The purpose of this exploratory study was to improve screening for depression and stigma among youth living with HIV in Swaziland, to introduce evidence-based psychotherapy and train local professionals in this therapy and to explore the feasibility of providing telemental health services.
Design: TTUHSC students and faculty screened adolescents with the PHQ-9A and the Stigma by Association scale with a SiSwati translator. The HIV clinic and local resources were analyzed for implementing telemental health. TFCBT training was provided by a TFCBT trainer from the university with the clinic director arranging for the location, resources and attendees.
Outcomes: Twenty-three (66%) of 35 adolescents screened had PHQ-9A scores indicating mild to severe depression while nine (25.7%) reported having frequent suicidal ideation. Stigmatization related to HIV status was reported by 98.89% (89) of the 90 adolescents completing the Stigma by Association scale. The 20 mental health professionals receiving training indicated they would implement TFCBT and attend monthly telephone consultations. The WHO director indicated a desire to expand the training to other health professionals and other countries. The feasibility of providing telemental health services is limited due to a lack of translators and follow-through by clinic staff in preparation for testing feasibility.
Implications: The need and opportunity exist to improve adolescent mental health in Swaziland through expanding TFCBT training to other health care workers, streamlining screening tool use through the EHR, implementing telemental health and introducing evidence-base interventions for depression and stigma reduction. experienced by adolescents living with HIV in Swaziland.