To send content items to your account,
please 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 account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
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.
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.
The PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.
To provide quantitative measures of outputs related to implementation processes, describe the role of contextual factors that facilitated and impeded implementation processes, and discuss what has been learned from the MHCP implementation.
A convergent parallel mixed-methods design was used. The quantitative strand consisted of process data on mental health indicators whereas the qualitative strand consisted of in-depth interviews and focus group discussions with key stakeholders involved in PRIME implementation.
The implementation of the MHCP in Sehore district in Madhya Pradesh, India, demonstrated that it is feasible to establish structures (for example Mann-Kaksha) and operationalise processes to integrate mental health services in a ‘real-world’ low-resource primary care setting. The key lessons can be summarised as: (a) clear ‘process maps’ of clinical interventions and implementation steps are helpful in monitoring/tracking the progress; (b) implementation support from an external team, in addition to training of service providers, is essential to provide clinical supervision and address the implementation barriers; (c) the enabling packages of the MHCP play a crucial role in strengthening the health system and improving the context/settings for implementation; and (d) engagement with key community stakeholders and incentives for community health workers are necessary to deliver services at the community-platform level.
The PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.
National Mental Health Survey found that in India, the point prevalence
of major depressive disorder (MDD) was 2.7% and the treatment gap was
85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and
the treatment gap was 80%.
To describe the baseline prevalence of depression among adults,
association of various demographic and socioeconomic variables with
depression and estimation of contact coverage for the same.
Population-based cross-sectional survey of 3220 adults in Sehore district
of Madhya Pradesh, India. The outcome of interest was a probable
diagnosis of depression that was measured using the Patient Health
Questionnaire (PHQ-9) and the proportion of individuals with depression
(PHQ-9>9) who sought care for the same. The data were analysed using
simple and multiple log-linear regression.
Low educational attainment, unemployment and indebtedness were associated
with both moderate/severe depression (PHQ-9 score >9) and severe
depression only (PHQ-9 score >14), whereas age, caste and marital
status were associated with only moderate or severe depression. Religion,
type of house, land ownership and amount of loan taken were not
associated with either moderate/severe or only severe depression. The
contact coverage for moderate/severe depression was 13.08% (95% CI
There is an urgent need to bridge the treatment gap by targeting
individuals with social vulnerabilities and integrating evidence-based
interventions in primary care.
The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.
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.
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.
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.
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.
Email your librarian or administrator to recommend adding this to your organisation's collection.