12 Health workers who had previously been trained by AMANI in detecting and managing psychological disorders identified patients. The criteria used for selection by these nurses were multiple vague complaints, frequent clinic or hospital visits, and an SRQ 8 score of 4 or more. The SRQ-8 is a short version of the Self-Reporting Questionnaire [SRQ-20], and has been previously validated for Zimbabwe18. Altogether eighteen patients were screened using the SRQ 8, and then referred to the AMANI therapist [EH]. All the referred patients were then further interviewed using the following instruments: • SRQ-20; • The Structured Assessment Form; • Genogram; • Self-rating scale. The SRQ-20 is a self-reporting questionnaire designed by The World Health Organisation as a prescriptive screening instrument for use in epidemiological studies of non-psychotic mental illness. This instrument has been widely used in Africa, including Zimbabwe19. Previous research has indicated that scores on the SRQ-20 in excess of 10/20 are indicative of clinically significant disorder. The Structured Assessment Form elicited socio- demographic, personal and family data as well as information about the economic status of the individual. The Structured Assessment Form was taken from a manual developed for primary care workers, which has been widely used by the AMANI Trust20. In particular, note was taken of the following: • • • • • • • Number of presenting symptoms; Number of interventions in the past six months; Number of referrals to the doctors and medications being taken; Presence of any family problems; Presence of marital problems; Presence of financial difficulties; Life events in the past six months prior to the interview. The Genogram is a method of representing family structure and process, which enables the therapist to identify possible family disturbance and the supportiveness of the patient’s family21. The Self-ratings used a simple 3-point scale (better, same, worse), all answered on a “yes-no” basis. The scale was scored from 3 (much worse) to 1 (much better). A very simple scale was used due to the nature of the client population, most of who have very little education and are not very psychologically sophisticated. 18 See Patel,V. & Todd.(1996) The validity of the Shona version of the Self Report Questionnaire and the development of the SRQ-8, International Journal of Methods in Psychiatric Research,, 6 , 153-160. 19 See Reeler AP, TODD CH (1995), An overview of psychological disorders and psychiatric services in Zimbabwe, in Y.Pillay & A Bhana (eds), "Proceedings of a Primary Mental Health Care Workshop", DURBAN: UNIVERSITY OF DURBAN-WESTVILLE. 20 See Reeler AP (1997), The Chiweshe Nurse-Counsellor Programme: Resource Manual (revised), HARARE:AMANI. 21 See Walrond-Skinner S. (1976), Family Therapy: The Treatment of Natural Systems. ROUTLEDGE & KEGAN PAUL: LONDON. Training nurses in the assessment and management of psychological disorders: Report of AMANI Trust’s programme in Mashonaland Central Province, Zimbabwe.