Mapping resources available for early identification and recovery-oriented intervention for people with psychosis in Addis Ababa, Ethiopia

Background There is a pressing need to reduce the long duration of untreated illness and improve care and outcomes for people with psychosis in Ethiopia. This study aimed to map community resources that have the potential to be leveraged to achieve earlier and more recovery-oriented interventions for people with psychosis in Addis Ababa, Ethiopia. Method A strength-based resource mapping exercise was undertaken in two sub-cities, covering an estimated population of half a million people. We identified the types of resources to be mapped, based on their importance for multi-sectoral care in mental health: healthcare facilities, religious organisations, traditional and faith healers, non-governmental organisations (NGOs), and social/community organisations. The lead investigator traversed the study sites to gather information on community resources, recorded the Global Positioning System (GPS) coordinates of the resources, and consulted with key informants. The information obtained was complemented by a participatory Theory of Change workshop attended by 30 stakeholders. Results We identified 124 health facilities, of which only 16 health centres and nine hospitals currently provide mental health services. We identified three registered traditional healers, 38 religious organisations, 104 non-governmental organisations, and other charitable/community-based organisations. In addition, three health facilities, six holy water religious healing sites, and four traditional healers were identified as out-of-site resources that were popular and frequently visited by people living in the sub-cities. The two sub-cities also had six feeding centres each providing meals for 1000 people in need. There were extensive networks of social organisations and community-based associations. Existing care pathways are complex but commonly include traditional and religious healing sites as places of first contact. Conclusions We identified important available resources that provide a wealth of opportunities for improving the early identification and outcomes of people with psychosis. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: We received ethical approval from the Institutional Review Board of the College of Health Science, Addis Ababa University (084/11/PSY) and Kings College London as part of a baseline situation appraisal. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable All relevant data are within the manuscript and its Supporting Information files.