Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T13:46:45.142Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of district mental healthcare plans: The PRIME consortium methodology

Published online by Cambridge University Press:  02 January 2018

Mary J. De Silva ,
Sujit D. Rathod ,
Charlotte Hanlon ,
Erica Breuer ,
Dan Chisholm ,
Abebaw Fekadu ,
Mark Jordans ,
Fred Kigozi ,
Inge Petersen  and
Rahul Shidhaye
...Show all authors
Mary J. De Silva*
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Sujit D. Rathod
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
Charlotte Hanlon
Affiliation:
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia and Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Erica Breuer
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Dan Chisholm
Affiliation:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
Abebaw Fekadu
Affiliation:
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia and Department of Psychological Medicine, Centre for Affective Disorders and the Affective Disorders Research Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Mark Jordans
Affiliation:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and HealthNet TPO, Research and Development Department, Amsterdam, The Netherlands
Fred Kigozi
Affiliation:
Butabika National Referral and Teaching Hospital/Makerere University, Kampala Uganda
Inge Petersen
Affiliation:
School of Applied Human Sciences, Howard College, University of KwaZulu-Natal, South Africa
Rahul Shidhaye
Affiliation:
Centre for Mental Health, The Public Health Foundation of India, India and Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands
Girmay Medhin
Affiliation:
Department of Psychological Medicine, Centre for Affective Disorders and the Affective Disorders Research Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
Joshua Ssebunnya
Affiliation:
Butabika National Referral and Teaching Hospital/Makerere University, Kampala, Uganda
Martin Prince
Affiliation:
Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Graham Thornicroft
Affiliation:
Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Mark Tomlinson
Affiliation:
Centre for Public Mental Health, Department of Psychology, Stellenbosch University and Department of Psychiatry and Mental Health, University of Cape Town, Stellenbosch, South Africa
Crick Lund
Affiliation:
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Vikram Patel
Affiliation:
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, the Public Health Foundation of India, India and Sangath, Goa, India
*
Mary De Silva, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Email: mary.desilva@lshtm.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

Few studies have evaluated the implementation and impact of real-world mental health programmes delivered at scale in low-resource settings.

Aims

To describe the cross-country research methods used to evaluate district-level mental healthcare plans (MHCPs) in Ethiopia, India, Nepal, South Africa and Uganda.

Method

Multidisciplinary methods conducted at community, health facility and district levels, embedded within a theory of change.

Results

The following designs are employed to evaluate the MHCPs: (a) repeat community-based cross-sectional surveys to measure change in population-level contact coverage; (b) repeat facility-based surveys to assess change in detection of disorders; (c) disorder-specific cohorts to assess the effect on patient outcomes; and (d) multilevel case studies to evaluate the process of implementation.

Conclusions

To evaluate whether and how a health-system-level intervention is effective, multidisciplinary research methods are required at different population levels. Although challenging, such methods may be replicated across diverse settings.

Type
Papers
Information
The British Journal of Psychiatry , Volume 208 , Issue s56: Mental health plans in five low- and middle-income countries: PRogramme for Improving Mental health carE (PRIME) , January 2016 , pp. s63 - s70
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Copyright
Copyright © Royal College of Psychiatrists, 2016

Footnotes

This paper was produced as part of the PRogramme for Improving Mental health carE (PRIME) funded by UK aid from the UK government. However, the views expressed do not necessarily reflect the UK government's official policies. The RISE trial of community-based rehabilitation in Ethiopia is supported by the Wellcome Trust (grant number 100142/Z/12/Z). M.J.D.S. is supported by a Wellcome Trust/London School of Hygiene and Tropical Medicine career fellowship. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Declaration of interest

None.

