Challenges and Opportunities for Implementing Integrated Mental Health Care
A District Level Situation Analysis from Five Low- and Middle-Income Countries
Bibliographic Data
| ID | 23315809 |
|---|---|
| Authors | C Hanlon (0000-0002-7937-3226, King's College London, corresponding author), Nagendra P Luitel (0000-0002-8291-0205, NLR Nepal), Tasneem Kathree (0000-0002-8451-9197, University of KwaZulu-Natal), Vaibhav Murhar (0000-0002-1028-0363, Sangath), Sanjay Shrivasta (Sangath), Girmay Medhin (0000-0003-2146-4261, Addis Ababa University), Joshua Ssebunnya (0000-0002-6715-9265, Butabika Hospital), Abebaw Fekadu (0000-0003-2219-0952, Addis Ababa University), Rahul Shidhaye (0000-0001-9365-7164, Public Health Foundation of India), Inge Petersen (0000-0001-8057-8336, University of KwaZulu-Natal), Mark J D Jordans (0000-0001-5925-8039, HealthNet TPO), Mark Jordans (0000-0003-1901-1255), Fred Kigozi (Butabika Hospital), Graham Thornicroft (0000-0003-0662-0879, King's College London), Vikram Patel (0000-0003-1066-8584, London School of Hygiene & Tropical Medicine), Mark Tomlinson (0000-0001-5846-3444, University of Cape Town), Crick Lund (0000-0002-5159-8220, University of Cape Town), Erica Breuer (0000-0003-0952-6650, University of Cape Town), Mary De Silva (London School of Hygiene & Tropical Medicine), Martin Prince (0000-0003-1379-7146, King's College London) |
| Editors | Ali Montazeri (0000-0001-6826-8968) |
| Year | 2014 |
| Volume | 9 |
| Issue | 2 |
| Pages | e88437 |
| Publication date | 2014-02-18 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLoS ONE (JOURNAL) |
| Journal identifiers | ISSN: 1932-6203 • E-ISSN: 1932-6203 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pone.0088437 |
| PMID | 24558389 |
| OpenAlex | W2151272134 |
| Language | EN |
| Citations received | 69 |
| References cited | 31 |
BACKGROUND: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. METHODS: A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. RESULTS: The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. CONCLUSIONS: The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care.
Business · Context (archaeology) · Developing country · Economic growth · Environmental health · Geography · Health care · Mental health · Mental health literacy · Mental illness · Outreach · Poverty · Psychiatry · Public health · Service (business) · Service delivery framework · Family Caregiving in Mental Illness · Healthcare Systems and Reforms · Medicine · Mental Health Treatment and Access · Nursing
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| Unique citing works | 69 |
|---|---|
| Citations per year | 5,75 |
| Citation span | 2014 - 2026 (13) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 66 |