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 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.

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 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.

scholarly journals The potential of low-intensity and online interventions for depression in low- and middle-income countries

2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech
Keyword(s):  
Mental Health ◽  
World Health ◽  
Online Interventions ◽  
Treatment Protocols ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Intensity ◽  
The World ◽  
Health Gap ◽  
Low And Middle Income

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.

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 Drop out from out-patient mental healthcare in the World Health Organization's World Menta Health Survey initiative

2013 ◽  
Vol 202 (1) ◽  
pp. 42-49 ◽  
Author(s):  
J. Elisabeth Wells ◽  
Mark Oakley Browne ◽  
Sergio Aguilar-Gaxiola ◽  
Ali Al-Hamzawi ◽  
Jordi Alonso ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
Income Group ◽  
Drop Out ◽  
World Health ◽  
Health Treatment ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World

BackgroundPrevious community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.AimsTo explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.MethodRepresentative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.ResultsOverall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/ lower/middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.ConclusionsDrop out needs to be reduced to ensure effective treatment.

scholarly journals Cultural psychiatry, diversity and political correctness in a shrinking world

2008 ◽  
Vol 5 (2) ◽  
pp. 27-28 ◽  
Author(s):  
John L. Cox
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Low Income ◽  
Global Mental Health ◽  
World Health ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).

scholarly journals Effective Treatment Interventions for Global Mental Health: An Analysis of Biomedical and Psychosocial Approaches in Use Today

2020 ◽  
Vol 4 (3) ◽  
pp. 01-14
Author(s):  
Michael Galvin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Treatment ◽  
Health Workers ◽  
Global Mental Health ◽  
Psychosocial Treatment ◽  
Middle Income ◽  
Public Health Workers ◽  
The Right ◽  
Psychosocial Approaches

We are in an important moment for mental health treatment around the world, as many Low and Middle Income Countries (LMICs) – representing an increasing majority of the world’s population – are currently developing and scaling up services for the first time. Yet, research on Global Mental Health (GMH) best practices remains scattered and difficult to synthesize. This review aims to simplify existing GMH research on effective biomedical and psychosocial treatment approaches from both high-income countries and LMICs to enable a more comprehensive understanding of the benefits and drawbacks of existing interventions, based on the highest quality, up-to-date research. By understanding which treatments are most effective and why, we can begin to not only implement more effective practices, but guide the future of GMH research in the right directions. The purpose of this review is therefore to understand mental illness, what it is, how it was treated in the past, how it manifests differently around the globe, and how to best treat it. Ultimately, while psychosocial approaches are advised for patients with more mild to moderate disorders, medications and other biomedical approaches are recommended increasingly only for more severe cases. While significant evidence exists to justify the use of psychotropic medications for mental illness, their adverse effects indicate that psychosocial approaches should be prioritized as first line treatments, particularly for mild to moderate disorders. As one of the first to analyze this research, this review is useful not only for GMH scholars, but for practitioners and public health workers globally, as well.

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