Skip to main content Accessibility help
×
Home

The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

  • Leonardo Cubillos (a1) (a2), Sophia M. Bartels (a1), William C. Torrey (a1) (a2) (a3), John Naslund (a4), José Miguel Uribe-Restrepo (a5), Chelsea Gaviola (a1), Sergio Castro Díaz (a6), Deepak T. John (a1), Makeda J. Williams (a7), Magda Cepeda (a6), Carlos Gómez-Restrepo (a5) (a6) and Lisa A. Marsch (a1) (a2) (a3)...

Abstract

Aims and method

This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.

Results

Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.

Clinical implications

Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence to Leonardo Cubillos (leonardo.cubillos@dartmouth.edu)

References

Hide All
1World Health Organization (WHO). Depression and Other Common Mental Disorders Global Health Estimates. WHO, 2017 (http://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=F8EA4E7FFF9B38B407D395EF9DEE295E?sequence=1).
2World Health Organization (WHO). Global Status Report on Alcohol and Health 2014. WHO, 2014 (https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?ua=1).
3Ferrari, AJ, Charlson, FJ, Norman, RE, Patten, SB, Freedman, G, Murray, CJL, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med 2013; 10(11): e1001547.
4Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013; 382(9904): 1575–86.
5Uribe, JM, Pinto, DM, Vecino-Ortiz, AI, Gómez-Restrepo, C, Rondón, MP. Absenteeism, and lost work productivity among depressive patients from five cities of Colombia. Value Heal Reg Issues 2017; 14: 15–9.
6Thavorncharoensap, M, Teerawattananon, Y, Yothasamut, J, Lertpitakpong, C, Thitiboonsuwan, K, Neramitpitagkul, P, et al. The economic costs of alcohol consumption in Thailand, 2006. BMC Public Health 2010; 10(1): 323.
7Kessler, RC. The costs of depression. Psychiatr Clin North Am 2012; 35(1): 114.
8Patel, V, Maj, M, Flisher, AJ, De Silva, MJ, Koschorke, M, Prince, M, et al. Reducing the treatment gap for mental disorders: a WPA survey. World Psychiatry 2010; 9(3): 169–76.
9Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, Gasquet, I, Kovess, V, Lepine, JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004; 291(21): 2581.
10Degenhardt, L, Glantz, M, Evans-Lacko, S, Sadikova, E, Sampson, N, Thornicroft, G, et al. Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. World Psychiatry 2017; 16(3): 299307.
11World Health Organization (WHO). Mental Health Atlas 2017 Country Profiles. WHO, 2017 (https://www.who.int/mental_health/evidence/atlas/profiles-2017/en/).
12Bruckner, TA, Scheffler, RM, Shen, G, Yoon, J, Chisholm, D, Morris, J, et al. The mental health workforce gap in low- and middle-income countries: a needs-based approach. Bull World Health Organ 2011; 89(3): 184–94.
13Saxena, S, Thornicroft, G, Knapp, M, Whiteford, H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet 2007; 370(9590): 878–89.
14Lancet Global Mental Health Group, Chisholm, D, Flisher, AJ, Lund, C, Patel, V, Saxena, S, et al. Scale up services for mental disorders: a call for action. Lancet 2007; 370(9594): 1241–52.
15Kaner, EFS, Beyer, FR, Muirhead, C, Campbell, F, Pienaar, ED, Bertholet, N, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2018; 2: CD004148.
16Butler, M, Robert Kane, ML, McAlpine, D, Kathol, RG, Fu, SS, Hildi Hagedorn, M, et al. Integration of Mental Health/Substance Abuse and Primary Care: Evidence Report/Technology Assessment, No. 173. Agency for Healthcare Research and Quality, 2008 (https://www.ahrq.gov/downloads/pub/evidence/pdf/mhsapc/mhsapc.pdf).
17Archer, J, Bower, P, Gilbody, S, Lovell, K, Richards, D, Gask, L, et al. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev 2012; 10: CD006525.
18Substance Abuse and Mental Health Services Administration (SAMSHA). A Standard Framework for Levels of Integrated Healthcare and Update throughout the Document. SAMSHA, 2013 (https://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdf).
19Tice, JA, Daniel, F, Ollendorf, A, Reed, SJ, Shore, KK, Weissberg, J. Integrating Behavioral Health into Primary Care. A Technology Assessment. Institute for Clinical and Economic Review, 2015 (https://collections.nlm.nih.gov/master/borndig/101679435/Integrating%20Behavioral%20Health%20into%20Primary%20Care.pdf).
