Trainings programmes in the Maldives in association with Mental Health Awareness Foundation, Maldives
By Dr Shaazneen Ali, Specialist Registrar in the Charing Cross training scheme, London Deanery and Co-founder of Mental Health Awareness Foundation (MHAF)
Dr Soumitra Burman-Roy, Specialist Registrar in the South London and Maudsley training scheme, London Deanery
Dr Bartlomiej Matras, Specialist Registrar in the St. Mary’s training scheme, London Deanery
There is extremely limited research on mental health disorder prevalence, availability of services and effectiveness of the services in the Maldives (1-4). A case study identified lack of training in the nation’s only in-patient setting for long term care of psychiatric patients at the Home for People with Special Needs, in the island of Guraidoo, Kaafu atoll (5).
In January 2015, the Mental Health Awareness Foundation (MHAF) was launched. This was the first and is the only non-governmental organisation in the Maldives addressing mental health.
The goals of MHAF are as follows:
- To bring awareness and promote the issues associated with mental health problems, the importance of good mental health and treating mental disorders.
- To work towards decreasing the stigma associated with mental illness in society with the aim to do this via Facebook, Twitter, and other social media, and media such as television and radio.
- To organise and provide training programmes to the existing and related human resources such as doctors, nurses, other health care workers and also non-health professionals in the country to improve their knowledge and expertise in mental health within their own related field.
In August 2015, the three authors delivered MHAF’s pilot training programmes. Mentoring and training for the authors for the first programme was provided by Dr Peter Hughes, based on World Health Organisation’s (WHO) Mental Health GAP Intervention Guide for neurological and substance use disorders in non-specialised health settings, published by the WHO, in September 2011.
This was formulated into MHAF’s Mental Health Training 1 programme as an intensive 6 days training for the participants, held between 23 and 29 August 2015, (with a 1 day break on 28 August). It was attended by 29 participants, both health professionals and non-health professionals, working in front line services and coming into contact with mental health patients and included; doctors, nurses and community health care workers, supervisors from the Home for People with Special Needs, the social workers from the Ministry of Gender and Law, civil officers at the Police victim support unit and other organisations.
The modules were carefully selected to fit into the cultural context after consultation with local healthcare professionals. The course had a pre-course assessment and was finished with a post-course assessment. Each module was also evaluated by the participants.
Course facilitators were overwhelmed by the participants’ enthusiasm and commitment to the training. On various sources of feedback, the participants expressed their opinion that the training was appropriate, valuable and much needed for the community.
Subsequently, the authors also provided a second training programme; "Training 2: Mental Health Awareness and Psychological First Aid Course", held over two days (30 and 31 August). This was a basic introduction to some of the main mental disorders, providing a basic and general awareness of some of the common mental disorders.
The course began with an anti-stigma workshop before proceeding to discuss psychological first aid; depression, suicide, psychosis, drug use and its disorders. The course was based on and referenced the following: WHO’s Psychological First Aid: Guide for Field workers, published by the WHO in 2011; Mental Health First Aid Australia. Depression: first aid guidelines. Melbourne: Mental Health First Aid Australia 2008; ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines WHO 1992; Mental Health GAP Intervention Guide for neurological and substance use disorders in non-specialised health settings, published by WHO in September 2011, and online resources available from:
- Here to Help
- Mend the Mind
- Walk in Our Shoes
- Here to Help - Stigma and discrimination around mental health and substance use problems
- Canadian Mental Health Association
This course was attended by 23 participants from non-healthcare backgrounds including those working in various charities in the Maldives, school teachers, counsellors and police officers. The feed-back by the second group of participants again described the training as one that was a required one for them to serve their community.
The training programmes’ value was also highlighted during the well received closing ceremony with attendees including the chief guest, Honourable Iruthisham Adam, the Minister of Health of the Maldives and Dr Arvind Mathur, WHO representative, both of whom praised the training programmes’ initiatives and MHAF. From the participants; Fathimath Neema, Civil Officer from the Maldivian Police Service’s Victim Support Unit gave a moving speech describing the potential benefit of the trainings for the country.
Overall, the training programmes were attended by 52 participants from 22 different organisations. We plan to publish the outcome measures from the courses as this is an important element to monitoring the effectiveness of MHAF’s pilot projects. MHAF wishes to hold annual trainings in the Maldives. It welcomes volunteer psychiatrists to continue this journey and sustain achieving the goals of MHAF.
MHAF website and social media links:
- World Health Organisation, A report of the assessment of the mental health system in Maldives using the World Health Organization- Assessment Instrument for Mental Health System (WHO-AIMS). WHO Library Cataloguing-in-publication data, 2006.
- World Health Organisation, Mental Health Atlas, Maldives, World Health Organisation, 2011.
- Niyaz H, Naz AA, Mental Health Situation in the Maldives, 2003.
- Human Rights Commission Maldives and United Nations Development Programme Activities addressing rights of persons with disabilities, A baseline assessment, 2010.
- Ali S, Case study on the services for mental health patients residing at the Home for People with Special Needs, Guraidhoo, Kaafu Atoll, Republic of the Maldives, MSc thesis, London School of Hygiene and Tropical Medicine and the Institute of Psychiatry, King's College London, 2013.