindorf Amissah Amma Mpomaa Boadu Priscilla Makau Agitu Tadesse Philip Timms Martin Prince Graham Thornicroft Brandon Kohrt Atalay Alem |
| author_sort | Charlotte Hanlon |
| collection | DOAJ |
| description | Abstract
Aim
HOPE (National Institute for Health and Care Research Global Health Research Group on Homelessness and Mental Health in Africa) aims to develop and evaluate interventions that address the unmet needs of people who are homeless and have severe mental illness (SMI) living in three African countries in ways that are rights-based, contextually grounded, scalable and sustainable.
Methods
We will work in the capital city (Addis Ababa) in Ethiopia, a regional city (Tamale) in Ghana, and the capital city (Nairobi) and a rural county (Makueni) in Kenya to understand different approaches to intervention needed across varied settings.
We will be guided by the MRC/NIHR framework on complex interventions and implementation frameworks and emphasise co-production. Formative work will include synthesis of global evidence (systematic review, including grey literature, and a Delphi consensus exercise) on interventions and approaches to homelessness and SMI. We will map contexts; conduct focused ethnography to understand lived experiences of homelessness and SMI; carry out a cross-sectional survey of people who are homeless (n = 750 Ghana/Ethiopia; n = 350 Kenya) to estimate prevalence of SMI and identify prioritised needs; and conduct in-depth interviews and focus group discussions with key stakeholders to understand experiences, challenges and opportunities for intervention. This global and local evidence will feed into Theory of Change (ToC) workshops with stakeholders to establish agreement about valued primary outcomes, map pathways to impact and inform selection and implementation of interventions. Intervention packages to address prioritised needs will be co-produced, piloted and optimised for feasibility and acceptability using participatory action research. We will use rights-based approaches and focus on community-based care to ensure sustainability. Realist approaches will be employed to analyse how contextual variation affects mechanisms and outcomes to inform methods for a subsequent evaluation of larger scale implementation. Extensive capacity-strengthening activities will focus on equipping early career researchers and peer researchers. People with lived experience of SMI and policymakers are an integral part of the research team. Community engagement is supported by working closely with multisectoral Community Advisory Groups.
Conclusions
HOPE will develop evidence to support action to respond to the needs and preferences of people experiencing homelessness and SMI in diverse settings in Africa. We are creating a new partnership of researchers, policymakers, community members and people with lived experience of SMI and homelessness to enable African-led solutions. Key outputs will include contextually relevant practice and policy guidance that supports achievement of inclusive development.
|
| format | Article |
| id | doaj-art-6c0d187844c847f9b6ecf51fcd8591af |
| institution | OA Journals |
| issn | 2045-7960 2045-7979 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj-art-6c0d187844c847f9b6ecf51fcd8591af2025-08-20T02:27:09ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792025-01-013410.1017/S2045796025000186Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programmeCharlotte Hanlon0https://orcid.org/0000-0002-7937-3226Caroline Smartt1Victoria N. Mutiso2Peter Yaro3Eleni Misganaw4Ursula Read5Rosie Mayston6https://orcid.org/0000-0002-2758-0194Ribka Birhanu7Phyllis Dako-Gyeke8David M. Ndetei9https://orcid.org/0000-0001-6891-4990Laura Asher10https://orcid.org/0000-0002-9857-6766Julie Repper11Julian Eaton12Kia–Chong Chua13https://orcid.org/0000-0002-6693-6333Abebaw Fekadu14Ruth Tsigebrhan15Cecilia Ashaley Fofo16Kimberly Kariuki17Sauharda Rai18https://orcid.org/0000-0002-9393-1466Sisay Abayneh19Caroline Reindorf Amissah20Amma Mpomaa Boadu21Priscilla Makau22Agitu Tadesse23Philip Timms24Martin Prince25Graham Thornicroft26Brandon Kohrt27https://orcid.org/0000-0002-3829-4820Atalay Alem28Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCentre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UKAfrica Institute of Mental and Brain Health, Nairobi, KenyaBasicNeeds-Ghana, Tamale, GhanaMental Health Service User Association, Addis Ababa, EthiopiaSchool of Health and Social Care, University of Essex, Colchester, UKDepartment of Global Health & Social Medicine, King’s College London, London, UKCollege of Health Sciences, School of Medicine, Department of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, GhanaAfrica Institute of Mental and Brain Health, Nairobi, Kenya Department of Psychiatry, University of Nairobi, Nairobi, KenyaCentre for Public Health and Epidemiology, School of Medicine, University of Nottingham, Nottingham, UK Institute of Mental Health, University of Nottingham, Nottingham, UKImroc (Charity Reg No. 1207904), Nottingham, UKCBM Global, UK Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UKDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UKCentre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Department of Global Health & Infection, Brighton and Sussex Medical School, Brighton, UKCollege of Health Sciences, School of Medicine, Department of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, EthiopiaBasicNeeds-Ghana, Accra, GhanaCentre for Clinical Research, Division of Mental Health, Kenya Medical Research Institute, Nairobi, kenyaCenter for Global Mental Health Equity, Department of Psychiatry and Behavioral Health, George Washington University, Washington, DC, USACollege of Education and Behavoural Studies, Arsi University, , Arsi Asela, Ethiopia Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaDeputy Chief Executive, Mental Health Authority, Accra, GhanaMental Health Department, Institutional Care Division, Ghana Health Service, Accra, GhanaKitui County, Ministry of Health, Nairobi, KenyaFederal Ministry of Health of Ethiopia, Addis Ababa, EthiopiaNational Psychosis Unit, South London and Maudsley NHS Foundation Trust, London, UK Department of Psychological Medicine, King’s College London, London, UKDepartment of Public Health Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UKCentre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UKCenter for Global Mental Health Equity, Department of Psychiatry and Behavioral Health, George Washington University, Washington, DC, USADepartment of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaAbstract Aim HOPE (National Institute for Health