SUCCEED Africa: Support, Comprehensive Care and Empowerment of People With Psychosocial Disabilities

Summary

Although psychotic disorders typically affect less than 1% of the population, they are a significant cause of disability worldwide. Psychotic symptoms such as hallucinations, delusions and suicidal ideation can be profoundly disturbing, and negatively impact daily living. However, the social consequences of psychosis are often even more troubling than the symptoms. For example, people with psychosis have a high risk of experiencing violence, poverty, homelessness, incarceration, and unemployment, among other adverse outcomes.

There is a need for a range of accessible, appropriate interventions for people with psychosis to be delivered to those in the most vulnerable situations, including in low-resource settings in sub-Saharan Africa. A systematic review recently carried out as part of the formative research for SUCCEED identified 10 studies evaluating the impact of interventions for people with psychosis in Africa, most of which had a strongly clinical focus. The review concluded that there was a need for further research involving people with lived experience of psychosis in designing and evaluating holistic interventions that meet their diverse needs, within and beyond the health sector.

SUCCEED Africa is a six-year Health Research Programme Consortium (RPC) that has brought together people with lived experience of psychosis and people with professional experience (researchers, clinicians) from four African countries (Malawi, Nigeria, Sierra Leone, Zimbabwe) to co-produce a community-based intervention for psychosis, using a Theory of Change-driven approach. The SUCCEED intervention takes the World Health Organisation's (WHO's) CBR Matrix as a point of departure to consider the multifaceted needs of people living with psychosis and other psychosocial disabilities, and how best to meet these needs by mobilising the resources of individuals and families affected, as well as their broader communities.

This protocol describes a pilot study in which the SUCCEED intervention will be delivered and evaluated on a small scale, in preparation for a larger multi-country research evaluation using more rigorous methods, including randomised controlled trials in Nigeria and Zimbabwe and observational studies in Malawi and Sierra Leone, respectively. The main outcome of interest is change in subjective quality of life among participants with lived experience of psychosis who are offered the intervention over a four-month follow up period.

Conditions

• Schizophrenia
• Schizoaffective Disorder
• Schizotypal Disorder
• Acute and Transient Psychotic Disorder
• Delusional Disorder
• Other Specified or Unspecified Primary Psychotic Disorder
• Bipolar Type I Disorder With Psychotic Symptoms
• Bipolar Type II Disorder With Psychotic Symptoms
• Single Episode Depressive Disorder With Psychotic Symptoms
• Recurrent Depressive Disorder With Psychotic Symptoms
• Perinatal Mental or Behavioural Disorder With Psychotic Symptoms

Interventions

BEHAVIORAL

SUCCEED Community-Based Intervention

The main components of the intervention are peer support, case management and livelihoods activities, delivered by a peer support worker and a community support worker. The peer support worker has lived experience of psychosis and draws on a variety of manualised tools and techniques adapted from previous studies. The community support worker mobilises families and communities to activate resources in support of participants (e.g., education and employment, social and recreational activities), drawing on established models of mental health case management and community-based inclusive development. The peer support worker and community support worker also run self-help groups for people with lived experience and their family members, respectively. Self-help group meetings are also used as an opportunity for group livelihoods activities taking an "ABCD" (asset-based community development" approach.

Sponsors & Collaborators

• University of Ibadan

  collaborator OTHER

• University of Malawi

  collaborator OTHER

• University of Makeni

  collaborator UNKNOWN

• University of Zimbabwe

  collaborator OTHER

• Zimbabwe National Association for Mental Health (ZIMNAMH)

  collaborator UNKNOWN

• Mental Health Users and Carers Association (MeHUCA) Malawi

  collaborator UNKNOWN

• The Asido Foundation

  collaborator UNKNOWN

• Mental Health Coalition Sierra Leone

  collaborator UNKNOWN

• London School of Hygiene and Tropical Medicine

  lead OTHER

Principal Investigators

• Professor Thomas Shakespeare · London School of Hygiene and Tropical Medicine

Study Design

Allocation

NA

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-18

Primary Completion

2023-12-15

Completion

2024-01-31

Countries

• Malawi
• Nigeria
• Sierra Leone
• Zimbabwe

Study Locations