Enhancing mental health and well-being in adults from lower-resource settings: A mixed-method evaluation of the impact of problem management plus

Abstract

Mental health conditions, recognised as a global crisis, were further exacerbated by the COVID-19 pandemic. Access to mental health services remains limited, particularly in low-income regions. Task-sharing interventions, exemplified by Problem Management Plus (PM+), have emerged as potential solutions to bridge this treatment gap. This study presents an evaluation of the PM+ scale-up in Sub-Saharan Africa (Ethiopia and Benin) and Eastern Europe (Croatia and Bosnia and Herzegovina) as part of a mental health and psychosocial support programming including 87 adult participants. A mixed-method approach assesses the impact of the intervention. Quantitative analyses reveal significant reductions in self-reported problems, depression, anxiety and improved functioning. Qualitative data highlight four main themes: general health, family relationships, psychosocial problems and daily activities. These thematic areas demonstrate consistent improvements across clients, irrespective of the region. The findings underscore the impact of PM+ in addressing a broad spectrum of client issues, demonstrating its potential as a valuable tool for mitigating mental health challenges in diverse settings. This study contributes to the burgeoning body of evidence supporting PM+ and highlights its promise in enhancing mental health outcomes on a global scale, particularly for vulnerable populations. Impact statementThis study represents a groundbreaking exploration of Problem Management Plus (PM+) in real-life settings, focussing on Sub-Saharan Africa and Eastern Europe. The choice of these regions is motivated by the unique challenges faced by their populations, including limited access to mental health professionals and a lack of prior research on PM+. This research aims to address critical gaps in the existing literature, specifically its application in non-research settings and the analysis of qualitative aspects. By undertaking a mixed-method evaluation, our study unveils compelling evidence supporting the impact of PM+ in reducing self-reported problems, symptoms of depression and anxiety and improving overall functioning among participants. This efficacy extends across diverse thematic areas such as general health, family relationships, psychosocial problems and daily activities, demonstrating PM+'s versatility in addressing various client needs. The findings underscore PM+'s potential as a scalable approach to mental health challenges in resource-constrained settings. Task-sharing interventions like PM+ emerge as pivotal in bridging the mental health care gap, especially where access to specialised professionals is limited. This study not only addresses the identified gaps in literature but also contributes to the broader discourse on improving mental health outcomes for marginalised and underserved populations globally. In a global context characterised by the exacerbation of mental health conditions, straining resources and disparately impacting vulnerable communities, PM+ provides valuable insights. The study's implications ext...