A strong social support system can make all the difference in stress and hardship.

Psychological intervention programs like Problem Management Plus (PM+), developed by the WHO, recognize the critical role of community and relationships in helping individuals manage life's challenges.

MIDRIFT HURINET and DIGNITY use Problem Management Plus (PM+) to respond to the need for Mental Health and Psychosocial Support Services in areas of adversity with little or no access to mental health specialists.

PM+ is a simplified, focused non, specialized approach that can be provided by trained non-specialists (lay counselors) to help people with common Mental Health problems such as depression, anxiety, and stress.

By being trauma-informed, Problem Management Plus (PM +) is an approach that targets trauma-affected populations, including survivors of torture and violence.

It is a scalable community-based approach that can be adapted to fit the local context. It is part of the World Health Organization's Mental Health Gap Action Programme (mhGAP) forms.

At the intervention level, there are pre- and post-assessment forms and five PM+ sessions. To embrace technology, MIDRIFT HURINET has digitized the forms using the KOBO tool and secured tablets for the Supervisors and community health promoters, enabling efficiency and protecting sensitive data.

In October this year (2024), MIDRIFT HURINET facilitated a refresher course for two practicing groups; one has been in practice for over 1 year, and the other one, three months, trained on PM+ from Nakuru Town East, Nakuru Town West, and Naivasha Sub Counties, covering the intervention areas of Bondeni, Kaptembwa, and Karagita.

The training aimed to remind them of the strategies and what is important in PM+ and provide a knowledge-sharing experience since they come from different communities with different dynamics and contexts.

During the training, the PM+ Helpers shared how they have supported their peers after the training.

Nancy Wangari was challenged to comprehend some parts of the training since it was done in English.

"After our last training, I needed to fully understand some components since they were done in English.

During the training sessions, I was using the Kiswahili manuals.

Due to these dynamics, I was paired with Jane Wahu after the training.

We exchanged our contacts and planned how we would meet. She guided me through my difficulties and has been helpful and helpful when I have had difficulties.

Before supervision visits and when I met my clients, we went through what I was supposed to undertake. I can confidently attribute my success to her support.

I am now confident in handling my duties in PM+ without hesitation."

For her part, Jane Wahu says that it's important to assist a fellow PM+ helper since constant exposure to others' struggles without them getting help can reduce their ability to empathize effectively, deliver inconsistent or less effective assistance to clients, and improve their problem-solving and coping skills, which directly impacts their performance.

"When I was paired with Nancy, we journeyed together to ensure she delivered well to her clients. She also assists me in my interventions, as she has dynamics that were not reflected on my side," she added.

According to George Kungu, PM+ Supervisor from Nakuru Town West, regular check-ins with supervisors to discuss challenges and solutions, facilitating group discussions where helpers can share experiences and advice, offering refresher courses or specialized workshops and promoting breaks, counseling, and activities that reduce stress are some of the interventions that assist a helper who is having challenges in her duties.

He added, "I thank MIDRIFT HURINET for this PM+ training program.

Residents facing mental health issues in our communities have benefitted, and I have received positive feedback from the beneficiaries.

The Helpers trained by MIDRIFT HURINET have diligently performed their duties and cascaded the same information to their peers as they support each other.

They have also created safe spaces where they feel heard, understood, and valued and established informal peer support groups where they share their experiences and learn from one another.

They have empowered communities with skills and information to help others navigate stress and adversity. They have also normalized talking about emotions and mental health to reduce stigma.

They use culturally relevant strategies to make discussions comfortable and relatable and involve local organizations, faith-based groups, and volunteers to extend support networks.

This is geared towards helping individuals feel less isolated, enhance coping mechanisms, and foster a sense of hope and empowerment."

In the refresher course, the PM+ Helpers were also trained on:

1.     Aim of PM+ Basic Helping Skills

2.     PM+ and adversity

3.     Managing Stress and Problems

4.     Get going. Keep doing

Other helpers in the training also shared their experiences;

Esther Kibati (Nakuru West Sub County)

"The first training I got from Madam Gitte was impactful as a Community Health Promoter. It empowered me and has made me assist community members facing adversity and other challenges.

It has upgraded my intervention areas as cases are referred to me. I had challenges before, but I can assist community members better and confidently with this refresher training and peer and supervision support."

Moses Njenga (Nakuru West Sub County)

"After the first training, we were all happy with the new skills. Before that, I wanted to know what PM+ was and how it could help me and my community.

The training was intensive. I have been using the skills to assist my community, but it took work because it was a new concept different from PFA.

I got assistance from my supervisor and peers, but still, it felt like a heavy load.

This refresher has rejuvenated me, and I feel more energized to tackle challenges affecting my community members.

I understand the concepts much better and how to handle them.

Caroline Baraza (Nakuru Town East Sub County)

"I am thankful to MIDRIFT HURINET for the PM+ training. It has been challenging since it is a departure from the PFA training we had previously undertaken.

I received peer support from my colleagues and supervisor to keep me going.

Time has also been a factor for my clients, and we plan to meet. Still, other economic situations force us to reschedule.

The refresher course has been helpful, as it has addressed the factors that led to my not performing to the best of my ability."

Ezekiel Gitau (Nakuru Town East Sub County)

"I am thankful for this refresher training.

In the first ten days of training, I experienced some challenges because this was a new concept. Serving in the community was also challenging because of the new dynamics.

Through this refresher training, I have improved my understanding of the PM+ components, which will benefit my community members and me."

As finally shared by MIDRIFT HURINET, Youth psychologist Britney Marcella,

"As a young psychologist, PM+ has been an integral intervention since it tackles three major components of Mental Health that affect the Youth, i.e., stress, depression, and anxiety.

The strategies in PM+ help me categorize my problems, determine which ones are solvable, and decide which strategies to pursue if they are solvable.

PM+ is a practical method for Youth who are looking for direct solutions or solutions with immediate impact. It is very good because, although the whole intervention takes five weeks, the strategies are hands-on, and the results are almost immediate.

It provides a good base for encouragement and resilience."

By

Jacob Karani