+ Site Statistics
References:
52,572,879
Abstracts:
28,705,754
PMIDs:
27,750,366
DOIs:
25,464,004
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Recommendations from primary care providers for integrating mental health in a primary care system in rural Nepal



Recommendations from primary care providers for integrating mental health in a primary care system in rural Nepal



Bmc Health Services Research 16: 492



Globally, access to mental healthcare is often lacking in rural, low-resource settings. Mental healthcare services integration in primary care settings is a key intervention to address this gap. A common strategy includes embedding mental healthcare workers on-site, and receiving consultation from an off-site psychiatrist. Primary care provider perspectives are important for successful program implementation. We conducted three focus groups with all 24 primary care providers at a district-level hospital in rural Nepal. We asked participants about their concerns and recommendations for an integrated mental healthcare delivery program. They were also asked about current practices in seeking referral for patients with mental illness. We collected data using structured notes and analyzed the data by template coding to develop themes around concerns and recommendations for an integrated program. Participants noted that the current referral system included sending patients to the nearest psychiatrist who is 14 h away. Participants did not think this was effective, and stated that integrating mental health into the existing primary care setting would be ideal. Their major concerns about a proposed program included workplace hierarchies between mental healthcare workers and other clinicians, impact of staff turnover on patients, reliability of an off-site consultant psychiatrist, and ability of on-site primary care providers to screen patients and follow recommendations from an off-site psychiatrist. Their suggestions included training a few existing primary care providers as dedicated mental healthcare workers, recruiting both senior and junior mental healthcare workers to ensure retention, recruiting academic psychiatrists for reliability, and training all primary care providers to appropriately screen for mental illness and follow recommendations from the psychiatrist. Primary care providers in rural Nepal reported the failure of the current system of referral, which includes sending patients to a distant city. They welcomed integrating mental healthcare into the primary care system, and reported several concerns and recommendations to increase the likelihood of successful implementation of such a program.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058709439

Download citation: RISBibTeXText

PMID: 27643684

DOI: 10.1186/s12913-016-1768-9


Related references

Health system constraints in integrating mental health services into primary healthcare in rural Uganda: perspectives of primary care providers. International Journal of Mental Health Systems 13: 16, 2019

The Mental Health Education Gap among Primary Care Providers in Rural Nepal. Academic Psychiatry 40(4): 667-671, 2016

Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients. Wellcome Open Research 3: 9, 2018

Training needs and perspectives of community health workers in relation to integrating child mental health care into primary health care in a rural setting in sub-Saharan Africa: a mixed methods study. International Journal of Mental Health Systems 11: 15, 2017

Integrating health and mental health services in schools: psychologists collaborating with primary care providers. Clinical Psychology Review 19(2): 179-198, 1999

Integrating mental health and primary care services in the Department of Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings 15(1): 73-78, 2009

Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. General Hospital Psychiatry 36(6): 555-562, 2015

Integrating mental health into primary care an integrative collaborative primary care model--the Jamaican experience. West Indian Medical Journal 60(4): 483-489, 2011

Lessons From Rural Peru in Integrating Mental Health Into Primary Care. Psychiatric Services 2018: Appips201800079, 2018

Integrating primary care and mental health services in rural America. 1995

Rural models for integrating primary care and mental health services. Administration and Policy in Mental Health 25(3): 287-308, 1998

On-site mental health workers delivering psychological therapy and psychosocial interventions to patients in primary care: effects on the professional practice of primary care providers. Cochrane Database of Systematic Reviews 2009(1): Cd000532, 2009

Primary Care Providers' Views of Recent Trends in Health Care Delivery and Payment. Findings from the Commonwealth Fund/Kaiser Family Foundation 2015 National Survey of Primary Care Providers. Issue Brief 24: 1-13, 2015

Mental Health Services in Rural China: A Qualitative Study of Primary Health Care Providers. Biomed Research International 2015: 151053, 2016

Integrating primary health care and mental health services--a successful rural linkage. Public Health Reports 98(1): 67-72, 1983