20World Health Organization (WHO). Task Shifting: Global Recommendations and Guidelines HIV/AIDS. WHO, 2008 (https://www.who.int/healthsystems/TTR-TaskShifting.pdf?ua=1).
21World Health Organization (WHO). Integrating Mental Health into Primary Care. WHO, 2008 (https://www.who.int/mental_health/resources/mentalhealth_PHC_2008.pdf).
22World Health Organization (WHO). MhGAP Intervention Guide Version 2.0 for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings. WHO, 2016 (https://www.who.int/publications-detail/mhgap-intervention-guide---version-2.0).
23van Ginneken, N, Tharyan, P, Lewin, S, Rao, GN, Meera, SM, Pian, J, et al. Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries. Cochrane Database Syst Rev 2013; 11: CD009149.
24Seidman, G, Atun, R. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Hum Resour Health 2017; 15(1): 29.
25Drummond, M. Methods for the Economic Evaluation of Health Care Programmes (4th ed.). Oxford University Press, 2015.
26National Institute of Mental Health (NIMH). Scaling Up Mental Health Interventions in Latin America. NIMH, 2019 (https://www.nimh.nih.gov/about/organization/cgmhr/scaleuphubs/scaling-up-mental-health-interventions-in-latin-america.shtml).
27Moher, D, Schulz, KF, Altman, DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 2001; 357(9263): 1191–4.
28World Bank. World Bank Country and Lending Groups. World Bank, 2019 (https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups).
29World Health Organization (WHO). A Vision for Primary Health Care in the 21st Century: Towards Universal Health Coverage and the Sustainable Development Goals. WHO, 2018 (https://www.who.int/docs/default-source/primary-health/vision.pdf).
30Higgins, JPT, Green, S. Cochrane Handbook for Systematic Reviews of Interventions – Cochrane Training. Cochrane, 2011 (https://training.cochrane.org/handbook).
31The Joint Comission. The Joint Commission Accreditation Standards. The Joint Commission, 2018 (https://e-dition.jcinc.com/maincontent.aspx).
32World Health Organization (WHO). World Health Statistics 2018. WHO, 2018 (https://apps.who.int/iris/bitstream/handle/10665/272596/9789241565585-eng.pdf?ua=1).
33Jenkins, R, Othieno, C, Okeyo, S, Kaseje, D, Aruwa, J, Oyugi, H, et al. Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial. Int J Ment Health Syst 2013; 7(1): 25.
34Lima, AFBdS, Fleck, MPdA. Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care. Rev Bras Psiquiatr 2011; 33(3): 245–51.
35Fairall, LR, Folb, N, Timmerman, V, Lombard, C, Steyn, K, Bachmann, MO, et al. Educational outreach with an integrated clinical tool for nurse-led non-communicable chronic disease management in primary care in South Africa: a pragmatic cluster randomised controlled trial. PLoS Med 2016; 13: e1002178.
36Rojas, MG, Castro, A, Guajardo, V, Alvarado, R, Isamit, C, Fritsch, R. Programa colaborativo a distancia para el tratamiento de la enfermedad depresiva. Rev Med Chil 2014; 142(9): 1142–9.
37Patel, V, Weiss, HA, Chowdhary, N, Naik, S, Pednekar, S, Chatterjee, S, et al. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet 2010; 376(9758): 2086–95.
38Pradeep, J, Isaacs, A, Shanbag, D, Selvan, S, Srinivasan, K. Enhanced care by community health workers in improving treatment adherence to antidepressant medication in rural women with major depression. Indian J Med Res 2014; 139(2): 236–45.
39Malakouti, SK, Nojomi, M, Ahmadkhaniha, HR, Hosseini, M, Yekeh Fallah, M, Mirzaei Khoshalani, M. Integration of suicide prevention program into primary health care network: a field clinical trial in Iran. Med J Islam Repub Iran 2015; 29: 208.
40Husain, N, Chaudhry, N, Fatima, B, Husain, M, Amin, R, Chaudhry, IB, et al. Antidepressant and group psychosocial treatment for depression: a rater blind exploratory RCT from a low income country. Behav Cogn Psychother 2014; 42(6): 693705.
41Noknoy, S, Rangsin, R, Saengcharnchai, P, Tantibhaedhyangkul, U, McCambridge, J. RCT of effectiveness of motivational enhancement therapy delivered by nurses for hazardous drinkers in primary care units in Thailand. Alcohol Alcohol 2010; 45(3): 263–70.
