History and publications
The history of the department of Mental Health
Mental Health has been part of the College of Medicine (COM) MBBS programme since the college was first established. Psychology teaching is integrated into the pre-clinical years and has been led for many years by Associate Professor Dr Chiwoza Bandawe.
Clinical psychiatry was taught in a short block in Year 4 by a single lecturer, but in 2006, the teaching of psychiatry at COM began to change. Dr Felix Kauye returned from WHO-funded specialist training in Cape Town to work in both Zomba Mental Hospital and COM. 2 overseas groups also started offering their support for the medical student teaching; psychiatrists from Vestfald Mental Health Trust, Norway, and others from Scotland.
The latter collaboration subsequently developed into the Scotland-Malawi Mental Health Education Project (SMMHEP). Volunteer psychiatrists from both Norway and Scotland have continued to support psychiatry teaching and curriculum development. SMMHEP has sent out over 100 psychiatrists and since 2007 has received total funding of approximately £1 million from the Scottish Government to support undergraduate and postgraduate training in psychiatry at COM.
2011 was another important year for mental health teaching at COM: the department became an independent Department of Mental Health including both psychology and psychiatry; psychiatry became a rotational teaching block, on a par with other clinical specialities; and a postgraduate MMed (psychiatry) programme was approved by the University.
The MMED In psychiatry programme is a collaboration with University of Cape Town. Trainees spend 2 years in Malawi to complete their general adult psychiatry training and complete a research project and dissertation and 2 years in South Africa to have subspecialty training.
The first three trainees are due to graduate in 2017, and a further four trainees will be recruited through the recently announced Psychiatry Capacity Development Programme, funded by the Scottish Government through SMMHEP.
The department staff support the clinical services in QECH and ZMH, the two sites where psychiatry teaching takes place, as well as providing an important service to COM students struggling with psychological problems.
The department has also become increasingly research active, and has established important international collaborations. Through the NIH-funded AFFIRM project, 3 students graduated from the MPhil in Public Mental Health from Cape Town/Stellenbosch Universities. COM is now part of the Wellcome Trust funded AMARI project (in collaboration with Universities of Cape Town, Addis Ababa and Harare).
Finally, for the last 6 years the department worked with SMMHEP to host the Annual Malawi Mental Health Research and Practice Development Conference that has provided a stimulating forum for the sharing of best practice in mental health with colleagues from other Malawian institutions as well as regional and international partners.
Publications (selection)
Stewart RC, Ashorn P, Umar E, Dewey KG, Ashorn U, Creed F, Rahman A, Tomenson, B, Prado EL, Maleta K (2016) The impact of maternal diet fortification with lipid-based nutrient supplements on postpartum depression in rural Malawi: a randomised-controlled trial. Maternal & Child Nutrition, Published online 5 March 2016.
Eaton J, Bouras N, Jones L, Hanlon C, Stewart R. & Patel V. (2015). Sustaining international careers: a peer group for psychiatrists working in global mental health. BJPsych International, 12, 1, 5-7.
Kelly CM, van Oosterhout JJ, Ngwalo C, Stewart RC, Benjamin L, Robertson KR, Khoo S, Allain TJ, Solomon T. (2014) HIV-Associated Neurocognitive Disorders (HAND) in Malawian Adults and Effect on Adherence to Combination Anti-Retroviral Therapy: A Cross Sectional Study. PLoS ONE 9(6):e98962.
Stewart RC, Umar E, Tomenson B, Creed F. (2014) Validation of the Multi-dimensional Scale of Perceived Social Support (MSPSS) and the relationship between social support, intimate partner violence and antenatal depression in Malawi. BMC Psychiatry. 14 (1):180
Stewart RC, Umar E, Gleadow-Ware S, Creed F, Bristow K. (2014) Perinatal distress and depression in Malawi: an exploratory qualitative study of stressors, supports and symptoms. Archives Women’s Mental Health. Published online 25 June 2014
Stewart RC, Umar E, Tomenson B, Creed F (2013) A cross-sectional study of antenatal depression and associated factors in Malawi. Archives Women’s Mental Health. Apr;17(2):145-54
Lommerse K, Stewart RC, Chilimba Q, et al. (2013) A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi. PLoS ONE 8:e72171 EP – doi:10.1371/journal.pone.0072171
Colman S, Stewart RC, MacArthur C, Kennedy N, Tomenson B, Creed F. (2013) Psychological distress in mothers of children admitted to a nutritional rehabilitation unit in Malawi – a comparison with other paediatric wards. Maternal Child Nutrition. Published online 14 Nov 2013. doi: 10.1111/mcn.12091
Stewart RC, Umar E, Tomenson B, Creed F (2013) Validation of screening tools for antenatal depression in Malawi – A comparison of the Edinburgh Postnatal Depression Scale and Self Reporting Questionnaire. Journal of Affective Disorders 150:1041–1047. doi: 10.1016/j.jad.2013.05.036
Richardson J, Masson N, Crabb J, Stewart R (2013) Introducing problem-based learning to Malawi. Medical Teacher 35:872. doi: 10.3109/0142159X.2013.786811
Udedi M, Swartz L, Stewart RC, Kauye F (2013) Health service utilization by patients with common mental disorder identified by the Self-reporting Questionnaire in a primary care setting in Zomba, Malawi: A descriptive study. International Journal of Social Psychiatry. Published online 1 August 2013 doi: 10.1177/0020764013495527
Crabb J, Stewart RC, Kokota D, Masson N, Chabunya S, & Krishnadas R. (2012) Attitudes towards mental illness in Malawi: a cross-sectional survey. BMC Public Health, 12, 541
Stewart RC, Bunn J, Vokhiwa M, Umar E, Kauye F, Tomenson B, Rahman A, Creed F (2011); A Prospective Study of Psychological Distress Amongst Mothers of Children Admitted to a Nutritional Rehabilitation Unit in Malawi, and its Impact on Post-discharge Child Weight Gain. Child:Care, Health and Development. 37(1):55-63
Stewart RC, Bunn J, Vokhiwa M, Umar E, Kauye F, Fitzgerald M, Tomenson B, Rahman A, Creed F (2010); Common Mental Disorder and Associated Factors Amongst Women With Young Infants in Rural Malawi. Social Psychiatry and Psychiatric Epidemiology, 45(5):551-9
Stewart RC, Kauye F, Umar E, Bunn J, Vokhiwa M, Fitzgerald M, Tomenson B, Rahman A, Creed F (2008); Validation of a Chichewa version of the Self-Reporting Questionnaire (SRQ) as a brief measure of Maternal Depressive Disorder in Malawi, Africa. Journal of Affective Disorders, 112, 126-34
Stewart RC, Umar E, Kauye F, Bunn J, Vokhiwa M, Fitzgerald M, Tomenson B, Rahman A, Creed F (2008); Maternal Common Mental Disorder and Infant Growth – A Cross-Sectional Study from Malawi. Maternal Child Nutrition, 4, 209-19
Baig BJ, Beaglehole A, Stewart RC, Platt J, Strachan J, Boeing L, Blackwood D, Leuvennick J, Kauye F. (2008) Assessment of an Undergraduate Psychiatry Course in an African Setting BMC Medical Education 8:23
Beaglehole A, Baig BJ, Stewart RC, Platt J, Strachan J, Kauye F, Boeing L, Leuvennick J (2008); Training in trans-cultural psychiatry and delivery of education in a developing country, 32: 111-112. Psychiatric Bulletin, Royal College of Psychiatrists Publishing.
Stewart, RC (2007); Maternal depression and infant growth: a review of recent evidence. Maternal Child Nutrition, 3, 94-107