Community psychiatry in Mozambique – a transcultural journey

Abstract

Historically the psychiatric clinical practice in Mozambique evolved from an eminently reclusive care setting (colonial period) to a phase where the patients were rapidly deinstitutionalized into their communities (post-independence years). In 1990, in order to restructure the mental health care network, the National Mental Health Plan was approved. Its main goal was to promote a semi-open treatment setting, activating the community role in the rehabilitation and social reintegration of the psychiatric patient. To cope with the scarcity of human resources, a three-year technical degree was created, training medical technicians in psychiatry. Presently, there are two specialized psychiatric hospitals, one in Maputo and another in Nampula. Through the description of our 3-month community psychiatry internship in Mozambique, we intend to depict the country's mental health care reality. Our internship took place in Sao Joao de Deus Mental Health Centre, the psychiatric hospital located in Nampula, which is responsible for the country's northern region. Besides offering in-patient and ambulatory treatment, it also aims to intervene at a community level. We will address the hospital's community intervention project, the developed activities, the most commonly observed pathologies, the cross-cultural relevant aspects, as well as the challenges we had to face in a harsh environment. As one would expect, the social and medical realities we encountered were quite different from the ones we are used to, forcing us to adapt constantly in order to surpass challenges of a multiple nature. Nonetheless, these were also the circumstances that turned this experience into something unique, extremely enriching and certainly unrepeatable.