Decentralized psychiatric nursing service in Ethiopia--a model for low income countries

Mental health services in low income countries are inadequate. Health care delivery services in these countries are mainly focused on vector-borne diseases and HIV/AIDS. To make the situation worse, trained health workers are leaving developing countries for higher paying jobs elsewhere; this "brain drain" is robbing countries of their energetic and highly trained manpower. In response to this dire situation, Ethiopia started a psychiatric nursing training program where by nurses are trained and assigned to different parts of the country as mental health workers. Their activities range from prescribing psychiatric and anti epileptic drugs to counselling and teaching the local community about early identification and prevention of mental and behavioural disorders. While decentralization of mental services started twenty years ago and has played a major role in promoting mental health in the country, more needs to be done to retain existing staff and attract more mental health workers to the field. This paper examines the services provided by psychiatric nurses throughout the country. It attempts to evaluate strengths and weaknesses of the program and suggest recommendations which might be helpful for similar programs in low-income countries where highly trained mental health professionals are a luxury.