Implementation of the Mental Health Gap Action Programme (mhGAP) in Kosrae State in the Federated States of Micronesia

2021 ◽  
pp. 101053952110248
Author(s):  
Caitlin Engelhard ◽  
Sara Haack ◽  
Tholman Alik
Keyword(s):  
Mental Health ◽  
Community Health Center ◽  
World Health ◽  
Successful Implementation ◽  
Pacific Island ◽  
Federated States Of Micronesia ◽  
Significant Treatment ◽  
Health Gap ◽  
Action Programme ◽  
Pacific Island Countries

Improving access to mental health care is a global health priority, and a significant treatment gap exists in Pacific Island Countries. One strategy to bridge the gap is the World Health Organization’s Mental Health Gap Action Programme (mhGAP), which provides evidence-based guidance for managing mental, neurological, and substance abuse conditions. mhGAP has been implemented in more than 90 countries, but there has been limited training within many Pacific Island countries. We describe implementation of mhGAP training in Kosrae, a state within the Federated States of Micronesia. mhGAP training was conducted with 18 members of the Kosrae Community Health Center (KCHC). Our training model included 2 helpful modifications: (1) participants attended a combination of online sessions and a 1-week in-person training, which allowed for more time and flexibility in delivering training; and (2) longitudinal support posttraining, which has been identified as an important factor in successful implementation of mhGAP.

scholarly journals Contextualizing and pilot testing the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) to primary healthcare workers in Kilifi, Kenya

2020 ◽  
Vol 7 ◽  
Author(s):  
Mary A. Bitta ◽  
Symon M. Kariuki ◽  
Anisa Omar ◽  
Leonard Nasoro ◽  
Monica Njeri ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Healthcare ◽  
Implementation Process ◽  
Research Programme ◽  
Rank Test ◽  
Situational Analysis ◽  
Successful Implementation ◽  
Pilot Testing ◽  
Health Gap ◽  
Action Programme

Abstract Background Little data exists about the methodology of contextualizing version two of the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) in resource-poor settings. This paper describes the contextualisation and pilot testing of the guide in Kilifi, Kenya. Methods Contextualisation was conducted as a collaboration between the KEMRI-Wellcome Trust Research Programme (KWTRP) and Kilifi County Government's Department of Health (KCGH) between 2016 and 2018. It adapted a mixed-method design and involved a situational analysis, stakeholder engagement, local adaptation and pilot testing of the adapted guide. Qualitative data were analysed using content analysis to identify key facilitators and barriers to the implementation process. Pre- and post-training scores of the adapted guide were compared using the Wilcoxon signed-rank test. Results Human resource for mental health in Kilifi is strained with limited infrastructure and outdated legislation. Barriers to implementation included few specialists for referral, unreliable drug supply, difficulty in translating the guide to Kiswahili language, lack of clarity of the roles of KWTRP and KCGH in the implementation process and the unwillingness of the biomedical practitioners to collaborate with traditional health practitioners to enhance referrals to hospital. In the adaptation process, stakeholders recommended the exclusion of child and adolescent mental and behavioural problems, as well as dementia modules from the final version of the guide. Pilot testing of the adapted guide showed a significant improvement in the post-training scores: 66.3% (95% CI 62.4–70.8) v. 76.6% (95% CI 71.6–79.2) (p < 0.001). Conclusion The adapted mhGAP-IG version two can be used across coastal Kenya to train primary healthcare providers. However, successful implementation in Kilifi will require a review of new evidence on the burden of disease, improvements in the mental health system and sustained dialogue among stakeholders.

scholarly journals Mental health e-supervision for primary care doctors in Sudan using the WHO mhGAP Intervention Guide

2015 ◽  
Vol 12 (S1) ◽  
pp. S-16-S-19 ◽  
Author(s):  
Anne Aboaja ◽  
Puja Myles ◽  
Peter Hughes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Primary Care Doctors ◽  
Health Organization

This paper describes the evaluation of a pilot e-supervision programme, with a focus on feasibility. The findings suggest that e-supervision in mental health using the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide and case-based discussions is valued by participants and can improve the knowledge, confidence and beliefs of primary care doctors in low- and middle-income countries.

A Fallacy of the World Health Organization's Mental Health Gap Action Programme and Intervention Guide: Counseling and Psychotherapy Are Also (Western) Indigenous/Traditional Healing Methods

2020 ◽  
Vol 22 (1) ◽  
pp. 49-61
Author(s):  
Robinder P. Bedi ◽  
Mohit Bassi
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Global Mental Health ◽  
World Health ◽  
Middle Income ◽  
Western Countries ◽  
The World ◽  
Health Gap ◽  
Cultural Healing ◽  
Action Programme

This article will argue that, rather than being objective and universal treatment appro-aches, counseling and psychotherapy are indigenous/traditional (i.e., cultural) healing methods of the Euro-American West. Therefore, the World Health Organization's Mental Health Gap Action Programme (MHGAP), designed to provide increased access to reportedly highly effective Western mental health treatment services in many low- and middle-income countries, is likely to falter. It can be argued that culturally adapted counseling and psychotherapy will be most effective for individuals in non-Western countries who endorse or are somewhat acculturated to Western understandings and ways of living. Therefore, Western psychological interventions should not be at the forefront of the MHGAP in non-Western countries. Supportive evidence for this perspective is summarized and alternative approaches to promoting global mental health that draw on non-Western indigenous healing practices are presented.

scholarly journals The WHO mhGAP Intervention Guide for people with intellectual disability: the Sri Lankan experience

2015 ◽  
Vol 12 (S1) ◽  
pp. S-19-S-23
Author(s):  
Rohit Gumber ◽  
Shweta Gangavati ◽  
Sabyasachi Bhaumik ◽  
Sherva Cooray ◽  
Kiran Purandare ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Pilot Project ◽  
World Health ◽  
Sri Lankan ◽  
Treatment Gap ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

In recognition of the treatment gap in mental health, the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) was launched in 2008 and has proved successful. The paper describes the launch of the first mhGAP intellectual disabilities pilot project in Sri Lanka. It reports on the development of the materials and the key lessons learnt.

scholarly journals Evaluation of a mental health training project in the Republic of the Sudan using the Mental Health Gap Action Programme curriculum

2012 ◽  
Vol 9 (2) ◽  
pp. 43-45
Author(s):  
Sherese Ali ◽  
Khalid Saeed ◽  
Peter Hughes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Positive Impact ◽  
Field Tests ◽  
World Health ◽  
Mental Health Training ◽  
Middle Income ◽  
Health Gap ◽  
Action Programme

This paper reports on the training of primary care physicians in the family medicine programme at the University of Gezira, Sudan, using the World Health Organization's Mental Health Gap Action Programme Intervention Guide (mhGAP-IG). The training had a positive impact on their knowledge of and attitudes to mental disorder. More field tests of the mhGAP-IG would be useful to make further recommendations on its cultural relevance and its adaptation for use in low- and middle-income countries. Distance supervision of training of primary care physicians by internal facilitators is seen as critical for the sustainability of the intervention.

scholarly journals WHO Mental Health Gap Action Programme implementation in the Small Island Development States: experience from the Pacific and English-speaking Caribbean countries

2018 ◽  
Vol 15 (2) ◽  
pp. 27-30 ◽  
Author(s):  
Yutaro Setoya ◽  
Dévora Kestel
Keyword(s):  
Mental Health ◽  
World Health ◽  
Small Island ◽  
Close Monitoring ◽  
Mental Health Systems ◽  
Programme Implementation ◽  
Health Gap ◽  
Action Programme ◽  
English Speaking ◽  
Small Island Development States

Owing to the relatively small population sizes and remoteness of the Small Island Development States (SIDS), their mental health systems face many common difficulties. These include having few mental health specialists per country, limited access to mental health services and low awareness. To overcome these limitations, the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP), which aims to decrease the treatment gap by training non-specialists, was implemented in more than 20 Pacific and English-speaking Caribbean countries. Many lessons were learnt from the experience. Mental health specialist support is crucial, and online training and supervision could be a solution. mhGAP training proved to be effective to improve knowledge and attitude, but close monitoring and supervision are needed to change clinical practice. Awareness raising and mental health service capacity building need to occur simultaneously. To realise sustainable development goals, countries need to invest more in mental health, especially in human resources; mhGAP will be one effective solution.

scholarly journals Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations

2018 ◽  
Vol 5 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Wahid Melki ◽  
Imen Guesmi ◽  
...  
Keyword(s):  
Mental Health ◽  
World Health Organization ◽  
Mental Health Treatment ◽  
Training Programme ◽  
World Health ◽  
Adaptation Process ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

BackgroundIn order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0), developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia.MethodsThe phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations.ResultsThrough the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care.ConclusionsTargeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

scholarly journals Towards a more nuanced global mental health

2014 ◽  
Vol 204 (6) ◽  
pp. 415-417 ◽  
Author(s):  
Ross G. White ◽  
S. P. Sashidharan
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

SummaryThe World Health Organization has made concerted efforts to scale up mental health services in low- and middle-income countries through the Mental Health Gap Action Programme (mhGAP) initiative. However, an overreliance on scaling up services based on those used in high-income countries may risk causing more harm than good.

scholarly journals Manual operativo del mhGAP: Programa de acción para superar las brechas en salud mental (mhGAP)

2020 ◽  
Keyword(s):  
Mental Health ◽  
World Health Organization ◽  
World Health ◽  
Health Gap ◽  
El Sistema ◽  
Action Programme ◽  
Salud Mental ◽  
Version 2.0 ◽  
Health Organization

La OMS inició el Programa de acción mundial para superar las brechas en salud mental (mhGAP) para alcanzar las metas del plan y cerrar la significativa brecha existente en los servicios de salud mental. El mhGAP tiene como objetivo ampliar los servicios de salud mental en entornos de salud no especializados para lograr una cobertura de salud universal. Este manual operativo es un componente integral del paquete del mhGAP dirigido a brindar apoyo a los directores y gerentes de salud distritales y otros responsables de integrar los servicios de salud mental y física. El manual ofrece orientación práctica y herramientas necesarias para planificar, preparar, implementar, monitorear y evaluar el mhGAP. Se insta a los directores de salud distritales y otros interesados directos involucrados en la implementación del mhGAP a utilizar el manual como orientación práctica. Los contenidos se vinculan con los módulos de implementación de la versión 2.0 de la GI-mhGAP y comprenden tres etapas para abordar los requisitos y prioridades de los directores distritales de salud en diversos aspectos de la implementación: 1) planificar mediante la evaluación de los sistemas de salud y la organización de la implementación del mhGAP a nivel distrital; 2) preparar la implementación del mhGAP mediante el fortalecimiento de la capacidad del personal y la confirmación de que el sistema de salud está preparado para la integración de la salud mental en los servicios; y 3) proveer servicios para integrar el mhGAP en todos los niveles del sistema de salud, en los establecimientos y las comunidades. Versión oficial en español de la obra original en inglés: mhGAP operations manual: mental health Gap Action Programme (mhGAP). © World Health Organization 2018. ISBN 978-92-4-151481-1.

scholarly journals Mental Health Gap Action Programme training in Nigeria: reflections for progressive learning among primary care workers

2021 ◽  
pp. 1-3
Author(s):  
Alvina Ali ◽  
Nandini Chakraborty
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Knowledge Base ◽  
Mental Healthcare ◽  
World Health ◽  
Middle Income ◽  
Care Workers ◽  
The World ◽  
Health Gap ◽  
Action Programme

In the majority of low- and middle-income countries, mental healthcare is delivered by primary care workers. Often, they are the only contact for patients and their families. Although their knowledge base can be limited, they are expected to manage complex cases with few resources. The authors describe their experience of partnership with mental health centres set up by the Nigeria Health Care Project, and training their primary care workers based on the World Health Organization's Mental Health Gap Action Programme. Although the programme was very effective in helping to upskill their knowledge and experience, a need for continued professional development was highlighted. Based on their feedback, multiple evidence-based options are explored, including the use of remote learning and social media (increased significantly around the world because of the COVID-19 pandemic), to help primary care workers improve their knowledge base and maintain their competencies with the limited resources available.

Sign in / Sign up

Export Citation Format

Share Document