Integrating mental health into primary health care in fragile and conflict-affected settings

A scoping review of mhGAP effectiveness

Bibliographic Data

ID14618523
AuthorsMarcello Roriz de Queiroz (0000-0002-0603-0206, Università del Piemonte Orientale, Italy; Vrije Universiteit Brussel, Belgium), Elena Rubini (0000-0002-5802-2734, Università del Piemonte Orientale, Italy), Martina Valente (0000-0002-8599-2162, Università del Piemonte Orientale, Italy; Università del Piemonte Orientale, Italy), Ives Hubloue (0000-0002-4535-801X, Vrije Universiteit Brussel), Francesco della Corte (0000-0003-2436-8240, Università del Piemonte Orientale, Italy)
Year2025
Volume41
Issue9
Pagese00199224-e00199224
Publication date2025-01-01
Open AccessYes
TypeARTICLE
VenueCadernos de Saude Publica (JOURNAL)
Journal identifiersISSN: 0102-311X • E-ISSN: 1678-4464
PublisherFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311xen199224
PMID41059813
OpenAlexW4414785832
SciELOS0102-311X2025000900501
LanguageEN
Citations received3
References cited29

In 2008, the World Health Organization launched the Mental Health Gap Action Program (mhGAP) to scale up mental health care in non-specialized health care settings. Studies have demonstrated the benefits of mhGAP implementation while highlighting the need for better contextual adaptation and ongoing support. The challenge of integrating mental health into primary care is particularly noticeable in fragile and conflict-affected settings, where the need for such services is greater and health systems are often disrupted. A literature search was conducted on PubMed, PsycINFO, Scopus, and Web of Science to identify relevant peer-reviewed studies addressing the effectiveness of mhGAP in fragile and conflict-affected settings. Information was collected on study characteristics and design, impact of mhGAP, and main operational challenges. After full-text review, 10 articles met the inclusion criteria, reporting the impact of mhGAP on primary care personnel, on service user outcomes and in health systems. Studies reported post-training improvements in knowledge, mainly on epilepsy and psychosis. However, gaps remained in skills related to conducting mental state examinations, assessing suicide risk, and strengthening psychosocial support. The evidence was inconclusive regarding the impact of mhGAP on improving access to mental health care at the primary level. Several implementation challenges were identified, including an overemphasis on short-term knowledge transfer and the lack of structured supervision following mhGAP training

Action (physics) · Health care · Inclusion (mineral) · MEDLINE · Mental health · Psychosocial · Public health · Scale (ratio) · Emergency and Acute Care Studies · Mental Health Treatment and Access · Migration, Health and Trauma

Tools

Open DOIOpen Access