Lumuno Mental Health Pilot Results

In 2023, DMI embarked on a new project to evaluate whether a radio campaign would be able to tackle an important yet poorly supported health area: mental health.

The burden of mental illness is high in many low- and middle-income countries (LMICs), and the availability of mental health services is low. In Zambia alone, there were fewer than 5 mental health professionals per 100,000 people in 2020, with no community based mental health facilities (WHO, 2020). DMI’s pilot mental health project Lumuno (meaning “peace” in Tonga) was developed to deliver and evaluate whether a radio campaign could improve mental health outcomes amongst peri-urban adults with common mental illness (CMI), specifically mild-to-moderate depression and anxiety. 

Funded by Unorthodox Philanthropy and DMI’s unrestricted funds, the project took place in the town of Mazabuka, in the Southern Province of Zambia. DMI worked with a Zambian psychiatrist, local mental health practitioners, community members and script writers to adapt the WHO’s Step-By-Step mental health intervention (WHO, 2024) from an online format to radio. The resulting 26 scripts were broadcast at saturation levels in Tonga and English languages for six months, in partnership with two local radio stations.  

The campaign promoted a combination of behavioural activation and improved giving and receiving of support. The six core messages were:  

1. Get support by reaching out to your social circle 
2. Give support by asking questions and listening 
3. Give support by encouraging social interaction 
4. Get started with activities you enjoy 
5. Breathing to manage stress  
6. Breathing and relaxation to calm the mind

The Lumuno campaign ended earlier this year, and we are pleased to share promising results from the pilot evaluation. The mixed-methods design allowed for a nuanced understanding of how the campaign was experienced by and impacted on listeners in Mazabuka. The primary quantitative outcomes were clinical measures of depression (PHQ-9) and anxiety (GAD-7). The qualitative analysis explored whether and how listeners understood, interpreted and actioned the Lumuno core messages.  

The findings show that a large majority (79%) of all participants had been exposed to the Lumuno campaign. Among those with CMI, there was a highly significant 19.7% reduction in average depression score (effect size -0.65, p<0.001) over the campaign period. Moreover, 41% of those who had moderate or moderately severe depression at the start of the campaign achieved a clinically significant reduction in depression by the end. Furthermore, just over half (54%) of those with moderate anxiety at the start of the campaign showed a clinically significant improvement in anxiety at the end.  

The pilot nature of this project means that the evaluation did not include a control group, therefore these changes cannot be attributed solely to the Lumuno campaign. However, the findings show promising indication of impact, further supported by statements from key interviews with listeners from the qualitative evaluation: 

“I reached out to a friend about a problem I was going through. He gave me a lot of sound advice. I was amazed that he knew so much regarding mental health issues, so I asked him where he learnt it from. He told me that he had been listening to some spots on radio that talk about dealing with stress, and other mental health issues. It was then that I also started listening to the spots and have been able to use the breathing exercise whenever I feel anxious just to calm myself. I also like to play soccer with my friends as a way to interact with friends and not spend too much time alone when I am stressed.” (male participant, aged 18). 

The Lumuno radio campaign was a feasible, culturally adapted and relatively low-cost mental health intervention. A self-help radio campaign such as this could realistically be delivered at scale in populations that have extremely limited access to mental health services, thus closing the gap in accessible mental health services found in many LMICs. Given the findings from this evaluation, we are encouraged to use the experience gained in this pilot to design and continue our work on mental health in Zambia and elsewhere.