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Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia

BACKGROUND: The WHO’s mental health Gap Action Programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care (PHC). This study aimed to assess the challenges and opportunities of this approach from the perspective of PHC workers...

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Autores principales: Abera, Mubarek, Tesfaye, Markos, Belachew, Tefera, Hanlon, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946769/
https://www.ncbi.nlm.nih.gov/pubmed/24602215
http://dx.doi.org/10.1186/1472-6963-14-113
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author Abera, Mubarek
Tesfaye, Markos
Belachew, Tefera
Hanlon, Charlotte
author_facet Abera, Mubarek
Tesfaye, Markos
Belachew, Tefera
Hanlon, Charlotte
author_sort Abera, Mubarek
collection PubMed
description BACKGROUND: The WHO’s mental health Gap Action Programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care (PHC). This study aimed to assess the challenges and opportunities of this approach from the perspective of PHC workers in a sub-Saharan African country. METHODS: A facility-based cross-sectional survey of 151 PHC workers was conducted from 1(st) to 30(th) November 2011 in Jimma zone, south-west Ethiopia. A structured questionnaire was used to ask about past training and mental health experience, knowledge and attitudes towards mental disorders and provision of mental health care in PHC. Semi-structured interviews were carried out with 12 heads of health facilities for more in-depth understanding. RESULTS: Almost all PHC workers (96.0%) reported that mental health care was important in Ethiopia and the majority (66.9%) expressed interest in actually delivering mental health care. Higher levels of general health training (degree vs. diploma) and pre-service clinical exposure to mental health care were associated with more favourable attitudes. Knowledge about mental disorder diagnoses, symptoms and treatments was low. Almost half (45.0%) of PHC workers reported that supernatural factors were important causes of mental disorders. Health system and structural issues, such as poor medication supply, lack of rooms, time constraints, absence of specialist supervision and lack of treatment guidelines, were identified as challenges. Almost all PHC workers (96.7%) reported a need for more training, including a clinical attachment, in order to be able to deliver mental health care competently. CONCLUSIONS: Despite acceptability to PHC workers, the feasibility of integrating mental health into PHC in this sub-Saharan African setting is limited by important gaps in PHC worker knowledge and expectations regarding mental health care, coupled with health system constraints. In addition to clinically-based refresher mental health training, expansion of the specialist mental health workforce may be needed to support integration in practice.
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spelling pubmed-39467692014-03-09 Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia Abera, Mubarek Tesfaye, Markos Belachew, Tefera Hanlon, Charlotte BMC Health Serv Res Research Article BACKGROUND: The WHO’s mental health Gap Action Programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care (PHC). This study aimed to assess the challenges and opportunities of this approach from the perspective of PHC workers in a sub-Saharan African country. METHODS: A facility-based cross-sectional survey of 151 PHC workers was conducted from 1(st) to 30(th) November 2011 in Jimma zone, south-west Ethiopia. A structured questionnaire was used to ask about past training and mental health experience, knowledge and attitudes towards mental disorders and provision of mental health care in PHC. Semi-structured interviews were carried out with 12 heads of health facilities for more in-depth understanding. RESULTS: Almost all PHC workers (96.0%) reported that mental health care was important in Ethiopia and the majority (66.9%) expressed interest in actually delivering mental health care. Higher levels of general health training (degree vs. diploma) and pre-service clinical exposure to mental health care were associated with more favourable attitudes. Knowledge about mental disorder diagnoses, symptoms and treatments was low. Almost half (45.0%) of PHC workers reported that supernatural factors were important causes of mental disorders. Health system and structural issues, such as poor medication supply, lack of rooms, time constraints, absence of specialist supervision and lack of treatment guidelines, were identified as challenges. Almost all PHC workers (96.7%) reported a need for more training, including a clinical attachment, in order to be able to deliver mental health care competently. CONCLUSIONS: Despite acceptability to PHC workers, the feasibility of integrating mental health into PHC in this sub-Saharan African setting is limited by important gaps in PHC worker knowledge and expectations regarding mental health care, coupled with health system constraints. In addition to clinically-based refresher mental health training, expansion of the specialist mental health workforce may be needed to support integration in practice. BioMed Central 2014-03-06 /pmc/articles/PMC3946769/ /pubmed/24602215 http://dx.doi.org/10.1186/1472-6963-14-113 Text en Copyright © 2014 Abera et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Abera, Mubarek
Tesfaye, Markos
Belachew, Tefera
Hanlon, Charlotte
Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title_full Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title_fullStr Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title_full_unstemmed Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title_short Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia
title_sort perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946769/
https://www.ncbi.nlm.nih.gov/pubmed/24602215
http://dx.doi.org/10.1186/1472-6963-14-113
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