Build a Mental Health Triage Tool for Lagos Community Health Workers

Nigeria has roughly 250 psychiatrists for a population of over 220 million. The treatment gap for mental health conditions sits above 90%. Meanwhile, community health extension workers are already embedded in primary health centres across Lagos State, doing home visits, managing antenatal registers, and triaging physical complaints. They are an untapped point of contact for people in distress. The problem is that CHEWs receive almost no mental health training and have no practical tool to guide them. If a community member shows signs of depression or psychosis during a home visit, the CHEW does not know what to ask, what it means, or where to send the person. Referral pathways exist on paper but break down in practice because of stigma, transport costs, and a lack of follow-through. Your task is to design a mental health triage and referral aid for CHEWs working in primary health centres in Lagos. The deliverable is a functional prototype, which could be a low-fidelity mobile screen flow, a laminated job aid card, or a simple USSD decision tree. It should cover: a short validated screening checklist adapted for low-literacy contexts, a three-tier response guide (manage here, refer to facility, refer urgently), and a list of realistic referral options within Lagos State. Good work will show that you have engaged with the actual constraints. That means no tool that requires reliable internet, no clinical jargon a CHEW would not understand, and no referral pathway that assumes the patient has money for a private hospital. Include a one-page rationale explaining your design choices and what you would test if you had two weeks and access to three CHEWs in Mushin or Alimosho.