scholarly journals Evaluation of Mental Health Integration in Primary Health Care in View of Participants and Rural Health Workers of Dezful, Khuzestan

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Mohammad Hossein Khosrotaj ◽  
Mansour Zahiri ◽  
Sheyda Javadipoor ◽  
Seyyd Mahmood Latifi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Health ◽  
Health Workers ◽  
Primary Health ◽  
Mental Health Integration

scholarly journals Primary Health Worker's Perception on the Need of Integrating Mental Health in Primary Health Care Settings of Kaski District

2019 ◽  
Vol 9 (2) ◽  
pp. 48-52
Author(s):  
Arati Poudel ◽  
Bimala Bhatta
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Workers ◽  
Care Level ◽  
Health Care Settings ◽  
Primary Health ◽  
Mental Health Integration ◽  
Primary Health Care Settings

Introduction: The most effective way to close the treatment gap is to integrate mental health services with primary care to ensure that people receive mental health care they need in their place. Understanding providers' perceptions of evidence-based intervention have an undeniable role in improving their dissemination, implementation, and sustained use. Methods: This study was carried out to assess primary health workers' perception of the need of integrating mental health in primary health care settings in which 200 health workers from all the PHC, HP and UHC of the Kaski district were given a self-administered Likert scale having 5 points to assess the perception of health workers on need of integrating mental health in primary health care settings. The median score of Likert scale of perception of need was calculated then the chi square test was done to find the association which was followed by calculating adjusted odds ratio using binary logistic regression analysis. Results: Health workers who had gained information on mental health from course of study are 2.316 [CI:1.124-4.770] times more likely to perceive need of mental health integration into the primary health care setting and those who have provided mental health service are 2.801 [CI: 1.495-5.249] times more likely to be positive towards need. Conclusions: The majority of the health workers working at the primary health care level at Kaski district are positive towards mental health integration with the high number of health workers interested in receiving mental health training thus they should be provided with basic training in mental health to enhance their knowledge and skills for being able to provide mental health care to patients seeking help at the primary health care level.

Psychiatric Priorities in Developing Countries

1976 ◽  
Vol 128 (6) ◽  
pp. 513-522 ◽  
Author(s):  
R. Giel ◽  
T. W. Harding
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Developing Countries ◽  
Primary Health Care ◽  
Health Services ◽  
Health Workers ◽  
Limited Range ◽  
Primary Health ◽  
Wide Range ◽  
Health Action

SummaryMany psychiatrists assert that an expansion of mental health services in the developing countries is overdue. This will only take place if: (i) the tasks of mental health care are undertaken by a wide range of non-specialist health workers, including those responsible for primary health care; and (ii) services are directed initially at a very limited range of priority conditions. The method of priority selection is discussed, and the process required for translation of priority decisions into health action is exemplified by two illustrations.

scholarly journals Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Population Based ◽  
Ogun State ◽  
Primary Health

Introduction: Integration of mental health services into Primary Health Care (PHC) is a proven way of reducing the treatment gap in developing countries. A major constraint to scaling up mental health services in developing countries is scarcity of mental health professionals. A practical solution is to adopt task shifting and task sharing strategies involving Primary Health Care Workers (PHW). One of the major challenges of such integrative services is their long term outcomes and sustainability. The Neuropsychiatric Hospital Aro, Abeokuta, Nigeria embarked on mental health services provision across primary health care facilities in Ogun state six (6) years ago. Objective: This report describes the development, challenges of the programme and presents a post-implementation evaluation after 6 years of its commencement. Methods: Applying a population based expansion of pilot- tested integration model of Aro Primary Care Mental Health Programme (APCMHP) for Ogun State, 80 PHC workers were trained using an adapted mental health Gap Action Programme (mhGAP) intervention guide to assess and treat/refer 5 priority conditions: Psychosis, Depression, Epilepsy, Alcohol and Substance abuse and Other Significant Emotional Complaints (OSEC).There was mental health service provision in 40 designated PHC centers across Ogun state. There was support and supervision of the trained health workers by field supervisors, supplementary training and re-training for skill sustenance, periodic stakeholders meeting with Local Government Service Commission, zonal consultants’ review, financial and other resources commitment by the hospital, monthly programme evaluation and monitoring by the faculty members. We reviewed caseload of patients managed by trained PHC Workers since commencement of the programme in November 2011 till October 2017 (6 years period) using descriptive statistics. Appropriate ethical approval was obtained. Results: During the six-year period (November 2011-October 2017), 2194 cases (average of 366 new cases yearly) were identified and treated by Trained Health Workers (THWs). About 90% of cases were Psychosis and Epilepsy. There was a steady attrition of THWs and at the end of the sixth year only 29% of the THWs remained within the programme. Treatment outcomes were fair as over 50% of patients had ≥ 3 follow-up visits, symptom remission of ≥ 30% and a subjective improvement in Global Ratings. Conclusion: Our project has demonstrated that it is feasible, practicable and cost effective with community acceptance to scale up mental health services at primary care setting in Nigeria using adapted mhGAP-IG document. The need to understand the dynamics and econometrics of sustainable primary mental health services is indicated.

