title: Mental Health Care for Vulnerable People With Complex Needs in Low-Income Countries: Two Services in West Africa.
abstract: People with severe and enduring mental illnesses, such as schizophrenia, are among the most disabled, socially excluded, and underserved populations, especially in low- and middle-income countries. Some programs have been created to target this group. The current global development agenda emphasizes the need to provide care to vulnerable groups. This column compares two long-standing and successful programs for homeless people with mental illness in three West African countries--Nigeria, Côte d'Ivoire, and Bénin. The authors describe essential ingredients of these programs and their integration into existing systems, including funding and other resources, leadership models, and staff. The success of these programs provides support for initiatives to scale up services for people with severely disabling and complex needs, even as the focus is increasingly on cost-effectiveness of mental health integration into decentralized health services.
authors.affiliation: Dr. Eaton is with CBM International in Lomé, Togo, and London School of Hygiene and Tropical Medicine (e-mail: julian.eaton@cbm.org ). Dr. Des Roches is with the Département de Médecine de Famille et Médecine d'Urgence, Université de Montréal, Montreal, Canada, and Association St. Camille de Lellis, Cotonou, Bénin Republic. Very Rev. Nwaubani is with Amaudo Itumbauzo, Abia State, Nigeria. Dr. Winters is with the Department of Child Mental Health, Whittington Hospital, London. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Julian
authors.initials: J
authors.lastname: Eaton
authors.affiliation: Dr. Eaton is with CBM International in Lomé, Togo, and London School of Hygiene and Tropical Medicine (e-mail: julian.eaton@cbm.org ). Dr. Des Roches is with the Département de Médecine de Famille et Médecine d'Urgence, Université de Montréal, Montreal, Canada, and Association St. Camille de Lellis, Cotonou, Bénin Republic. Very Rev. Nwaubani is with Amaudo Itumbauzo, Abia State, Nigeria. Dr. Winters is with the Department of Child Mental Health, Whittington Hospital, London. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Benoît
authors.initials: B
authors.lastname: Des Roches
authors.affiliation: Dr. Eaton is with CBM International in Lomé, Togo, and London School of Hygiene and Tropical Medicine (e-mail: julian.eaton@cbm.org ). Dr. Des Roches is with the Département de Médecine de Famille et Médecine d'Urgence, Université de Montréal, Montreal, Canada, and Association St. Camille de Lellis, Cotonou, Bénin Republic. Very Rev. Nwaubani is with Amaudo Itumbauzo, Abia State, Nigeria. Dr. Winters is with the Department of Child Mental Health, Whittington Hospital, London. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nwaubani
authors.affiliation: Dr. Eaton is with CBM International in Lomé, Togo, and London School of Hygiene and Tropical Medicine (e-mail: julian.eaton@cbm.org ). Dr. Des Roches is with the Département de Médecine de Famille et Médecine d'Urgence, Université de Montréal, Montreal, Canada, and Association St. Camille de Lellis, Cotonou, Bénin Republic. Very Rev. Nwaubani is with Amaudo Itumbauzo, Abia State, Nigeria. Dr. Winters is with the Department of Child Mental Health, Whittington Hospital, London. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.
authors.forename: Lopa
authors.initials: L
authors.lastname: Winters
mesh_terms: D001541:Benin; D007560:Cote d'Ivoire; D003906:Developing Countries; D006703:Ill-Housed Persons / Q000523:psychology; D006801:Humans; D008507:Medically Underserved Area; D001523:Mental Disorders / Q000191:economics*; D008605:Mental Health Services / Q000592:standards*; D009549:Nigeria; D011203:Poverty; D015397:Program Evaluation / Q000592:standards*; D035862:Vulnerable Populations / Q000523:psychology*