References

1 De Silva, MJ, Cohen, A, Patel, V. Evaluation of interventions in the real world. In Global Mental Health Trials (eds Thornicroft, G, Patel, V): 282–302. Oxford University Press, 2014.Google Scholar
2 Eaton, J, McCay, L, Semrau, M, Chatterjee, S, Baingana, F, Araya, JE, et al. Scale up of services for mental health in low-income and middle-income countries. Lancet 2011; 378: 1592–603.CrossRefGoogle ScholarPubMed
3 Lancet Global Mental Health Group. Scale up services for mental disorders: a call for action. Lancet 2007; 370: 1241–52.Google Scholar
4 De Silva, MJ, Lee, L, Fuhr, D, Rathod, S, Chisholm, D, Schellenberg, J, et al. Estimating the coverage of mental health programmes: a systematic review. Int J Epidemiol 2014; 43: 341–53.CrossRefGoogle ScholarPubMed
5 Lund, C, Tomlinson, M, De Silva, MJ, Fekadu, A, Shidhaye, R, Jordans, M, et al. PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries. PLoS Med 2012; 9: e1001359.CrossRefGoogle Scholar
6 Fekadu, A, Hanlon, C, Medhin, G, Alem, A, Selamu, M, Giorgis, TW, et al. Development of a scalable mental healthcare plan for a rural district in Ethiopia. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153676).CrossRefGoogle Scholar
7 Jordans, MJD, Luitel, NP, Pokhrel, P, Patel, V. Development and pilot testing of a mental healthcare plan in Nepal. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153718).CrossRefGoogle Scholar
8 Kigozi, NF, Kizza, D, Nakku, J, Ssebunnya, J, Ndyanabangi, S, Nakiganda, B, et al. Development of a district mental healthcare plan in Uganda. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153742).CrossRefGoogle Scholar
9 Petersen, I, Fairall, L, Bhana, A, Kathree, T, Selohilwe, O, Brooke-Sumner, C, et al. Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153726).CrossRefGoogle Scholar
10 Shidhaye, R, Shrivastava, S, Murhar, V, Samudre, S, Ahuja, S, Ramaswamy, R, et al. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153700).CrossRefGoogle Scholar
11 Craig, P, Dieppe, P, Macintyre, S, Michie, S, Nazareth, I, Petticrew, M, et al. Developing and evaluating complex interventions: the new medical research council guidance. BMJ 2008; 337: a1655.CrossRefGoogle ScholarPubMed
12 Weiss, C. Nothing as practical as good theory: exploring theory-based evaluation for comprehensive community initiatives for children and families. In New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts (eds Connell, J, Kubisch, AC, Schorr, LB, Weiss, CA): 65–92. Aspen Institute, 1995.Google Scholar
13 Anderson, A. The Community Builder's Approach to Theory of Change. A Practical Guide to Theory Development. Aspen Institute, 2005.Google Scholar
14 De Silva, MJ, Breuer, E, Lee, L, Asher, L, Chowdhary, N, Lund, C, et al. Theory of change: a theory-driven approach to enhance the MRC framework for complex interventions. Trials 2014; 15: 267.CrossRefGoogle Scholar
15 Breuer, E, De Silva, MJ, Fekadu, A, Luitel, NP, Murhar, V, Nakku, J, et al. Using workshops to develop theories of change in five low and middle income countries: lessons from the Programme for Improving Mental Health Care (PRIME). Int J Ment Health Syst 2014; 8: 15.CrossRefGoogle ScholarPubMed
16 Breuer, E, De Silva, MJ, Shidaye, R, Petersen, I, Nakku, J, Jordans, MJD, et al. Planning and evaluating mental health services in low- and middle-income countries using theory of change. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153841).CrossRefGoogle Scholar
17 Hanlon, C, Medhin, G, Selamu, M, Breuer, E, Worku, B, Hailemariam, M, et al. Validity of brief screening questionnaires to detect depression in primary care in Ethiopia. J Affect Disord 2015; 186: 32–9.CrossRefGoogle ScholarPubMed
