The University of the Free State (UFS) is the first university in South Africa and Africa to implement the MEGA mobile application in primary healthcare settings to improve access for children and adolescents to mental-health services and appropriate care in South Africa and Zambia.

The MEGA project is a three-year project that started in October 2017 and is part of a larger European Union-funded project to build capacity by implementing the World Health Organisation’s (WHO) Mental Health Gap Action Programme (mhGAP) mobile intervention in SADC countries.

According to Ronelle Jansen, Manager of the UFS team, the Mega consortium consists of an interprofessional team including registered professional nurses, psychiatrists, psychologists, IT specialists, a sociologist, researchers, and administrative specialists in project funding. 

The screening proses
The project involves primary healthcare professionals installing the app either on their phone or on a device, and the app then automatically generates a patient ID when the healthcare professional starts the screening process. 

Jansen says for screening, multiple-choice questions or closed questions are used with a ‘yes’ or ‘no’ answer, but some sections allow the primary healthcare professional to manually insert additional information if necessary. The mental-health screening modules assess the following conditions:  depression, anxiety, substance use, suicide and self-harm, trauma, and PTSD. 

The healthcare worker can ask for the screening results, and possible diagnoses will appear.  The primary healthcare professional must save and export data to a secure server.  

UFS’ team first to implement deliverables
The UFS team in the School of Nursing formed part of each work package and the deliverables set out in all nine work packages. They were the first university team to implement deliverables and were used as an example during feedback discussions. Team UFS hosted one face-to-face partner meeting in April 2018 and will also host the last face-to-face partner meeting in 2020 before the final dissemination conference.

The aim of the project is to improve child and adolescent mental-health services through early diagnosis and treatment by improving the skills and competencies of primary healthcare professionals with capacity building in mental-health education, says Jansen. 

“There is a high burden of mental-health disorders among adolescents, but limited access to mental healthcare. There is also a lack of knowledge about mental healthcare among workers in public healthcare settings. The Mega project hopes to improve the delivery of mental healthcare to adolescents by supporting and educating primary healthcare professionals through a mobile application. Also, by disseminating the results and outcomes to the National Departments of Health in both SA and Zambia,” says Jansen, who is currently working on her PhD.

According to her, Dr Mari Lahti and Dr Heikki Ellilä, Nursing lecturers from the Turku University of Applied Sciences (TUAS) in Finland, developed the proposal and applied for funding. Following the oral presentation for her master’s thesis at the 4th European Conference on Mental Health in 2016, they contacted her and asked if she was interested in joining their project. 

“They were very interested in my passion for mental health, as well as that of the UFS and South Africa. I had to negotiate this opportunity with my study promoter as well as with Prof Magda Mulder as Head of the School of Nursing, because I was busy writing the proposal for my PhD. I received the go-ahead from both, and a lot of support. It was the first time in the history of the School of Nursing that a staff member would be part of the Erasmus + programme’s international research arena.”  

The project is currently busy with its sixth work package (WP), which involves the implementation and evaluation of the app after the primary healthcare professionals have received training on the content and use of the app. The UFS was the first to start implementing the app in seven clinics and with eight nurses.   

Partners are important
Jansen says it is a tremendous honour and privilege to be part of an international mental-health project funded by the Erasmus + programme and the EU.

“I enjoy every moment of the project and am learning a lot. I have an excellent team that is dependable and experienced in their respective fields. For me, it is important to work with international partners from different settings and professions.

“The successful development and implementation of the app is very important. To try and make a difference in mental healthcare for our adolescent population and to support primary healthcare professionals.”

Partner institutions include the Turku University of Applied Science in Finland; Hamburg University of Applied Sciences in Germany; Riga Technical University in Latvia; the University of the Free State; Stellenbosch University; the University of Cape Town; the University of Pretoria; the University of Zambia; and Lusaka Apex Medical University in Zambia.