Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol.
Malawi has a population of around 20 million people and is one of the world's most economically deprived nations. Severe mental illness (largely comprising psychoses and severe mood disorders) is managed by a very small number of staff in four tertiary facilities, aided by clinical officers and...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293370&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849468667766505472 |
|---|---|
| author | Stephen Lawrie Charlotte Hanlon Lucinda Manda-Taylor Martin Knapp Martyn Pickersgill Robert C Stewart Jen Ahrens Judith Allardyce Action Amos Annette Bauer Erica Breuer Dennis Chasweka Kate Chidzalo Saulos Gondwe Sumeet Jain Demoubly Kokota Kazione Kulisewa Olive Liwimbi Angus MacBeth Thandiwe Mkandawire Anthony Sefasi Wakumanya Sibande Michael Udedi Eric Umar |
| author_facet | Stephen Lawrie Charlotte Hanlon Lucinda Manda-Taylor Martin Knapp Martyn Pickersgill Robert C Stewart Jen Ahrens Judith Allardyce Action Amos Annette Bauer Erica Breuer Dennis Chasweka Kate Chidzalo Saulos Gondwe Sumeet Jain Demoubly Kokota Kazione Kulisewa Olive Liwimbi Angus MacBeth Thandiwe Mkandawire Anthony Sefasi Wakumanya Sibande Michael Udedi Eric Umar |
| author_sort | Stephen Lawrie |
| collection | DOAJ |
| description | Malawi has a population of around 20 million people and is one of the world's most economically deprived nations. Severe mental illness (largely comprising psychoses and severe mood disorders) is managed by a very small number of staff in four tertiary facilities, aided by clinical officers and nurses in general hospitals and clinics. Given these constraints, psychosis is largely undetected and untreated, with a median duration of untreated psychosis (DUP) of around six years. Our aim is to work with people with lived experience (PWLE), caregivers, local communities and health leaders to develop acceptable and sustainable psychosis detection and management systems to increase psychosis awareness, reduce DUP, and to improve the health and lives of people with psychosis in Malawi. We will use the UK Medical Research Council guidance for developing and evaluating complex interventions, including qualitative work to explore diverse perspectives around psychosis detection, management, and outcomes, augmented by co-design with PWLE, and underpinned by a Theory of Change. Planned deliverables include a readily usable management blueprint encompassing education and community supports, with an integrated care pathway that includes Primary Health Centre clinics and District Mental Health Teams. PWLE and caregivers will be closely involved throughout to ensure that the interventions are shaped by the communities concerned. The effect of the interventions will be assessed with a quasi-experimental sequential implementation in three regions, in terms of DUP reduction, symptom remission, functional recovery and PWLE / caregiver impact, with quality of life as the primary outcome. As the study team is focused on long-term impact, we recognise the importance of having embedded, robust evaluation of the programme as a whole. We will therefore evaluate implementation processes and outcomes, and cost-effectiveness, to demonstrate the value of this approach to the Ministry of Health, and to encourage longer-term adoption across Malawi. |
| format | Article |
| id | doaj-art-6ef2b2d0c2b94017928c8dab2d3f8b5a |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-6ef2b2d0c2b94017928c8dab2d3f8b5a2025-08-20T03:25:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011811e029337010.1371/journal.pone.0293370Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol.Stephen LawrieCharlotte HanlonLucinda Manda-TaylorMartin KnappMartyn PickersgillRobert C StewartJen AhrensJudith AllardyceAction AmosAnnette BauerErica BreuerDennis ChaswekaKate ChidzaloSaulos GondweSumeet JainDemoubly KokotaKazione KulisewaOlive LiwimbiAngus MacBethThandiwe MkandawireAnthony SefasiWakumanya SibandeMichael UdediEric UmarMalawi has a population of around 20 million people and is one of the world's most economically deprived nations. Severe mental illness (largely comprising psychoses and severe mood disorders) is managed by a very small number of staff in four tertiary facilities, aided by clinical officers and nurses in general hospitals and clinics. Given these constraints, psychosis is largely undetected and untreated, with a median duration of untreated psychosis (DUP) of around six years. Our aim is to work with people with lived experience (PWLE), caregivers, local communities and health leaders to develop acceptable and sustainable psychosis detection and management systems to increase psychosis awareness, reduce DUP, and to improve the health and lives of people with psychosis in Malawi. We will use the UK Medical Research Council guidance for developing and evaluating complex interventions, including qualitative work to explore diverse perspectives around psychosis detection, management, and outcomes, augmented by co-design with PWLE, and underpinned by a Theory of Change. Planned deliverables include a readily usable management blueprint encompassing education and community supports, with an integrated care pathway that includes Primary Health Centre clinics and District Mental Health Teams. PWLE and caregivers will be closely involved throughout to ensure that the interventions are shaped by the communities concerned. The effect of the interventions will be assessed with a quasi-experimental sequential implementation in three regions, in terms of DUP reduction, symptom remission, functional recovery and PWLE / caregiver impact, with quality of life as the primary outcome. As the study team is focused on long-term impact, we recognise the importance of having embedded, robust evaluation of the programme as a whole. We will therefore evaluate implementation processes and outcomes, and cost-effectiveness, to demonstrate the value of this approach to the Ministry of Health, and to encourage longer-term adoption across Malawi.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293370&type=printable |
| spellingShingle | Stephen Lawrie Charlotte Hanlon Lucinda Manda-Taylor Martin Knapp Martyn Pickersgill Robert C Stewart Jen Ahrens Judith Allardyce Action Amos Annette Bauer Erica Breuer Dennis Chasweka Kate Chidzalo Saulos Gondwe Sumeet Jain Demoubly Kokota Kazione Kulisewa Olive Liwimbi Angus MacBeth Thandiwe Mkandawire Anthony Sefasi Wakumanya Sibande Michael Udedi Eric Umar Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. PLoS ONE |
| title | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. |
| title_full | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. |
| title_fullStr | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. |
| title_full_unstemmed | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. |
| title_short | Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE) protocol. |
| title_sort | psychosis recovery orientation in malawi by improving services and engagement promise protocol |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293370&type=printable |
| work_keys_str_mv | AT stephenlawrie psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT charlottehanlon psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT lucindamandataylor psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT martinknapp psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT martynpickersgill psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT robertcstewart psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT jenahrens psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT judithallardyce psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT actionamos psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT annettebauer psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT ericabreuer psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT dennischasweka psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT katechidzalo psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT saulosgondwe psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT sumeetjain psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT demoublykokota psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT kazionekulisewa psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT oliveliwimbi psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT angusmacbeth psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT thandiwemkandawire psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT anthonysefasi psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT wakumanyasibande psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT michaeludedi psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol AT ericumar psychosisrecoveryorientationinmalawibyimprovingservicesandengagementpromiseprotocol |