42Nadkarni, A, Weobong, B, Weiss, HA, McCambridge, J, Bhat, B, Katti, B, et al. Counselling for alcohol problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial. Lancet 2017; 389(10065): 186–95.
43Ramarumo, M, Peltzer, K, Khoza, LB. Screening and brief intervention of alcohol problems in primary care in South Africa: a brief report. J Psychol Africa 2016; 26(1): 7880.
44Mertens, JR, Ward, CL, Bresick, GF, Broder, T, Weisner, CM. Effectiveness of nurse-practitioner-delivered brief motivational intervention for young adult alcohol and drug use in primary care in South Africa: a randomized clinical trial. Alcohol Alcohol 2014; 49(4): 430–8.
45L'Engle, KL, Mwarogo, P, Kingola, N, Sinkele, W, Weiner, DH. A randomized controlled trial of a brief intervention to reduce alcohol use among female sex workers in Mombasa, Kenya. J Acquir Immune Defic Syndr 2014; 67(4): 446–53.
46Peltzer, K, Naidoo, P, Louw, J, Matseke, G, Zuma, K, McHunu, G, et al. Screening and brief interventions for hazardous and harmful alcohol use among patients with active tuberculosis attending primary public care clinics in South Africa: results from a cluster randomized controlled trial. BMC Public Health 2013; 13: 699.
47Rotheram-Borus, MJ, Tomlinson, M, Roux, IL, Stein, JA. Alcohol use, partner violence, and depression. Am J Prev Med 2015; 49(5): 715–25.
48Rendall-Mkosi, K, Morojele, N, London, L, Moodley, S, Singh, C, Girdler-Brown, B. A randomized controlled trial of motivational interviewing to prevent risk for an alcohol-exposed pregnancy in the Western Cape, South Africa. Addiction 2012; 108: 725–32.
49Sorsdahl, K, Petersen, P. Feasibility and preliminary responses to a screening and brief intervention program for maternal mental disorders within the context of primary care. Community Ment Health J 2015; 51: 962–9.
50Papas, RK, Sidle, JE, Gakinya, BN, Baliddawa, JB, Martino, S, Mwaniki, MM, et al. Treatment outcomes of a stage 1 cognitive-behavioral trial to reduce alcohol use among human immunodeficiency virus-infected out-patients in western Kenya. Addiction 2011; 106(12): 2156–66.
51Assanangkornchai, S, Nima, P, McNeil, EB, Edwards, JG. Comparative trial of the WHO ASSIST-linked brief intervention and simple advice for substance abuse in primary care. Asian J Psychiatr 2015; 18(2015): 7580.
52del Carmen Lara-Muñoz, M, Robles-García, R, Orozco, R, Real, T, Chisholm, D, Medina-Mora, ME. Estudio de costo-efectividad del tratamiento de la depresión en México. Salud Ment 2010; 33(4): 301–8.
53Patel, V, Weobong, B, Weiss, HA, Anand, A, Bhat, B, Katti, B, et al. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. Lancet 2017; 389(10065): 176–85.
54Buttorff, C, Hock, R, Weiss, H, Naik, S, Araya, R, Kirkwood, B, et al. Economic evaluation of a task-shifting intervention for common mental disorders in India. Bull World Health Organ 2012; 90(11): 813–21.
55Chisholm, D, Sekar, K, Kumar, KK, Saeed, K, James, S, Mubbashar, M, et al. Integration of mental health care into primary care. Demonstration cost-outcome study in India and Pakistan. Br J Psychiatry 2000; 176: 581–8.
56Araya, R, Flynn, T, Rojas, G, Fritsch, R, Simon, G. Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago, Chile. Am J Psychiatry 2006; 163(8): 1379–87.
57Siskind, D, Araya, R, Kim, J. Cost-effectiveness of improved primary care treatment of depression in women in Chile. Br J Psychiatry 2010: 291–6.
58Gureje, O, Chisholm, D, Kola, L, Lasebikan, V, Saxena, S. Cost-effectiveness of an essential mental health intervention package in Nigeria. World Psychiatry 2007; 6(1): 42–8.
59World Health Organization (WHO). WHO Guide to Cost-Effectiveness Analysis. WHO, 2003 (https://www.who.int/choice/publications/p_2003_generalised_cea.pdf).
60James, S, Chisholm, D, Murthy, RS, Kumar, KK, Sekar, K, Saeed, K, et al. Demand for, access to and use of community mental health care: lessons from a demonstration project in India and Pakistan. Int J Soc Psychiatry 2002; 48(3): 163–76.
61Berbesi, D, Segura, A, Torres, Y. Evaluación de un programa para el tratamiento de la depresión en Antioquia, Colombia, 2007 Evaluation of a program for the treatment of depression in Antioquia. Rev Fac Nac Salud Publica 2010; 28(1): 4855.
