Tackling mental health is a major global health challenge. Nearly 75% of the 450 million people worldwide with a mental illness live in the developing world, and 85% of these people have no access to treatment. The social and economic costs are enormous.
Given the immense challenge that there exists when it comes to mental health, the SHM Foundation decided to look at how we could develop a low cost and sustainable solutions. Khuluma was launched in late 2013 in South Africa through clinics in Pretoria and Cape Town and was set up specifically to address the mental health and wellbeing needs of HIV positive adolescents.
The Khuluma model is an mHealth platform that provides an integrated, cost-effective and scalable solution to the growing challenge of mental ill health for chronic illness sufferers, currently in South Africa; where currently, over 15% of young women and 5% of young men aged 15-24 in South Africa are infected with HIV (UNAIDS, 2010).
The Khuluma platform leverages the power of small groups to facilitate interactive, closed support groups of 10 to 15 participants who have been diagnosed with a chronic illness. Currently live with 99 HIV positive adolescents, participants are able to communicate amongst themselves and with a facilitator and a mentor (an HIV positive adolescent who has been through Khuluma) via mobile phone about any topic that they deem important to discuss.
The model has been applied in the UK, Mexico and Guatemala with HIV positive pregnant women, new mothers and parents, and is now expanding into new populations, conditions and countries.
Accessible, where ever, whenever
Stigma and discrimination. Despite nation wide campaigns in South Africa many fear disclosing their chronic illness or HIV status and experience stigma and discrimination in the communities that they live in.
Finding the time to attend a support group. HIV positive adolescents can have complex lives, with regular visits to clinics and hospitals to pick up their medication and check ups along with attending school and fulfilling responsibilities at home.
Social Isolation. Support groups are tailored to them. If they are lucky enough to have access to a support group at their clinic or hospital the support groups tend to cover a wide age range making it challenging to bring up age appropriate topics.
Having the necessary funds such as transport costs available to attend.
The Khuluma model is a ‘digito-social approach’ to mental illness that brings together two concepts – the power of small support groups, and the power of mHealth – in an integrated platform. The model breaks down barriers through this integrated platform to make a support group that is accessible, immediate and age appropriate. The digito-social approach to mental illness leverages the ‘digital habitat’ of adolescents today to increase disclosure, medical adherence and collect quality data on mental illness.
Decreased levels of anxiety and depression
Increased perceived levels of social support
Decreased perceived levels of internalised stigma
Increased knowledge about their condition and how to access specific services