Apart from suicide and filicide, the findings of this study are similar to those performed in other countries. It is recommended that parents' psychological issues be managed concurrently when providing services for their children. There is also a need to develop psychosocial training interventions to address the needs of the parents of these children.

BackgroundChildren with intellectual disabilities are common and are increasing in number as more children survive globally. In stark contrast to the 1–3% prevalence of intellectual disability in children globally (reported by WHO), studies from Malawi provide alarmingly high rates (26%). We know that the prevalence of psychological distress is as high as 50% in parents of children with intellectual disabilities in Europe and the US. No such studies have yet been conducted in Africa. This study is aimed at determining the prevalence and risk factors for psychological distress among parents of intellectually disabled children in Malawi.MethodsThis quantitative cross-sectional study was conducted in January and February 2015. One hundred and seventy mothers and fathers of children with intellectual disabilities as diagnosed by psychiatric clinical officers were randomly sampled from two selected child disability clinics. The Self-Reporting Questionnaire (SRQ) was used “as measure for psychological distress and questions on socio-demographic variables were administered to all consenting participants.” Data was coded, cleaned and analyzed using STATA.Results70/170 (41.2%) of parents of children with intellectual disabilities reported psychological distress. Univariate and multivariate analysis showed that area of residence (P < 0.05), low socio-economic status (P < 0.05), knowledge of the disability of one’s child (P < 0.05), low confidence in managing the disabled child (P < 0.05), increased perceived burden of care (P = 0.05), and having no sources for psychological support (P < 0.05) significantly predicted psychological distress among the parents for children with disabilities.ConclusionThere is huge burden of psychological distress among parents of intellectually disabled children in Malawi. Psychosocial interventions are urgently needed to support parents of children with intellectual disability in Malawi.

In this study, it has been found that help-seeking is influenced by the understanding of the source of the illness - which has a bio-psychosocial inclination. The socio-cultural explanation of witchcraft and spirit possession is dominant and a determinant of help-seeking behaviour. While participants noted benefits to hospital treatment, barriers and bio-psychosocial in nature were also noted. Guardians and not clients hold the key to choice of treatment modality and therefore a potential ally in all treatment interventions promotive, preventive and curative. There is need for strengthening of a bio-psychosocial intervention model in the treatment of mental illness.

BackgroundThe burden of intellectual disabilities in low and middle income countries (LMIC) is high and is associated with parental psychological distress. There are few services for children and parents in most developing countries and few interventions have been created that target the psychological issues among parents of such children. This study aimed to develop a contextualized intervention to provide psychological support for parents of children with intellectual disabilities in an African setting.MethodsSix steps were adopted from the Medical Research Council framework for designing complex interventions. This include: literature review of similar interventions and models, qualitative studies to gain insights of lived experiences of parents of such children, a consensus process with an expert panel of professionals working with children with disabilities and piloting and pre-testing the draft intervention for its acceptability and practicability in this settings.Results21 intervention modules were found from a systematic search of the literature which were listed for possible use in our intervention along with four themes from our qualitative studies. An expert panel formed consensus on the eight most pertinent and relevant modules for our setting. This formed the intervention; “Titukulane.” This intervention was piloted and found to have high acceptability and practicability when contextualized in the field.ConclusionThe use of a systematic framework for designing a complex intervention for supporting the mental health of parents of children with disabilities enables good acceptability and practicability for future use in low resource settings.

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