Skip to main content Accessibility help
×
Home

Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

  • Rahul Shidhaye (a1), Sanjay Shrivastava (a2), Vaibhav Murhar (a2), Sandesh Samudre (a3), Shalini Ahuja (a3), Rohit Ramaswamy (a4) and Vikram Patel (a5)...

Abstract

Background

The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.

Aims

To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.

Method

Mixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility.

Results

The MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment.

Conclusions

There are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models.

    • 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.

      Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India
      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.

      Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India
      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.

      Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India
      Available formats
      ×

Copyright

This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Corresponding author

Rahul Shidhaye, Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh, India. Email: rahul.shidhaye@phfi.org

Footnotes

Hide All

This study is an output of the PRogramme for Improving Mental health carE (PRIME). This research has been funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies. V.P. is supported by a Wellcome Trust senior clinical fellowship.

Declaration of interest

None.

Footnotes

References

Hide All
1 Institute for HealthMetrics and Evaluation (IHME). India: Global Burden of Disease Study. IHME, 2010 (http://www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_india.pdf/).
2 Patel, V, Araya, R, Chatterjee, S, Chisholm, D, Cohen, A, De Silva, M, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet 2007; 370: 9911005.
3 Murthy, RS. Mental health initiatives in India (1947-2010). Natl Med J India 2011; 24: 98107.
4 Goel, DS. Why mental health services in low- and middle-income countries are underresourced, under-performing: an Indian perspective. Natl Med J India 2011; 24: 94–7.
5 Ministry of Health & Family Welfare (MOHFW). The Mental Health Care Bill. MOHFW, 2013 (http://www.prsindia.org/billtrack/the-mental-healthcare-bill-2013-2864).
6 Ministry of Health & Family Welfare (MOHFW). XIIth Plan District Mental Health Programme. MOHFW, 2012 (https://mhpolicy.files.wordpress.com/2012/07/final-dmhp-design-xii-plan2.pdf).
7 Lund, C, Tomlinson, M, De Silva, M, Fekadu, A, Shidhaye, R, Jordans, M, et al. PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries. PLoS Med 2012; 9: e1001359.
8 Craig, P, Dieppe, P, Macintyre, S, Michie, S, Nazareth, I, Petticrew, M, et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008; 337: a1655.
9 De Silva, MJ, Rathod, SD, Hanlon, C, Breuer, E, Chisholm, D, Fekadu, A, et al. Evaluation of district mental healthcare plans: the PRIME consortium methodology. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153858).
10 Rahman, A, Surkan, PJ, Cayetano, CE, Rwagatare, P, Dickson, KE. Grand challenges: integrating maternal mental health into maternal and child health programmes. PLoS Med 2013; 10: e1001442.
11 Hanlon, C, Luitel, NP, Kathree, T, Murhar, V, Shrivasta, S, Medhin, G, et al. Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries. PLoS One 2014; 9: e88437.
12 Vogel, I. Review of the Use of ‘Theory of Change’. Department for International Development (DFID), 2012.
13 Breuer, E, De Silva, MJ, Shidaye, R, Petersen, I, Nakku, J, Jordans, MJD, et al. Planning and evaluating mental health services in low- and middle-income countries using theory of change. Br J Psychiatry 2015, in press (doi: 10.1192/bjp.bp.114.153841).
14 World Health Organization. Mental Health Gap Action Programme (mhGAP): Scaling Up Care for Mental, Neurological and Substance Abuse Disorders. WHO, 2008.
15 Bower, P, Gilbody, S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ 2005; 330: 839–42.
16 Jenkins, 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: 25.
17 Goncalves, DA, Fortes, S, Campos, M, Ballester, D, Portugal, FB, Tófoli, LF, et al. Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study. Gen Hosp Psychiatry 2013; 35: 304–8.
18 Patel, 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: 2086–95.
19 De Savigny, D, Adam, T. Systems Thinking for Health Systems Strengthening. Alliance for Health Policy and Systems Research. WHO, 2009.
20 Thornicroft, G, Tansella, M. Are community mental health services relevant in low- and middle-income countries? Epidemiol Psychiatr Sci 2014; 23: 115–8.
21 Thara, R, John, S, Chatterjee, S. Community mental health teams in low- and middle-income countries. Epidemiol Psychiatr Sci 2014; 23: 119–22.
22 Kigozi, F, Ssebunnya, J. The multiplier role of psychiatrists in low income settings. Epidemiol Psychiatr Sci 2014; 23: 123–7.
Type Description Title
PDF
Supplementary materials

Shidhaye et al. supplementary material
Supplementary Figure S1

 PDF (151 KB)
151 KB

Metrics

Altmetric attention score

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

Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

  • Rahul Shidhaye (a1), Sanjay Shrivastava (a2), Vaibhav Murhar (a2), Sandesh Samudre (a3), Shalini Ahuja (a3), Rohit Ramaswamy (a4) and Vikram Patel (a5)...
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? *