Scaling Up Addiction Services in Nigeria Using the Clergies and Clerics

Background 

The tendency for more people to receive psychiatric treatment from the clergy compared to psychiatrists or general practitioners has been reported in developed countries.1 Such a task-shifting approach can be useful in scaling up addiction services in Nigeria, where there is a high unmet need for the treatment of substance use disorders. 

Objectives

• ·         To modify the “Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members 3
• ·         To compare the modified version among Christian clergies and Islamic clerics. 

Method

This study was a two-stage mixed method, first was a Focus-Group Discussion (FGD) during which 1 item was modified and 1 added. During the quantitative segment, the modified version was administered to 64 Christian clergies and 64 Islamic clerics.

The sample size for the clergies and clerics was statistically determined. Both original and modified versions were administered.

The 25-item core competencies were rated on a Likert scale: 1 not at all, 2 a little bit, 3 somehow, 4 often, always. A mean score was generated for each item and compared between the two groups. 

Results

Mean scores were low in most of the items. There were religious differences in knowledge and attitudes except in five items (5,6, 22, 23, and 24). The Islamic clerics reported a higher mean score for “Be knowledgeable of the effects on the individual & family” p = 0.03, while Christian clerics reported a higher mean score for “Be knowledgeable of the characteristics of stages of recovery” p = 0.02.

The Islamic clerics also reported a higher mean score for “Have a general knowledge and if possible, exposure to other groups” p = 0.01, while the Christian clergies reported higher mean scores for “Be able to acknowledge and address values, issues, and other attitudes regarding AADD in oneself” and ” Be able to acknowledge and address values, issues, and other attitudes regarding AADD in one’s own family” p = 0.002 respectively. Both original and modified versions strongly correlated r = 1.0.

Conclusion

The “Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members” developed by the Substance Abuse and Mental Health Administration 3 is applicable for use in Nigeria. 

References

1.            Heseltine-Carp W, Hoskins M. Clergy as a frontline mental health service: a UK survey of medical practitioners and clergy. Gen Psychiatr. 2020;33(6):e100229.

2.          Substance Abuse and Mental Health Administration. Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members. 2003; https://www.samhsa.gov/sites/default/files/competency.pdf.