IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v118y2014icp33-42.html
   My bibliography  Save this article

Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda

Author

Listed:
  • Mendenhall, Emily
  • De Silva, Mary J.
  • Hanlon, Charlotte
  • Petersen, Inge
  • Shidhaye, Rahul
  • Jordans, Mark
  • Luitel, Nagendra
  • Ssebunnya, Joshua
  • Fekadu, Abebaw
  • Patel, Vikram
  • Tomlinson, Mark
  • Lund, Crick

Abstract

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs.

Suggested Citation

  • Mendenhall, Emily & De Silva, Mary J. & Hanlon, Charlotte & Petersen, Inge & Shidhaye, Rahul & Jordans, Mark & Luitel, Nagendra & Ssebunnya, Joshua & Fekadu, Abebaw & Patel, Vikram & Tomlinson, Mark &, 2014. "Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and U," Social Science & Medicine, Elsevier, vol. 118(C), pages 33-42.
    • Handle: RePEc:eee:socmed:v:118:y:2014:i:c:p:33-42
    DOI: 10.1016/j.socscimed.2014.07.057
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614004973
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.07.057?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
    2. Crick Lund & Mark Tomlinson & Mary De Silva & Abebaw Fekadu & Rahul Shidhaye & Mark Jordans & Inge Petersen & Arvin Bhana & Fred Kigozi & Martin Prince & Graham Thornicroft & Charlotte Hanlon & Ritsuk, 2012. "PRIME: A Programme to Reduce the Treatment Gap for Mental Disorders in Five Low- and Middle-Income Countries," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-6, December.
    3. Maes, Kenneth C. & Kohrt, Brandon A. & Closser, Svea, 2010. "Culture, status and context in community health worker pay: Pitfalls and opportunities for policy research. A commentary on Glenton et al. (2010)," Social Science & Medicine, Elsevier, vol. 71(8), pages 1375-1378, October.
    4. Padmanathan, Prianka & De Silva, Mary J., 2013. "The acceptability and feasibility of task-sharing for mental healthcare in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 97(C), pages 82-86.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Martin Agrest & PhuongThao D Le & Lawrence H Yang & Franco Mascayano & Silvia Alves-Nishioka & Saloni Dev & Tanvi Kankan & Thamara Tapia-Muñoz & Samantha Sawyer & Josefina Toso-Salman & Gabriella A D, 2019. "Implementing a community-based task-shifting psychosocial intervention for individuals with psychosis in Chile: Perspectives from users," International Journal of Social Psychiatry, , vol. 65(1), pages 38-45, February.
    2. Laura Asher & Abebaw Fekadu & Charlotte Hanlon & Gemechu Mideksa & Julian Eaton & Vikram Patel & Mary J De Silva, 2015. "Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    3. Sabrina Gabrielle Anjara & Chiara Bonetto & Poushali Ganguli & Diana Setiyawati & Yodi Mahendradhata & Bambang Hastha Yoga & Laksono Trisnantoro & Carol Brayne & Tine Van Bortel, 2019. "Can General Practitioners manage mental disorders in primary care? A partially randomised, pragmatic, cluster trial," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-26, November.
    4. Sarkar, Nandini D.P. & Baingana, Florence & Criel, Bart, 2022. "Integration of perinatal mental health care into district health services in Uganda: Why is it not happening? The Four Domain Integrated Health (4DIH) explanatory framework," Social Science & Medicine, Elsevier, vol. 296(C).
    5. Woollett, Nataly & Brahmbhatt, Heena & Dodd, Kate & Booth, Michelle & Berman, Hayley & Cluver, Lucie, 2017. "Revealing the impact of loss: Exploring mental health through the use of drawing/writing with HIV positive adolescents in Johannesburg," Children and Youth Services Review, Elsevier, vol. 77(C), pages 197-207.
    6. Jinvo Nam & Nicola Dempsey, 2018. "Community Food Growing in Parks? Assessing the Acceptability and Feasibility in Sheffield, UK," Sustainability, MDPI, vol. 10(8), pages 1-21, August.
    7. Nadja van Ginneken & Meera S Maheedhariah & Sarah Ghani & Jayashree Ramakrishna & Anusha Raja & Vikram Patel, 2017. "Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-25, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Medhin Selamu & Laura Asher & Charlotte Hanlon & Girmay Medhin & Maji Hailemariam & Vikram Patel & Graham Thornicroft & Abebaw Fekadu, 2015. "Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.
    2. Jia Lu & Shabana Jamani & Joseph Benjamen & Eric Agbata & Olivia Magwood & Kevin Pottie, 2020. "Global Mental Health and Services for Migrants in Primary Care Settings in High-Income Countries: A Scoping Review," IJERPH, MDPI, vol. 17(22), pages 1-28, November.
    3. Matthijs van den Berg & Filip Smit & Theo Vos & Pieter H M van Baal, 2011. "Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-7, August.
    4. Ide, Hiroo & Mollahaliloglu, Salih, 2009. "How firms set prices for medical materials: A multi-country study," Health Policy, Elsevier, vol. 92(1), pages 73-78, September.
    5. Eldon Spackman & Stewart Richmond & Mark Sculpher & Martin Bland & Stephen Brealey & Rhian Gabe & Ann Hopton & Ada Keding & Harriet Lansdown & Sara Perren & David Torgerson & Ian Watt & Hugh MacPherso, 2014. "Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-12, November.
    6. Peele, Morgan & Wolf, Sharon, 2020. "Predictors of anxiety and depressive symptoms among teachers in Ghana: Evidence from a randomized controlled trial," Social Science & Medicine, Elsevier, vol. 253(C).
    7. Carsten Hinrichsen & Vibeke Jenny Koushede & Katrine Rich Madsen & Line Nielsen & Nanna Gram Ahlmark & Ziggi Ivan Santini & Charlotte Meilstrup, 2020. "Implementing Mental Health Promotion Initiatives—Process Evaluation of the ABCs of Mental Health in Denmark," IJERPH, MDPI, vol. 17(16), pages 1-26, August.
    8. Gianni Tognoni & Alejandro Macchia, 2020. "Health as a Human Right: A Fake News in a Post-human World?," Development, Palgrave Macmillan;Society for International Deveopment, vol. 63(2), pages 270-276, December.
    9. Renske Kok & Mauricio Avendano & Teresa Bago d’Uva & Johan Mackenbach, 2012. "Can Reporting Heterogeneity Explain Differences in Depressive Symptoms Across Europe?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 105(2), pages 191-210, January.
    10. Emmanuel Peprah & Elisabet Caler & Anya Snyder & Fassil Ketema, 2020. "Deconstructing Syndemics: The Many Layers of Clustering Multi-Comorbidities in People Living with HIV," IJERPH, MDPI, vol. 17(13), pages 1-7, June.
    11. Qiumei Xu & Fangfen Yuan & Xuemei Shen & Hui Wen & Wei Li & Bei Cheng & Jing Wu, 2014. "Polymorphisms of C242T and A640G in CYBA Gene and the Risk of Coronary Artery Disease: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-8, January.
    12. Sumaiyah Docrat & Donela Besada & Susan Cleary & Crick Lund, 2020. "The impact of social, national and community-based health insurance on health care utilization for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic re," Health Economics Review, Springer, vol. 10(1), pages 1-23, December.
    13. Hoehun Ha & Wei Tu, 2018. "An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States," IJERPH, MDPI, vol. 15(4), pages 1-16, April.
    14. Eduardo Martínez-Martínez & María Luisa Zaragoza & Elmer Solano & Brenda Figueroa & Patricia Zúñiga & Juan P Laclette, 2012. "Health Research Funding in Mexico: The Need for a Long-Term Agenda," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-11, December.
    15. Zarish Noreen & Christopher A. Loffredo & Attya Bhatti & Jyothirmai J. Simhadri & Gail Nunlee-Bland & Thomas Nnanabu & Peter John & Jahangir S. Khan & Somiranjan Ghosh, 2020. "Transcriptional Profiling and Biological Pathway(s) Analysis of Type 2 Diabetes Mellitus in a Pakistani Population," IJERPH, MDPI, vol. 17(16), pages 1-20, August.
    16. Joern Birkmann & Susan Cutter & Dale Rothman & Torsten Welle & Matthias Garschagen & Bas Ruijven & Brian O’Neill & Benjamin Preston & Stefan Kienberger & Omar Cardona & Tiodora Siagian & Deny Hidayati, 2015. "Scenarios for vulnerability: opportunities and constraints in the context of climate change and disaster risk," Climatic Change, Springer, vol. 133(1), pages 53-68, November.
    17. Kimberley E Wever & Carlijn R Hooijmans & Niels P Riksen & Thomas B Sterenborg & Emily S Sena & Merel Ritskes-Hoitinga & Michiel C Warlé, 2015. "Determinants of the Efficacy of Cardiac Ischemic Preconditioning: A Systematic Review and Meta-Analysis of Animal Studies," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-17, November.
    18. Junyan Teng & Yanping Wei & Fengming Su & Zhiping Guo & Jing-Quan Zhong, 2015. "Evaluating of Physiological Chemical Levels in Blood to Assess the Risk of Morbidity and Mortality of Ischemic Cardiovascular Disease," IJERPH, MDPI, vol. 12(9), pages 1-11, September.
    19. G. Guindon, 2014. "The impact of tobacco prices on smoking onset in Vietnam: duration analyses of retrospective data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 19-39, January.
    20. Jessica Pinaire & Jérôme Azé & Sandra Bringay & Guillaume Cayla & Paul Landais, 2019. "Hospital burden of coronary artery disease: Trends of myocardial infarction and/or percutaneous coronary interventions in France 2009–2014," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-21, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:118:y:2014:i:c:p:33-42. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.