Integrating Psychotropic Medication Into the Care of People With Mental Disorders in a Prayer Camp in Ghana
Condition: Schizophrenia; Mood Disorders,; Anxiety Disorder
MeSH terms: Schizophrenia; Anxiety Disorders; Mental Disorders; Psychotic Disorders; Mood Disorders
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of this study is to evaluate a bundled intervention of psychotropic drugs and
      daily contact with a nurse for people with mental health disorders in a prayer camp and
      secondly to assess whether the attitudes of the prayer camp staff toward mental health
      disorders and conventional medicines remain the same after the intervention.
    

Detailed description: 
      The purpose of this study is to evaluate a bundled intervention of psychotropic drugs and
      daily contact with a nurse for people with mental health disorders in a prayer camp and
      secondly to assess whether the attitudes of the prayer camp staff toward mental health
      disorders and conventional medicines remain the same after the intervention.

      In the proposed study, residents of the sanatorium at the Mount Horeb Prayer Center located
      in Mamfe, Ghana will be screened for psychiatric disorders by a psychiatrist. Those who are
      diagnosed with a psychiatric disorder requiring treatment (schizophrenia, or mood disorder)
      and who meet the other inclusion criteria (see below) will be randomly assigned to receive a
      daily dose of the appropriate psychotropic drug (according to standard procedures of care) as
      well as regular prayer camp treatment (intervention group) or to receive only regular prayer
      camp treatment (control group). After randomization, the patients in the intervention group
      will receive the bundled treatment for 6 weeks, while control group patients will receive
      regular prayer camp treatment, e.g. encouragement to pray. Psychiatrists blinded to group
      assignments will assess outcomes over a 6 - 8 week period. Following this, patients will be
      referred for continued care with health care facilities as close to their homes as possible
      on discharge and if they so desire. At the start of the intervention, pastors and attendants
      at the prayer camp will be qualitatively assessed through a semi-structured interview
      concerning their attributions of mental illness causation. They will be assessed -0, -6 weeks
      after and again -12 weeks after intervention. The investigators hypothesize that patients who
      receive the bundled intervention will have improved mental health outcomes and functioning
      and that prayer camp staff will develop more positive attitudes toward conventional medicine
      and will begin to conceptualize mental health disorders as treatable illnesses, rather than
      only as a spiritual disorder. The results will provide empirical evidence for or against an
      integrated model of community based care which encompasses the medical and spiritual. This is
      the first intervention study in Sub-Saharan Africa to promote the use of psychotropic drugs
      in a traditional or spiritual healing setting. Its findings may inform the implementation of
      national policies governing collaboration between primary health care and faith healing
      centers, expanding access to and improving the quality of mental health care services.
    

Intervention name(s): olanzapine; risperidone; amitryptaline; fluoxetine
Intervention type(s): Drug; Drug; Drug; Drug
Intervention description(s): oral antipsychotic drug therapy; oral antipsychotic drug therapy; oral antidepressant drug therapy; oral drug therapy for depression
Other intervention name(s): Zyprexa; Risperdal; Elavil; Prozac
Intervention MeSH terms: Olanzapine; Risperidone; Fluoxetine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment