scholarly journals Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nagendra P. Luitel ◽  
Emily C. Garman ◽  
Mark J. D. Jordans ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Alcohol Use ◽  
Mental Health Care ◽  
Alcohol Use Disorder ◽  
Care Plan ◽  
Cross Sectional ◽  
Treatment Coverage ◽  
Health Care Plan

Abstract Background Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal. Methods The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N = 1983) and the follow-up (N = 1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire and Alcohol Use Disorder Identification Test were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE). Results The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. There was no significant reduction in the overall BACE score in both unadjusted and adjusted models for both depression and AUD. The possible reasons for non-significant changes in treatment coverage and barriers to care could be that (i) the method of repeat population level surveys with a random sample was too distal to the intervention to be able to register a change and (ii) the study was underpowered to detect such changes. Conclusion The study found non-significant trends for improvements in treatment coverage and barriers to mental health care following implementation of the district mental health care plan. The key areas for improvement in the current strategy to improve treatment coverage and barriers to mental health care included change in the content of the existing community sensitization program, particularly for changing attitude and intention of people with mental illness for seeking care.

scholarly journals Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal

2019 ◽  
Author(s):  
Nagendra Prasad Luitel ◽  
Emily C Garman ◽  
Mark JD Jord ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Alcohol Use ◽  
Mental Health Care ◽  
Alcohol Use Disorder ◽  
Care Plan ◽  
Cross Sectional ◽  
Treatment Coverage ◽  
Health Care Plan

Abstract Background: Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal. Methods: The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N=1983) and the follow-up (N=1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire and Alcohol Use Disorder Identification Test were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE). Results: The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. There was no significant reduction in the overall BACE score in both unadjusted and adjusted models for both depression and AUD. The possible reasons for non-significant changes in treatment coverage and barriers to care could be that (i) the method of repeat population level surveys with a random sample was too distal to the intervention to be able to register a change and (ii) the study was underpowered to detect such changes. Conclusion: The study found non-significant trends for improvements in treatment coverage and barriers to mental health care following implementation of the district mental health care plan. The key areas for improvement in the current strategy to improve treatment coverage and barriers to mental health care included change in the content of the existing community sensitization program, particularly for changing attitude and intention of people with mental illness for seeking care.

scholarly journals Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal

2019 ◽  
Author(s):  
Nagendra Prasad Luitel ◽  
Emily C Garman ◽  
Mark JD Jord ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Alcohol Use ◽  
Mental Health Care ◽  
Alcohol Use Disorder ◽  
Care Plan ◽  
Cross Sectional ◽  
Financial Barriers ◽  
Treatment Coverage

Abstract Background Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal. Methods The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N=1983) and the follow-up (N=1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT) were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE). Results The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. Significant reductions were found in the overall BACE score (p=0.004) and the specific BACE domains scores pertaining to financial barriers (p<0.001); stigma (p=0.004) and lack of support (p<0.001) among participants with depression. There was also a significant reduction between the baseline and follow-up in the overall BACE score (p=0.011) and the specific BACE domains scores pertaining to financial barriers (p<0.001) and lack of support (p<0.001) in the AUD group. Conclusion The study found a non-significant trend for improvements in treatment coverage but significant reductions in barriers to mental health care following implementation of the district mental health care plan. The possible areas for improvement in the current strategy to improve treatment coverage could include establishing a confidential place for consultation in each health facility, and targeted community awareness programs to sensitize community members about mental health problems and the availability of evidence-based treatment in primary and community health care systems.

scholarly journals Impact of a district mental health care plan on suicidality among patients with depression and alcohol use disorder in Nepal

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231158
Author(s):  
Luke R. Aldridge ◽  
Emily C. Garman ◽  
Nagendra P. Luitel ◽  
Mark J. D. Jordans
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Alcohol Use ◽  
Mental Health Care ◽  
Alcohol Use Disorder ◽  
Care Plan ◽  
Health Care Plan

Use of Psychiatric Emergency Services and Enrollment Status in a Public Managed Mental Health Care Plan

2001 ◽  
Vol 52 (11) ◽  
pp. 1494-1501 ◽  
Author(s):  
Dane Wingerson ◽  
Joan Russo ◽  
Richard Ries ◽  
Christos Dagadakis ◽  
Peter Roy-Byrne
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Emergency Services ◽  
Psychiatric Emergency ◽  
Care Plan ◽  
Psychiatric Emergency Services ◽  
Enrollment Status ◽  
Health Care Plan

scholarly journals Evaluation of the impacts of a district-level mental health care plan on contact coverage, detection and individual outcomes in rural Uganda: a mixed methods approach

