StrongMinds: Treating Depression at Scale in Africa

StrongMinds implements an innovative, simple and cost efficient approach to treating impoverished African women who suffer from depression. Our model is based on group interpersonal psychotherapy (IPT-G) and is facilitated by lay community workers. IPT-G is a proven technique, supported by clinical trial success in Africa.

1. Our solution is to train lay community workers in IPT-G to become mental health facilitators who in turn run their own depression groups. This unique, structured model runs for over three months to help group members identify and manage their interpersonal difficulties, ultimately reducing their symptoms of depression. 

2. African women with depression who participate in our program experience marked reduction in their depression symptoms, with the vast majority of these women being considered depression-free when assessed using the PHQ-9 (Patient Health Questionnaire) depression diagnostic tool at the completion of therapy. They also form strong social bonds with 81% of groups continuing to meet when StrongMinds' formal facilitation ends. This continuation permits participants to reinforce the skills they have learned, building resilience and managing future depressive episodes. 

3. The World Health Organization estimates some 300 million people suffering from depression worldwide. Many of these people occur in low and middle income countries were mental health services are chronically under-resourced or not available. In just three years of field work, we have treated almost 10,000 women with depression. In the next three years, we will treat 100,000 African women with depression, demonstrating the potential for our model to be significantly scaled. We also continue to partner with new with existing non-governmental organizations who will be able to replicate our model both within Africa and abroad. 

There is a real potential for us to spread globally, both as an organization and through partnerships, and end the depression epidemic through our proven and effective program. 

Depression is the number one cause of disability worldwide. No where is that more clear than in Africa where approximately 100 million people suffer from  this disease. African women are afflicted at twice the rate of men. Due to a lack of investment in mental health services in Africa, 85% of Africans - including 66 million women - have no access to treatment. 

An African women with depression suffers greatly compared to her peers. She is less productive, has lower income and is in poorer physical health. If she is a mother, the negative impact extends to her entire family. 

We believe that the current depression epidemic for women in Africa is so urgent that we need an innovative and scalable solution to treat these sufferers. We also believe that IPT-G is the optimal solution to reduce current symptoms and prevent future depressive episodes. This is supported by our own research in which 70-80% of women are depression-free at completion of therapy and this is sustained at six months. 

Our model is supported by a Johns Hopkins/Columbia University randomized control trial that took place in Uganda in 2002 and demonstrated depression-free rates as high as 93% using IPT-G.

Our current impact measures show that 70-80% of participants are depression-free immediately post therapy and this is sustained at six months and two years later. 

Our solution currently benefits impoverished African women living in slums throughout urban and rural Uganda. It has the potential to benefit all people living with depression in low and middle income countries. 

Our solution is deployed through community mobilizations efforts where people suffering from depression are screened, diagnosed and then enrolled into therapy groups. Progress of these women is then tracked through an app-based solution provided by Medic Mobile. 

Measured through organizational record keeping - Number of women treated for depression

Collected on tablets using the Medic Mobile app and PHQ-9 depression diagnostic tool - % of participants that are depression-free immediately after therapy

Collected on tablets using the Medic Mobile app and the PHQ-9 depression diagnostic tool - % of participants that are depression-free six months after therapy

StrongMinds' model is innovative in that it trains lay community workers to become Mental Health Facilitators and run StrongMinds Therapy Groups using group interpersonal psychotherapy. 

We use electronic tablets to screen patients for depression using app-based depression diagnostic tools. We also use  technology to track baseline, midline and end-line depression scores for our participants so that we can monitor their progress and focus our treatment methods on them.  

StrongMinds is unique in that it is the only organization implementing a scalable solution to the depression epidemic in Africa. 

StrongMinds adopts a human-centered approach with our participants being the core of our program. Targeting the poorest women in Uganda, a low-income, post-conflict country, we are committed to ensuring they benefit from our program and live more full and prosperous lives, free from depression and its debilitating impact. 

We use technology to track each and every woman that participates in our program, ensuring that we properly identify their depression and track their progress during our therapy. We use technology to track participants at the completion of, and many months after therapy, supporting their long-term recovery.

Our program is deployed through community mobilization efforts. Mental Health Facilitators meet with community members and educate them about depression and depression symptoms. Participants are then screened for depression and, if depressed, enrolled into our StrongMinds Therapy Groups following a one-on-one meeting with their Mental Health Facilitator. 

There is no cost to women to participate in these therapy groups, and groups are facilitated within their local communities, making them easily accessible. We have delivered over 800 therapy groups in three regions in Uganda: Kampala, Mukono and Iganga. 

StrongMinds continues to secure funding from private foundations, individual donations and bilateral government grants. Since commencing operations in 2014 we have raised almost $3.9 million to research, pilot and grow our solution. We have over twenty foundation partners that currently fund our work and have received a bilateral grant from the Canadian Government.

From 2017-2019 we will raise a total $8.4 million to scale our program, reaching 100,000 African women with depression across two countries. We will further diversify our funding streams ensuring that high-net-worth individuals and bilateral grants each make up 20% of our total revenue, with the remaining 60% of financial support obtained from new and existing foundation partners. 

With 66 million women in Africa suffering from depression, securing the necessary financial support to reach these women remains a critical challenge. 

The Institute of Health Metrics & Evaluation at the University of Washington, report that only 0.3% of development assistance for health goes to the area of Mental Illnesses in low and middle income countries. The overall lack of investment in mental health means seeking the necessary financial support for our program remains an important challenge. 

In order for us to reach so many depressed women, we need to continue securing philanthropic support to fund our vital work.

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StrongMinds is committed to forming constructive, thoughtful partnerships to share resources, build upon our technological capacity and achieve our ambitious organizational goals. 

By being a Solver, we will have the opportunity to connect and partner with technology thought leaders and groups that will help us refine and grow our innovative solution to depression in Africa. 

Our current program partners include BRAC-Uganda, Medic Mobile, Global Development Incubator, the Ugandan Ministry of Health and mhNOW - a multi-stakeholder initiative led by international thought leaders and key organizations from the private, public, and philanthropic sectors.

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