Phase II

Basic Package of oral care for mental health patients

Key Facts

Period August 2022- Ongoing
Phase 2 Key partners Ministry of Health and Child Care, Ingutsheni Hospital, Zimbabwe Dental Association, Non-profit organisations: Zero Water Day Partnership, Drum for Community Development, Pamumvuri PVO, University of Zimbabwe Partnership for Education Training and Research Advancement (PETRA), Merken Investments Pvt Ltd
Phase 2 Goals
Health service provider focused:
  1. To train mental health professionals in the management of oral and maxillofacial conditions amongst persons living with mental health conditions
  2. To assess improvement in the management of oral and maxillofacial conditions amongst persons living with mental health conditions following training.
  3. To determine barriers to provision of oral and maxillofacial care to persons living with mental conditions
  4. To evaluate the training content in the recently launched Manual on Oral health of mental health patients in Zimbabwe
Patient focused:
  1. Reduction of the oral disease burden in mental health patients
  2. Render oral health treatment and service for marginalized mental health patients.
  3. Improving access of oral health services by mental health patients.
  4. Raising community awareness on oral health effects of drug and substance abuse.
Our Approach
  • WHO AFRO Region Basic package of oral care: Fluoride toothpaste, oral urgent treatment, Atraumatic Restorative Technique
  • Interprofessional education & communication and the shift to less invasive and environmentally friendly dentistry
  • WHO Essential Oral medicines (Silver Diamine Fluoride and Fluoride toothpaste) in oral and mental health clinics
  • Social determinants of health in mental health patients and their communities
Targeted beneficiaries Ministry of Health and Child Care, Ingutsheni Mental Hospital (largest referral mental health facility in Southern Africa region); 20 000 indirect beneficiaries -families, communities and caregivers of patients with mental health conditions via improved quality of life.
Funder Funded by Partnership for Education Training and Research Advancement (PETRA) Mentorship Research Scholars Program in Dissemination and Implementation Science Training.

Background

In research conducted in 2021-2022 through the Oral health for mental health patients project on the knowledge, attitudes, and practices of Mental health professionals in Zimbabwe it became apparent that these attributes were either average or below average to address the oral disease burden. The mental health professionals expressed an urgent need for training on how to provide oral care to persons living with mental health conditions, as well as drug and substance abusers.

The project team members share a vision of improving healthcare for disadvantaged groups. We intend to join the rest of the world in supporting the 2021 World Health Assembly oral health resolution.

Mental health patients are a disadvantaged group that must be advocated for due to their predisposition to oral health conditions which result from incapacitation, oral health side effects of most psychiatric drugs. These include periodontitis, dental caries, xerostomia (dry mouth), oral ulcers, drooling and so on. Ideally, mental health professionals should be able to provide oral care, recognize oral conditions and refer to oral health professionals, where necessary. They however have not been equipped to do so in Zimbabwe, we are proposing doing so through Dental Outreach programmes and health communications media campaigns for mental health patients.

The project is an intervention that improves the oral care provided to persons living with mental health conditions in mental and oral health facilities, whilst using community engagement for information dissemination. The project is unique in its multidisciplinary approach uniting health experts, media professionals and community leads. This makes use of existing resources, in a low resource setting of an African Country, Zimbabwe with the added benefit of civil society organisations, health professionals and academics working together on common interests and increasing local and international collaboration.

Project Outline
    • Training and Calibration of oral and mental health professionals for outreach programs and health referral pathways in Bulawayo and Matabeleland Provinces
    • Pilot Dental Outreaches: Outreach sites are:
      1. Ingutsheni Hospital-targeting 800-900 institutionalized, admitted and day patients.
      2. Ngozi Mine Squatter Camp-targeting approximately 300 drug and substance abusers living in this area.
      3. Media content Creation of health information for dissemination to health professionals, families, caregivers and communities that live with or render any to mental health patients and substance abusers.
      4. Followup management and Referrals after the outreach’s patients requiring follow-up treatment and management will be managed by supporting oral health personnel proceed to Bulawayo Government Dental Centre and Mpilo Hospital
      5. Provide support for Ingutsheni Dental Unit for in-hospital basic oral care of institutionalized mental health patients
       

Phase II 2023 Achievements so far:

Capacitation of mental health professionals

Capacitation of mental health professionals in the country with best oral health and hygiene practices for the benefit of mental health patients, and deliver basic dental services to improve oral health services accessibility through:

  • Training of trainers’ workshop for provincial oral and mental health professionals Harare PETRA Conference room-26 May. 20 attendees
  • 29 May 2023-oral health workshop for 27 mental health professionals at Ingutsheni Hospital Bulawayo
  • 20 September 2023-oral health workshop for 32 mental health professionals at Ingutsheni Hospital Bulawayo
Oral health workshop for mental health professionals at Ingutsheni Hospital Bulawayo

3. Information dissemination

ZBC News Coverage
Oral disease burden assessment

30 May - 2 June 2023 Dental screening of all stable admitted mental health patients at Ingutsheni Hospital (approximately 800). Collaboration of Zimbabwe Dental Association Bulawayo Branch and Ingutsheni Hospital Ministry of Health and Child Care.
Community Stakeholder Engagement:

The Bulawayo Community Networking forum for disadvantaged/neglected mental health patients and substance abusers.
Project featured in WHO UNEP GEF7 phasing down dental amalgam project 28 April, WHO Headquarters, Geneva Global Project Kick-off meeting proceedings.
Project Conference presentation at Africa Health Ex Conference 6-8 June 2023