Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India
BackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo provide quantitative measures of outputs related to implementation processes, describe the role of cont...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2019-09-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S205647241900053X/type/journal_article |
| _version_ | 1811156979872169984 |
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| author | Rahul Shidhaye Vaibhav Murhar Shital Muke Ritu Shrivastava Azaz Khan Abhishek Singh Erica Breuer |
| author_facet | Rahul Shidhaye Vaibhav Murhar Shital Muke Ritu Shrivastava Azaz Khan Abhishek Singh Erica Breuer |
| author_sort | Rahul Shidhaye |
| collection | DOAJ |
| description | BackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo 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.MethodA 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.ResultsThe 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.ConclusionsThe PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.Declaration of interestNone. |
| first_indexed | 2024-04-10T04:59:50Z |
| format | Article |
| id | doaj.art-016d8aefbb124fc781bad0e16c2c3735 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:50Z |
| publishDate | 2019-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-016d8aefbb124fc781bad0e16c2c37352023-03-09T12:28:55ZengCambridge University PressBJPsych Open2056-47242019-09-01510.1192/bjo.2019.53Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, IndiaRahul Shidhaye0https://orcid.org/0000-0001-9365-7164Vaibhav Murhar1Shital Muke2Ritu Shrivastava3Azaz Khan4Abhishek Singh5Erica Breuer6Senior Research Scientist and Associate Professor, Center for Chronic Conditions and Injuries, Public Health Foundation of India, IndiaProject Director, PRIME, Sangath, IndiaResearch Coordinator, PRIME, Sangath, IndiaResearcher, PRIME, Sangath, IndiaIntervention Coordinator, PRIME, Sangath, IndiaResearch Coordinator, PRIME, Sangath, IndiaAlan J Flisher Centre for Public Mental Health, University of Cape Town, South Africa; and Conjoint Lecturer, University of Newcastle, AustraliaBackgroundThe PRogramme for Improving Mental health care (PRIME) designed, implemented and evaluated a comprehensive mental healthcare plan (MHCP) for Sehore district, Madhya Pradesh, India.AimsTo 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.MethodA 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.ResultsThe 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.ConclusionsThe PRIME implementation model could be used to scale-up mental health services across India and similar low-resource settings.Declaration of interestNone.https://www.cambridge.org/core/product/identifier/S205647241900053X/type/journal_articlePrimary carelow and middle income countriesalcohol disordersdepressive disorders |
| spellingShingle | Rahul Shidhaye Vaibhav Murhar Shital Muke Ritu Shrivastava Azaz Khan Abhishek Singh Erica Breuer Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India BJPsych Open Primary care low and middle income countries alcohol disorders depressive disorders |
| title | Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India |
| title_full | Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India |
| title_fullStr | Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India |
| title_full_unstemmed | Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India |
| title_short | Delivering a complex mental health intervention in low-resource settings: lessons from the implementation of the PRIME mental healthcare plan in primary care in Sehore district, Madhya Pradesh, India |
| title_sort | delivering a complex mental health intervention in low resource settings lessons from the implementation of the prime mental healthcare plan in primary care in sehore district madhya pradesh india |
| topic | Primary care low and middle income countries alcohol disorders depressive disorders |
| url | https://www.cambridge.org/core/product/identifier/S205647241900053X/type/journal_article |
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