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
J. E. M. Nakku ◽  
S. D. Rathod ◽  
E. C. Garman ◽  
J. Ssebunnya ◽  
S. Kangere ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Symptom Severity ◽  
Population Level ◽  
Care Plan ◽  
Health Care Plan ◽  
The Impact

Abstract Background The burden of mental disorders in low- and middle-income countries is large. Yet there is a major treatment gap for these disorders which can be reduced by integrating the care of mental disorders in primary care. Aim We aimed to evaluate the impact of a district mental health care plan (MHCP) on contact coverage for and detection of mental disorders, as well as impact on mental health symptom severity and individual functioning in rural Uganda. Results For adults who attended primary care facilities, there was an immediate positive effect of the MHCP on clinical detection at 3 months although this was not sustained at 12 months. Those who were treated in primary care experienced significant reductions in symptom severity and functional impairment over 12 months. There was negligible change in population-level contact coverage for depression and alcohol use disorder. Conclusion The study found that it is possible to integrate mental health care into primary care in rural Uganda. Treatment by trained primary care workers improves clinical and functioning outcomes for depression, psychosis and epilepsy. Challenges remain in accessing the men for care, sustaining the improvement in detection over time, and creating demand for services among those with presumed need.

scholarly journals Developing a mental health care plan in a low resource setting: the theory of change approach

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Maji Hailemariam ◽  
Abebaw Fekadu ◽  
Medhin Selamu ◽  
Atalay Alem ◽  
Girmay Medhin ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Theory Of Change ◽  
Care Plan ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Health Care Plan

scholarly journals Mental health care in Nepal: current situation and challenges for development of a district mental health care plan

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Nagendra P Luitel ◽  
Mark JD Jordans ◽  
Anup Adhikari ◽  
Nawaraj Upadhaya ◽  
Charlotte Hanlon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Current Situation ◽  
Care Plan ◽  
Health Care Plan

scholarly journals Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lindsey M. Filiatreau ◽  
Peter Vanes Ebasone ◽  
Anastase Dzudie ◽  
Rogers Ajeh ◽  
Brian Pence ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Health Care ◽  
Help Seeking ◽  
Alcohol Use Disorder ◽  
Hiv Care ◽  
Informal Networks ◽  
History Of

Abstract Background Mental health and substance use disorders (MSDs) increase the risk of poor human immunodeficiency virus (HIV) care outcomes among people living with HIV (PLWH). Receipt of mental health care may improve these adverse outcomes. We aimed to identify correlates of prior mental health help-seeking among PLWH with symptoms of an MSD in Cameroon. Methods We characterize prior mental health help-seeking from formal (mental health specialist/general medical provider) and informal (traditional healer/religious leader) sources among 161 people with symptoms of depression (Patient Health Questionnaire-9 scores> 9), anxiety (General Anxiety Disorder-7 scores> 9), probable post-traumatic stress disorder (PTSD Checklist for DSM-5 scores> 30), or possible alcohol use disorder (Alcohol Use Disorders Identification Test scores≥16) who were newly entering HIV care at three healthcare facilities in Cameroon between June 2019 and March 2020. Help-seeking was defined as ever speaking to a formal or informal source about emotional problems, sadness, or the way they were feeling or behaving. We estimated the association between sociodemographic and psychosocial measures and lifetime mental health help-seeking from each type of source using log-binomial regression. Results Overall, 55.3% of 161 PLWH with MSD symptoms reported prior mental health help-seeking, with 24.2% and 46.0% seeking help from formal and informal sources, respectively. Religious leaders were the most common source of help (40.4%), followed by general medical professionals (22.4%), traditional healers (16.8%), and mental health specialists (7.4%). Individuals with higher depressive, anxiety, and trauma symptom severity scores were more likely to have sought help than those with lower scores. Individuals with possible alcohol use disorder were the least likely to have sought help. Prior help-seeking was more common among those reporting a higher number of lifetime traumatic events (prevalence ratio [PR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11) and those with a history of emotional intimate partner violence (PR: 1.34; 95% CI: 1.01, 1.80). Conclusions Prior mental health help-seeking was associated with psychosocial stressors. Help-seeking from informal networks was more common than formal help-seeking. Training in the provision of evidence-based mental health support for informal networks could improve access to mental health care for PLWH with MSDs in Cameroon.

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