The Advocacy Project (Beta)

Contributors

Prof Christopher Dowrick MD FRCGP
Immediate Past Chair, WONCA Working Party on Mental Health

Dr Sankha Randenikumara MBBS MCGP
Immediate Past Young Doctors' Lead, WONCA

Dr Marilena Anastasaki MSc PhD
Public Health and Epidemiology Researcher, Department of Social Medicine, School of Medicine, University of Crete, Greece

Ms Emma Gilchrist MPH
Deputy Director, Farley Health Policy Center, University of Colorado, USA

Project Overview

The Advocacy project, conceived by the WONCA Working Party for Mental Health and the Farley Health Policy Center, aims to enable young family physicians to inspire, lead, and advocate for the integration of mental health services into their local practices.

After an Open Call, scholars were selected with the support of WONCA Young Doctors' Movement. Eight young doctors (six women and two men) from the Bahamas, Brazil, China, Ghana, Kenya, Mexico, Pakistan, and the Philippines participated as scholars in the second Advocacy Project (2023-2024). Building on the strengths of our previous project, we boosted mentorship and included two past scholars as Faculty members.

Course Format

The course included monthly online sessions between August 2023 and May 2024. These sessions focused on:

• Introduction to behavioural health integration and practice transformation
• Leadership
• Team-based care
• SWOT analysis and measuring and monitoring change
• Burnout, resilience, and compassion
• Advocacy and stigma
• Scholars' project presentations, reflections, and celebration

Scholars undertook individual projects, supported by monthly meetings with a mentor in a triad. The projects focused on:

• Screening for anxiety and depression among adolescents and providing group psychotherapy
• Engaging women in behavioural health promotion and prevention activities
• Reducing the abuse of sleeping pills
• Early diagnosis and psycho-education for depression in patients with diabetes mellitus
• Increasing awareness of stress and anxiety and offering group mindfulness sessions
• Creating a mental health program for hospital employees
• Integrating mental health into care for non-communicable diseases through screening and providing information and education
• Increasing the access and utilisation of mental health services within the community, improving mental health outcomes, and reducing stigma

Evaluation

The program was evaluated by an external researcher during and at the end of the process. Evaluation was performed through individual open-ended questionnaires and focus group discussions. The key messages are summarised below:

• Scholars would recommend the program to their colleagues as it provides valuable knowledge, tools, and networking opportunities.
• Mentors and the mentoring triad were highly valued by all scholars, particularly due to the personal bond fostered by mentors who exhibited interest and care for their mentees' mental health and provided support for professional growth beyond the program.
• Scholars mentioned that the course empowered them to take action beyond clinical work and boosted their confidence, especially in approaching their higher-ups regarding mental health integration.
• Scholars reported that they were inspired by learning about experiences from around the world shared by their peers and mentors. This helped them realise the importance of mental health advocacy and how it can improve the services they provide to their patients.

Conclusions

• We now have a cohort of 20 international scholars with experience and confidence in transforming practice.
• These scholars provide excellent evidence and resources to inform the scale-up of the program, with support from WONCA Executive and resources from major donors.