Stakeholder Consensus on Strategies for Collaboration Between Traditional and Biomedical Mental Health Services in Post-Conflict Tigray, Ethiopia

Ongoing conflicts in sub-Saharan Africa negatively affect the population's mental health and weaken health care systems. Collaboration among stakeholders is recommended to strengthen mental health services in post-conflict settings, despite limited evidence on context-specific strategies. This paper aimed to identify strategies for collaboration between traditional and biomedical services to improve mental health care. An adapted nominal group technique was employed during a one-day stakeholder workshop. Fourteen participants representing traditional and biomedical mental health services discussed and prioritised strategies based on importance and feasibility to reach consensus. Five collaborative care strategies were prioritised based on stakeholder consensus regarding importance and feasibility: (1) collaborative learning, (2) formalising coordination, (3) capacity building, (4) joint intervention programs, and (5) regulatory support. Key mechanisms for implementing these strategies were also identified, including piloting integrated interventions, appointing a dedicated focal person to coordinate, providing basic psychosocial counselling skills, reducing harmful practices, and strengthening supportive supervision. Mutual learning was identified as a crucial cross-cutting component of all approaches. The conclusion was that implementing these prioritised strategies could improve mental health care. Further research is needed to evaluate the effectiveness of these strategies in enhancing collaborative care and improving mental health outcomes for individuals.