18 Pradhan, B, Chappuis, F, Baral, D, Karki, P, Rijal, S. The AUD identification test (AUDIT): validation of a Nepali version for the detection of AUD and hazardous drinking in medical settings. Subst Abuse Treat Prev Policy 2012: 7: 42.CrossRefGoogle Scholar
19 Myer, L, Smit, J, Roux, LL, Parker, S, Stein, DJ, Seedat, S. Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care STD 2008; 22: 147–58.CrossRefGoogle ScholarPubMed
20 Spitzer, R, Kroenke, K, Williams, JB. Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. JAMA 1999; 282: 1737–44.CrossRefGoogle ScholarPubMed
21 Kroenke, K, Spitzer, R, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–13.CrossRefGoogle ScholarPubMed
22 Babor, TF, Higgins-Biddle, JC, Saunders, JB, Monteiro, MG. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. World Health Organization, 2001.Google Scholar
23 Lukoff, D, Liberman, RP, Nuechterlein, KH. Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophr Bull 1986; 12: 578–602.CrossRefGoogle ScholarPubMed
24 Üstün, T, Chatterji, S, Kostanjsek, N, Rehm, J. Measuring Health and Disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). World Health Organization, 2010.Google Scholar
25 Evans-Lacko, S, Little, K, Meltzer, H, Rose, D, Rhydderch, D, Henderson, C, et al. Development and psychometric properties of the Mental Health Knowledge Schedule. Can J Psychiatry 2010; 55: 440–8.CrossRefGoogle ScholarPubMed
26 Evans-Lacko, S, Rose, D, Little, K, Flach, C, Rhydderch, D, Henderson, C, et al. Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure. Epidemiol Psychiatr Sci 2011; 20: 263–71.CrossRefGoogle ScholarPubMed
27 Taylor, S, Dear, M. Scaling community attitudes toward the mentally ill. Schizophr Bull 1981; 7: 225–40.CrossRefGoogle ScholarPubMed
28 Beecham, J, Knapp, M. Costing psychiatric interventions. In Measuring Mental Health Needs, Second Edition (ed. Thornicroft, G): 200–24. Gaskell, 2001.Google Scholar
29 Brohan, E, Clement, S, Rose, D, Sartorius, N, Slade, M, Thornicroft, G. Development and psychometric evaluation of the Discrimination and Stigma Scale (DISC). Psychiatry Res 2013; 208: 33–40.CrossRefGoogle ScholarPubMed
30 Ritsher, J, Otilingam, PG, Grajales, M. Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 2003; 121: 31–49.CrossRefGoogle ScholarPubMed
31 Lauritsen, JM, Bruus, M. Epidata (Version 3). A Comprehensive Tool for Validated Entry and Documentation of Data. The EpiData Association, 2003.Google Scholar
32 Mayosi, BM, Flisher, AJ, Lalloo, UG, Sitas, F, Tollman, SM, Bradshaw, D. The burden of non-communicable diseases in South Africa. Lancet 2009; 374: 934–47.CrossRefGoogle ScholarPubMed
33 Hanlon, C, Fekadu, A, Jordans, M, Kigozi, F, Petersen, I, Shidhaye, R, et al. District mental healthcare plans for five low- and middle-income countries: commonalities, variations and evidence gaps. Br J Pyschiatry 2015, in press (doi: 10.1192/bjp.bp.114.153767).CrossRefGoogle Scholar
34 De Silva, MJ, Cooper, S, Li, H, Lund, C, Patel, V. Meta-analysis of the effect of psychosocial interventions on social functioning in depression and schizophrenia. Br J Psychiatry 2013; 202: 253–60.CrossRefGoogle ScholarPubMed
35 Landsberger, H. Hawthorne Revisited. Management and the Worker: Its Critics and Developments in Human Relations in Industry. Cornell University, 1958.Google Scholar
36 Bonell, C, Hargreaves, J, Cousens, S, Ross, D, Hayes, R, Petticrew, M, et al. Alternatives to randomisation in the evaluation of public health interventions: design challenges and solutions. J Epidemiol Community Health 2011; 65: 582–7.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

De Silva et al. supplementary material

Supplementary Figure S1

Download De Silva et al. supplementary material(PDF)
PDF 160.7 KB
Submit a response

eLetters

No eLetters have been published for this article.