62Petersen, I, Bhana, A, Baillie, K, MhaPP Research Programme Consortium. The feasibility of adapted group-based interpersonal therapy (IPT) for the treatment of depression by community health workers within the context of task shifting in South Africa. Community Ment Health J 2012; 48(3): 336–41.
63Barbui, C, Tansella, M. Identification and management of depression in primary care settings. A meta-review of evidence. Epidemiol Psichiatr Soc 2006; 15(4): 276–83.
64Gillies, D, Buykx, P, Parker, AG, Hetrick, SE. Consultation liaison in primary care for people with mental disorders. Cochrane Database Syst Rev 2015; 9: CD007193.
65Richards, DA. Stepped care: a method to deliver increased access to psychological therapies. Can J Psychiatry 2012; 57(4): 210–5.
66Katon, W. Collaborative depression care models: from development to dissemination. Am J Prev Med 2012; 42(5): 550–2.
67Chen, S, Conwell, Y, He, J, Lu, N, Wu, J. Depression care management for adults older than 60 years in primary care clinics in urban China: a cluster-randomised trial. Lancet Psychiatry 2015; 2(4): 332–9.
68Rahman, A, Usman Hamdani, S, Riaz Awan, N, Bryant, RA, Dawson, KS, Firaz Khan, M, et al. Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized clinical trial. JAMA 2016; 316(24): 2609–17.
69Weiss, WM, Murray, LK, Abdulla, G, Zangana, S, Mahmooth, Z, Kaysen, D, et al. Community-based mental health treatments for survivors of torture and militant attacks in southern Iraq: a randomized control trial. BMC Psychiatry 2015. Available from: https://doi.org/10.1186/s12888-015-0622-7.
70Cuijpers, P, Sijbrandij, M, Koole, SL, Andersson, G, Beekman, AT, Reynolds, CF, et al. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry 2013; 12(2): 137–48.
71Cuijpers, P, Hollon, SD, van Straten, A, Bockting, C, Berking, M, Andersson, G. Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013; 3(4): e002542.
72Cuijpers, P, Karyotaki, E, Reijnders, M, Purgato, M, Barbui, C. Psychotherapies for depression in low- and middle-income countries: a meta-analysis. World Psychiatry 2018; 17(1): 90101.
73Kaner, E, Bland, M, Cassidy, P, Coulton, S, Dale, V, Deluca, P, et al. Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial. BMJ 2013; 346: e8501.
74Simon, GE, Katon, WJ, VonKorff, M, Unützer, J, Lin, EHB, Walker, EA, et al. Cost-effectiveness of a collaborative care program for primary care patients with persistent depression. Am J Psychiatry 2001; 158(10): 1638–44.
75Kazungu, JS, Barasa, EW, Obadha, M, Chuma, J. What characteristics of provider payment mechanisms influence health care providers’ behaviour? A literature review. Int J Health Plann Manage 2018; 33(4): e892905.
76Wagstaff, A, Eozenou, P, Neelsen, S, Smitz, M. The 2018 Health Equity and Financial Protection Indicators Database: Overview and Insights. World Bank Group, 2018 (http://documents.worldbank.org/curated/en/582871539784481127/pdf/WPS8577.pdf).
77Stokes, J, Struckmann, V, Kristensen, SR, Fuchs, S, van Ginneken, E, Tsiachristas, A, et al. Towards incentivising integration: a typology of payments for integrated care. Health Policy (New York) 2018; 122(9): 963–9.
78Struckmann, V, Quentin, W, Busse, R, Ginneken, Ev, Richardson, E, Ginneken, Ev. How to Strengthen Financing Mechanisms to Promote Care for People with Multimorbidity in Europe? European Observatory on Health Systems and Policies, 2017 (http://www.ncbi.nlm.nih.gov/pubmed/29144696).
79Patel, V, Weiss, HA, Chowdhary, N, Naik, S, Pednekar, S, Chatterjee, S, et al. Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months. Br J Psychiatry 2011; 199(6): 459–66.
80Patel, V, De Silva, MJ, Kirkwood, BR, Patel, V, Weiss, HA, Chowdhary, N, et al. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet 2010; 376: 2086–95.
81Ford, J, Ford, L. Decoding Resistance to Change. Harvard Business Review, 2009 (https://hbr.org/2009/04/decoding-resistance-to-change).
82Araya, R, Rojas, G, Fritsch, R, Gaete, J, Rojas, M, Simon, G, et al. Treating depression in primary care in low-income women in Santiago, Chile: a randomised controlled trial. Lancet 2003; 361(9362): 9951000.
83Chibanda, D, Mesu, P, Kajawu, L, Cowan, F, Araya, R, Abas, MA. Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health 2011; 11: 828.

