University of Houston: Project Examines Mental Health Care Training in South Africa

It is almost impossible to imagine the long-term psychological problems faced by the over 16 million orphans and vulnerable children in the global society, difficult to conceptualize their sense of loss and sadness. One thing, however, is universally understood: Sensitive and responsive caregiving leads to positive outcomes, both intellectually and on a social and emotional basis, for all children.

For that reason, University of Houston professor of psychology Carla Sharp, with collaborators at the University of the Free State in South Africa and Michigan State University, is embarking on a five-year study to evaluate the effectiveness of the Mediational Intervention for Sensitizing Caregivers (MISC). The intervention gives caregivers the confidence to lift the socioemotional and cognitive skills of children in their care, according to Sharp.

The work is underwritten by a $1.7 million grant from the National Institute of Mental Health and will take place in South Africa where there are between 2-4 million orphans and a crisis in scarcity of mental health workers.

The objective of MISC is to turn out mentally healthy, intelligent and socially competent children and is based on a process that experts call the ‘serve and return.’ But instead of bouncing a tennis ball back and forth, caregivers and children interact in ways that promote learning, communication and closeness. MISC is based on the idea of understanding that there are interactions between adults and children that create learning moments that give meaning to their experience. The program also reminds caregivers that not all children develop at the same pace or at the same time. And that’s okay.

“MISC integrates aspects of socio-emotional health and cognitive development as well as being culturally sensitive,” said Sharp, whose previous work showed that MISC training significantly reduced mental health problems in orphaned and vulnerable children who speak Sesotho, one of the 11 official languages in South Africa.

Building on this work, Sharp will test the real-world effectiveness, beginning a clinical trial to fully establish the effectiveness of MISC in community-based organizations (CBO) with caregivers who take care orphans and vulnerable children between the ages of 7 and 11, a developmental stage critical for building mental health resilience against the adolescent onset of psychiatric problems.

Sharp’s team will work with 24 community-based organizations to recruit 360 children and 72 care workers in the Mangaung and Xhariep districts in the Free State province of South Africa.

“We hypothesize that MISC-CBO will be associated with comparative increases in care worker caregiving quality and reductions in mental health problems in children,” said Sharp. “Our work also will test cost-effectiveness and implementation readiness of MISC-CBO during the critical developmental window of at-risk children aging into adolescence, consistent with the strategic objectives of the National Institute of Mental Health.”