and Care Research Global Health Research Group on Homelessness and Mental Health in Africa) aims to develop and evaluate interventions that address the unmet needs of people who are homeless and have severe mental illness (SMI) living in three African countries in ways that are rights-based, contextually grounded, scalable and sustainable. Methods We will work in the capital city (Addis Ababa) in Ethiopia, a regional city (Tamale) in Ghana, and the capital city (Nairobi) and a rural county (Makueni) in Kenya to understand different approaches to intervention needed across varied settings. We will be guided by the MRC/NIHR framework on complex interventions and implementation frameworks and emphasise co-production. Formative work will include synthesis of global evidence (systematic review, including grey literature, and a Delphi consensus exercise) on interventions and approaches to homelessness and SMI. We will map contexts; conduct focused ethnography to understand lived experiences of homelessness and SMI; carry out a cross-sectional survey of people who are homeless (n = 750 Ghana/Ethiopia; n = 350 Kenya) to estimate prevalence of SMI and identify prioritised needs; and conduct in-depth interviews and focus group discussions with key stakeholders to understand experiences, challenges and opportunities for intervention. This global and local evidence will feed into Theory of Change (ToC) workshops with stakeholders to establish agreement about valued primary outcomes, map pathways to impact and inform selection and implementation of interventions. Intervention packages to address prioritised needs will be co-produced, piloted and optimised for feasibility and acceptability using participatory action research. We will use rights-based approaches and focus on community-based care to ensure sustainability. Realist approaches will be employed to analyse how contextual variation affects mechanisms and outcomes to inform methods for a subsequent evaluation of larger scale implementation. Extensive capacity-strengthening activities will focus on equipping early career researchers and peer researchers. People with lived experience of SMI and policymakers are an integral part of the research team. Community engagement is supported by working closely with multisectoral Community Advisory Groups. Conclusions HOPE will develop evidence to support action to respond to the needs and preferences of people experiencing homelessness and SMI in diverse settings in Africa. We are creating a new partnership of researchers, policymakers, community members and people with lived experience of SMI and homelessness to enable African-led solutions. Key outputs will include contextually relevant practice and policy guidance that supports achievement of inclusive development. https://www.cambridge.org/core/product/identifier/S2045796025000186/type/journal_articlecommunity mental healthmental illness stigmaminority issues and cross-cultural psychiatrypsychosissocial inclusion |
| spellingShingle | Charlotte Hanlon Caroline Smartt Victoria N. Mutiso Peter Yaro Eleni Misganaw Ursula Read Rosie Mayston Ribka Birhanu Phyllis Dako-Gyeke David M. Ndetei Laura Asher Julie Repper Julian Eaton Kia–Chong Chua Abebaw Fekadu Ruth Tsigebrhan Cecilia Ashaley Fofo Kimberly Kariuki Sauharda Rai Sisay Abayneh Caroline Reindorf Amissah Amma Mpomaa Boadu Priscilla Makau Agitu Tadesse Philip Timms Martin Prince Graham Thornicroft Brandon Kohrt Atalay Alem Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme Epidemiology and Psychiatric Sciences community mental health mental illness stigma minority issues and cross-cultural psychiatry psychosis social inclusion |
| title | Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme |
| title_full | Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme |
| title_fullStr | Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme |
| title_full_unstemmed | Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme |
| title_short | Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme |
| title_sort | improving outcomes for people who are homeless and have severe mental illness in ethiopia ghana and kenya overview of the hope programme |
| topic | community mental health mental illness stigma minority issues and cross-cultural psychiatry psychosis social inclusion |
| url | https://www.cambridge.org/core/product/identifier/S2045796025000186/type/journal_article |
| work_keys_str_mv | AT charlottehanlon improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT carolinesmartt improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT victorianmutiso improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT peteryaro improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT elenimisganaw improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT ursularead improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT rosiemayston improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT ribkabirhanu improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT phyllisdakogyeke improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT davidmndetei improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT lauraasher improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT julierepper improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT julianeaton improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT kiachongchua improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT abebawfekadu improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT ruthtsigebrhan improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT ceciliaashaleyfofo improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT kimberlykariuki improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT sauhardarai improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT sisayabayneh improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT carolinereindorfamissah improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT ammampomaaboadu improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT priscillamakau improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT agitutadesse improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT philiptimms improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT martinprince improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT grahamthornicroft improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT brandonkohrt improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme AT atalayalem improvingoutcomesforpeoplewhoarehomelessandhaveseverementalillnessinethiopiaghanaandkenyaoverviewofthehopeprogramme |