scholarly journals What did we learn from a pilot trial to inform the scale-up of training based on the Mental Health Gap Action Programme in Tunisia?

2021 ◽  
Author(s):  
Jessica Spagnolo ◽  
Fatma Charfi ◽  
Nesrine Bram ◽  
Leila Larbi Doghri ◽  
Wahid Melki
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Pilot Trial ◽  
Scale Up ◽  
Eastern Mediterranean Region ◽  
Training Programme ◽  
Lessons Learned ◽  
Health Gap ◽  
Action Programme

The Mental Health Gap Action Programme (mhGAP) Intervention Guide was developed to support evidence-based training offered to nonspecialists to further encourage the integration of mental health into primary care and community-based settings. This training programme was implemented in many countries of the Eastern Mediterranean Region (EMR). Tunisian primary care physicians were offered an mhGAP-based training programme as a pilot in 2016 and it was evaluated using an 18-month exploratory trial and implementation analysis. Pilot findings informed the scale-up of a mental health training programme that began in January 2020 by recommending amendments to mental health policy, informing training content, further operationalizing the National Strategy for Mental Health Promotion, and encouraging the sustainability of the training’s effects through a cascade model. Our lessons learned may be useful to other countries of the EMR, invested in furthering the training of primary care physicians/other nonspecialists, as well as the integration of mental health into primary care settings.

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 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 The influence of primary care physicians’ mental health knowledge, attitudes and self-efficacy on referrals to specialised services: findings from a longitudinal pilot trial

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Jessica Spagnolo ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche ◽  
François Champagne ◽  
Nicole Leduc ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Health Knowledge ◽  
Pilot Trial ◽  
Health Attitudes ◽  
Mental Health Knowledge

Background Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists’ mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown. Aims We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia. Method Participants included PCPs who completed questionnaires before (n = 112), immediately after (n = 88) and 18 months after (n = 59) training. Multivariable analyses with linear mixed models accounting for the correlation among participants were performed with the SAS version 9.4 PROC MIXED procedure. The significance level was α < 0.05. Results Data show a significant interaction between time and mental health attitudes on referrals to specialised mental health services per week. Higher scores on the attitude scale were associated with more referrals to specialised services before and 18 months after training, compared with immediately after training. Conclusion Findings indicate that, in parallel to mental health training, considering structural/organisational supports to bring about a sustainable change in the influence of PCPs’ mental health attitudes on referrals is important. Our results will inform the scale-up of an initiative to further integrate mental health into primary care settings across Tunisia, and potentially other countries with similar profiles interested in further developing task-sharing initiatives.

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.

Closing the Mental Health Gap for Primary Care Physicians in Pediatric Community Health Centers

2020 ◽  
Vol 112 (5) ◽  
pp. S41-S42
Author(s):  
Shawn Smith ◽  
Kristen Everett ◽  
Yolanda Lewis-Ragland ◽  
Theiline Gborkorquellie ◽  
Faith Kelley ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Community Health ◽  
Primary Care Physicians ◽  
Community Health Centers ◽  
Health Centers ◽  
Health Gap

scholarly journals A program to further integrate mental health into primary care: lessons learned from a pilot trial in Tunisia

2019 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Wahid Melki ◽  
Nesrine Bram ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Pilot Trial ◽  
Lessons Learned

scholarly journals A program to further integrate mental health into primary care: lessons learned from a pilot trial in Tunisia

2019 ◽  
Vol 3 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Wahid Melki ◽  
Nesrine Bram ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Pilot Trial ◽  
Lessons Learned

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.

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