mhGAP – the global scenario

Hughes, Peter; Thomson, Sophia

doi:10.1002/pnp.546

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Over the last decade, various new tools have been developed with the goal of scaling-up delivery of MNS services through task-sharing approaches aimed at improving mental health coverage among refugee populations (e.g., the mhGAP-HIG) [ 21 ] and considerable efforts have been made to train and supervise staff with these methods in some regions [ 22 , 35 – 37 ]. An evaluation of mhGAP-HIG capacity building efforts in refugee camps in seven sub-Saharan African countries showed various effects such as (1) strengthened capacities by facility- and community-based staff to deliver mental health and psychosocial support interventions, (2) positive changes in their attitudes towards people suffering from MNS conditions, and (3) improved collaboration among health and non-health staff regarding people suffering from MNS conditions [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Ten years of tracking mental health in refugee primary health care settings: an updated analysis of data from UNHCR’s Health Information System (2009–2018)

Fine

Kane

Spiegel

et al. 2022

BMC Med

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Background This study examines mental, neurological, and substance use (MNS) service usage within refugee camp primary health care facilities in low- and middle-income countries (LMICs) by analyzing surveillance data from the United Nations High Commissioner for Refugees Health Information System (HIS). Such information is crucial for efforts to strengthen MNS services in primary health care settings for refugees in LMICs. Methods Data on 744,036 MNS visits were collected from 175 refugee camps across 24 countries between 2009 and 2018. The HIS documented primary health care visits for seven MNS categories: epilepsy/seizures, alcohol/substance use disorders, mental retardation/intellectual disability, psychotic disorders, severe emotional disorders, medically unexplained somatic complaints, and other psychological complaints. Combined data were stratified by 2-year period, country, sex, and age group. These data were then integrated with camp population data to generate MNS service utilization rates, calculated as MNS visits per 1000 persons per month. Results MNS service utilization rates remained broadly consistent throughout the 10-year period, with rates across all camps hovering around 2–3 visits per 1000 persons per month. The largest proportion of MNS visits were attributable to epilepsy/seizures (44.4%) and psychotic disorders (21.8%). There were wide variations in MNS service utilization rates and few consistent patterns over time at the country level. Across the 10 years, females had higher MNS service utilization rates than males, and rates were lower among children under five compared to those five and older. Conclusions Despite increased efforts to integrate MNS services into refugee primary health care settings over the past 10 years, there does not appear to be an increase in overall service utilization rates for MNS disorders within these settings. Healthcare service utilization rates are particularly low for common mental disorders such as depression, anxiety, post-traumatic stress disorder, and substance use. This may be related to different health-seeking behaviors for these disorders and because psychological services are often offered outside of formal health settings and consequently do not report to the HIS. Sustained and equitable investment to improve identification and holistic management of MNS disorders in refugee settings should remain a priority.

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Section: Discussionmentioning

confidence: 99%

Ten years of tracking mental health in refugee primary health care settings: an updated analysis of data from UNHCR’s Health Information System (2009–2018)

Fine

Kane

Spiegel

et al. 2022

BMC Med

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Opportunities and Limitations in Global Mental Health Training: A Qualitative Study of Jordanian Primary Care Physicians

Rosal

Al-Delaimy

2022

International Journal of Systemic Therapy

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WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact

Keynejad

Spagnolo

Thornicroft

2021

Evid Based Mental Health

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QuestionThere is a large worldwide gap between the service need and provision for mental, neurological and substance use disorders. WHO’s Mental Health Gap Action Programme (mhGAP) intervention guide (IG), provides evidence-based guidance and tools for assessment and integrated management of priority disorders. Our 2017 systematic review identified 33 peer-reviewed studies describing mhGAP-IG implementation in low-income and middle-income countries.Study selection and analysisWe searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, ScieELO, Cochrane, PubMed databases, 3ie, Google Scholar and citations of our review, on 24 November 2020. We sought evidence, experience and evaluations of the mhGAP-IG, app or mhGAP Humanitarian IG, from any country, in any language. We extracted data from included papers, but heterogeneity prevented meta-analysis.FindingsOf 2621 results, 162 new papers reported applications of the mhGAP-IG. They described mhGAP training courses (59 references), clinical applications (n=49), research uses (n=27), contextual adaptations (n=13), economic studies (n=7) and other educational applications (n=7). Most were conducted in the African region (40%) and South-East Asia (25%). Studies demonstrated improved knowledge, attitudes and confidence post-training and improved symptoms and engagement with care, post-implementation. Research studies compared mhGAP-IG-enhanced usual care with task-shared psychological interventions and adaptation studies optimised mhGAP-IG implementation for different contexts. Economic studies calculated human resource requirements of scaling up mhGAP-IG implementation and other educational studies explored its potential for repurposing.ConclusionsThe diverse, expanding global mhGAP-IG literature demonstrates substantial impact on training, patient care, research and practice. Priorities for future research should be less-studied regions, severe mental illness and contextual adaptation of brief psychological interventions.

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mhGAP – the global scenario

Cited by 4 publications

References 7 publications

Ten years of tracking mental health in refugee primary health care settings: an updated analysis of data from UNHCR’s Health Information System (2009–2018)

Ten years of tracking mental health in refugee primary health care settings: an updated analysis of data from UNHCR’s Health Information System (2009–2018)

Opportunities and Limitations in Global Mental Health Training: A Qualitative Study of Jordanian Primary Care Physicians

WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact

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