72. Youth Perspectives of Working with Near Peer Lay Counsellors: The Safe Haven Pilot

Youth living with HIV (YLWH) have higher rates of symptoms of common mental disorders when compared to youth living without HIV. Botswana has a severely limited mental health professional infrastructure especially for youth. The Friendship Bench intervention is an evidence-based task-shifting psychological intervention for common mental disorders that includes psychoeducation, problem solving therapy sessions (PST), and peer support groups. We adapted the Friendship Bench to create a psychoeducation and PST based, young adult lay counselor delivered program for YLWH called the Safe Haven intervention. The goal of this study is to examine the perspectives of youth who participated in Safe Haven to better understand the acceptability of the intervention as a youth friendly service. We conducted semi-structured interviews with English- or Setswana-speaking youth aged 13-25 years with mild to moderate symptoms of common mental disorders who were not already in treatment for mental health symptoms before participating in Safe Haven. Interviews were conducted in August 2020, and from June to August 2021. Of the 22 youth interviewed, there were 64% female and 36% male. All of the youth participants were born with HIV. They were interviewed after conducting between four and six sessions with lay counselors during a pilot of the Safe Haven intervention. Two independent coders carried out an inductive thematic analysis of the transcribed interviews with discrepancies discussed to consensus. Prior to attending counseling sessions, some of the youth had fears and reservations while others were open to receiving help. Yet, after attending the sessions, the youth felt the Safe Haven program was a place where they had freedom of expression and could receive practical advice from well-trained counselors. Interviewees felt their peer counselors were approachable and friendly. The counselors addressed their needs and instilled confidence in them. However, they wished some counselors were more punctual, held longer sessions, and could speak fluent English and Setswana and adopt a less formal engagement approach. Participants advised other youth seeking mental health treatment to take a non-judgmental stance when seeking support from near peer lay counselors. The Safe Haven intervention was seen as largely acceptable among YLWH who have mild and moderate symptoms of common mental disorders. Task-shifting from highly qualified mental health professionals to trained youth lay professionals could address the needs of adolescent and young adult populations where mental health professionals are in short supply. Larger studies that monitor implementation for sustainability are needed.