scholarly journals Perception of service users and their caregivers on primary care-based mental health services: a qualitative study in Nepal

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
N. P. Luitel ◽  
M. J. D. Jordans ◽  
P. Subba ◽  
I. H. Komproe
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Service Users ◽  
Care Providers ◽  
Primary Health

Abstract Background Integration of mental health services into primary health care systems has been advocated as a strategy to minimize the tremendous mental health treatment gap, particularly in low- and middle-income countries. Barriers to integration of mental health into primary health care have been widely documented; however, very little is known about the perception of service users and their caregivers on primary care-based mental health services. This study assessed service users’ and caregivers’ perceptions of mental health services provided by trained primary health care workers in Nepal. Methods A qualitative study was conducted among people with depression, psychosis, alcohol use disorder and epilepsy, and their caregivers in Chitwan, a district in southern Nepal. Semi-structured interviews were conducted with 43 service users and 38 caregivers to assess their perceptions about the accessibility of the services, types of services they received, skills and competencies of health care providers, satisfaction and barriers to receiving services. Results Overall, both service users and caregivers were satisfied with the mental health services provided by primary health care providers. They also perceived health workers to be competent and skillful because the services they received were effective in reducing their mental health problems. Both psychological and pharmacological services were made available free of cost, however, they considered psychological services more effective than pharmacological treatment. Major challenges and difficulties accessing services were associated with frequent transfer of trained health workers, non-availability of the same health care provider at follow-ups, frequent stock-out of medicines or non-availability of required medicines, lack of a confidential space for consultation in health facilities, and stigmatizing and negative behavior of some health workers. Conclusion The results demonstrated that both service users and caregivers perceived primary care-based mental health services to be accessible, acceptable and effective. The key recommendations emerging from this study for improving mental health services in primary care include the provision of a separate cadre of psychosocial workers to provide psychological interventions, developing quick and efficient mechanisms for the procurement and supply of psychotropic medicines, establishing a confidential place within health facilities for consultation, and further training of health workers to reduce stigma.

Disaster Management in Rural and Remote Primary Health Care: A Scoping Review

2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Disaster Management ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Disaster Preparedness ◽  
Rural And Remote ◽  
Primary Health

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.

scholarly journals Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Service Users ◽  
Traditional Health ◽  
Healthcare Needs ◽  
Primary Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

scholarly journals Social determinants of depression: association with age, gender and primary health care model

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J China
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Social Determinants ◽  
Care Physician ◽  
Health Policies ◽  
Age And Gender ◽  
Primary Health ◽  
And Gender ◽  
Primary Health Care Physician

Abstract Background Depression is one of the most common mental disorders worldwide and is a major contributor to the overall global burden of disease. The social determinants of age, gender and access to a primary health care physician have been identified as significant determinants of variability in the prevalence of depression. This research evaluates the association between depression and these social determinants in the city of Almada, in Portugal. Methods This cross-sectional study reports the one-month prevalence (December, 2015) of depression and its association with age, gender and access to a primary health care doctor in Almada's primary health care population. Data was collected from the 'Information System of the Regional Health Administration' (SIARS) database. The diagnostic tools used for the identification of cases were the ICPC-2 codes 'P76: Depressive Disorder' and 'P03: Feeling Depressed'. An odds ratio was applied as an association measure. Results Regarding gender and age: women are more likely to develop depression than men (OR 3.21) and the age group of 40-64 years is more likely to develop depression compared with other age groups (OR 2.21). The odds of being affected by depression for patients with a permanent primary health care physician, compared with users without a permanent primary health care physician, are higher (OR 2.24). Conclusions The patterns of association of age and gender, uncovered in this dataset, are consistent with previously reported findings for other Western countries. The association between depression and the assignment of a permanent primary health care doctor is highly significant. This finding suggests the existence of a higher detection rate of depression in patients with a permanent doctor and adds weight to the need to implement health policies that guarantee a primary health care physician for each patient. Key messages The age and gender gap in depression calls for stronger public health and intersectoral strategies to promote and protect mental health, in community-based settings. Reducing barriers and enhancing access to high-quality primary medical care must be a cornerstone of mental health policies.

Supporting Young People at School With High Mental Health Needs

2005 ◽  
Vol 15 (2) ◽  
pp. 137-155 ◽  
Author(s):  
Debra Rickwood
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Young People ◽  
School Environment ◽  
Health Care Services ◽  
Mental Health Problems ◽  
School Setting ◽  
Care Services ◽  
Primary Health

AbstractFor young people still at school, the school setting is vital to their mental health and wellbeing. Not only does the school environment have a direct and indirect impact on mental health, it provides an opportunistic setting in which to identify and respond to emerging mental health problems. To do this effectively, schools and school staff must work in collaboration with the young people themselves, their families, and other support services within the community, particularly primary health care services, including general practice. The importance of developing effective partnerships and care pathways between schools and the primary health care sector is being increasingly acknowledged, and initiatives such as MindMatters Plus GP have advanced our understanding in this area.

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