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Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority.
To outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia.
A mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation).
The community packages were community case detection, community reintegration and community inclusion. The facility packages included capacity building, decision support and staff well-being. Organisational packages were programme management, supervision and sustainability.
The MHCP focused on improving demand and access at the community level, inclusive care at the facility level and sustainability at the organisation level. The MHCP represented an essential framework for the provision of integrated care and may be a useful template for similar LMIC.
Evidence on mortality in severe mental illness (SMI) comes primarily from
clinical samples in high-income countries.
To describe mortality in people with SMI among a population cohort from a
We followed-up 919 adults (from 68 378 screened) with SMI over 10 years.
Standardised mortality ratios (SMR) and years of life lost (YLL) as a
result of premature mortality were calculated.
In total 121 patients (13.2%) died. The overall SMR was twice that of the
general population; higher for men and people with schizophrenia.
Patients died about three decades prematurely, mainly from infectious
causes (49.6%). Suicide, accidents and homicide were also common causes
Mortality is an important adverse outcome of SMI irrespective of setting.
Addressing common natural and unnatural causes of mortality are urgent
priorities. Premature death and mortality related to self-harm should be
considered in the estimation of the global burden of disease for SMI.
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