Mental health integration in primary health services after the earthquake in Nepal: a mixed-methods program evaluation.
Humanitarian
Nepal
mental health
mental health in primary care
psychosocial support
Journal
Global mental health (Cambridge, England)
ISSN: 2054-4251
Titre abrégé: Glob Ment Health (Camb)
Pays: England
ID NLM: 101659641
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
05
2020
revised:
02
12
2020
accepted:
08
02
2021
entrez:
24
5
2021
pubmed:
25
5
2021
medline:
25
5
2021
Statut:
epublish
Résumé
In the aftermath of the devastating 2015 earthquakes in Nepal, three non-governmental organizations collaborated to develop a program responding to the immediate mental health and psychosocial support (MHPSS) needs in three severely affected districts: Dhading, Gorkha, and Sindhuli. The program was implemented between April 2015 and February 2017 and aimed to (i) strengthen health worker capacity to provide integrated MHPSS services; and (ii) increase access to mental health services. This paper describes the program's implementation and the results of a pragmatic evaluation of the program's overall reach, effectiveness, and lessons learned. The mixed-methods evaluation used routine program data, quantitative data from pre- and post-tests conducted with trainees and service users, and qualitative data from stakeholder interviews and focus group discussions. A total of 1041 health workers received MHPSS training and supervision. Participants demonstrated significant improvements in skills, knowledge, and self-rated perceived competency. Trainees went on to provide MHPSS services to 3422 people. The most commonly identified presenting problems were epilepsy (29%) and depression (26%). A total of 67% of service users reported being 'completely satisfied' with the services received and 83% of those experiencing severe functional impairments on enrollment demonstrated improvement after receiving services. Despite operational challenges, the program successfully engaged both laypeople and health workers to provide MHPSS in the aftermath of the crisis. Lessons learned can inform the planning and implementation of future training and integration programs to provide large-scale MHPSS efforts in humanitarian settings.
Sections du résumé
BACKGROUND
BACKGROUND
In the aftermath of the devastating 2015 earthquakes in Nepal, three non-governmental organizations collaborated to develop a program responding to the immediate mental health and psychosocial support (MHPSS) needs in three severely affected districts: Dhading, Gorkha, and Sindhuli. The program was implemented between April 2015 and February 2017 and aimed to (i) strengthen health worker capacity to provide integrated MHPSS services; and (ii) increase access to mental health services. This paper describes the program's implementation and the results of a pragmatic evaluation of the program's overall reach, effectiveness, and lessons learned.
METHODS
METHODS
The mixed-methods evaluation used routine program data, quantitative data from pre- and post-tests conducted with trainees and service users, and qualitative data from stakeholder interviews and focus group discussions.
RESULTS
RESULTS
A total of 1041 health workers received MHPSS training and supervision. Participants demonstrated significant improvements in skills, knowledge, and self-rated perceived competency. Trainees went on to provide MHPSS services to 3422 people. The most commonly identified presenting problems were epilepsy (29%) and depression (26%). A total of 67% of service users reported being 'completely satisfied' with the services received and 83% of those experiencing severe functional impairments on enrollment demonstrated improvement after receiving services.
CONCLUSIONS
CONCLUSIONS
Despite operational challenges, the program successfully engaged both laypeople and health workers to provide MHPSS in the aftermath of the crisis. Lessons learned can inform the planning and implementation of future training and integration programs to provide large-scale MHPSS efforts in humanitarian settings.
Identifiants
pubmed: 34026240
doi: 10.1017/gmh.2021.8
pii: S205442512100008X
pmc: PMC8127643
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e10Informations de copyright
© The Author(s) 2021.
Déclaration de conflit d'intérêts
None.
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