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Problem-based, peer-to-peer global mental health e-learning between the UK and Somaliland: a pilot study
  1. Roberta Murphy1,
  2. Elliot Clissold2,
  3. Roxanne C Keynejad1
  1. 1 South London and Maudsley NHS Foundation Trust, London, UK
  2. 2 St George’s, University of London, London, UK
  1. Correspondence to Dr Roberta Murphy, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK;{at}


Background WHO’s mental health gap action programme intervention guide (mhGAP-IG) is an evidence-based tool aimed at front-line health workers in low-income and middle-income countries (LMICs). Its potential to improve global mental health education, especially through digital technologies, has been little studied. Problem-based learning (PBL) is usually conducted face-to-face, but its remote application could facilitate cross-cultural education.

Objective To evaluate PBL, applied to peer-to-peer global mental health e-learning (Aqoon), using mhGAP-IG.

Methods Twelve pairs of UK and Somaliland medical students completed the full programme. Participants self-directedly met online, via the low-bandwidth Medicine Africa website, for PBL-style tutorials focused on modules of the mhGAP-IG, V.2.0. Preparticipation and postparticipation surveys used mixed methods to evaluate Aqoon, including the Attitudes Toward Psychiatry (ATP-30) instrument.

Findings Median ATP-30 scores for Somaliland (82.0 vs 95.0, p=0.003) and UK students (82.0 vs 95.0, p=0.011) improved significantly following Aqoon. Qualitative feedback showed that participants valued peer connectivity and learning about cultural and psychosocial differences in their partner’s country. Somaliland students were motivated by clinical learning and UK students by global health education. Feedback on the PBL structure was positive.

Conclusions Digital PBL represents an innovative method to extend the benefits of mhGAP-IG beyond front-line clinical staff, to healthcare students in LMICs.

Clinical implications Educational resource limitations in LMICs may be overcome using digital platforms and PBL. Replication with non-medical healthcare students is the next step for this model to explore Aqoon’s relevance to pressing global mental health workforce challenges.

  • global mental health
  • global health
  • psychiatry
  • e-learning
  • mhGAP
  • problem-based learning
  • e-medicine
  • peer education
  • attitudes to psychiatry
  • stigma

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  • Funding King’s Somaliland Partnership was formerly funded by Tropical Health and Education Trust (THET) and is now funded by a British Council SPHEIR grant. Aqoon receives no direct funding.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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