Keywords

Type Description Title
WORD
Supplementary materials

Cubillos et al. supplementary material
Cubillos et al. supplementary material 1

 Word (39 KB)
39 KB
WORD
Supplementary materials

Cubillos et al. supplementary material
Cubillos et al. supplementary material 2

 Word (99 KB)
99 KB
WORD
Supplementary materials

Cubillos et al. supplementary material
Cubillos et al. supplementary material 3

 Word (99 KB)
99 KB
UNKNOWN
Supplementary materials

Cubillos et al. supplementary material
Cubillos et al. supplementary material 4

 Unknown (14.0 MB)
14.0 MB

The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

  • Leonardo Cubillos (a1) (a2), Sophia M. Bartels (a1), William C. Torrey (a1) (a2) (a3), John Naslund (a4), José Miguel Uribe-Restrepo (a5), Chelsea Gaviola (a1), Sergio Castro Díaz (a6), Deepak T. John (a1), Makeda J. Williams (a7), Magda Cepeda (a6), Carlos Gómez-Restrepo (a5) (a6) and Lisa A. Marsch (a1) (a2) (a3)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

  • Leonardo Cubillos (a1) (a2), Sophia M. Bartels (a1), William C. Torrey (a1) (a2) (a3), John Naslund (a4), José Miguel Uribe-Restrepo (a5), Chelsea Gaviola (a1), Sergio Castro Díaz (a6), Deepak T. John (a1), Makeda J. Williams (a7), Magda Cepeda (a6), Carlos Gómez-Restrepo (a5) (a6) and Lisa A. Marsch (a1) (a2) (a3)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *