PHA-Exch> Integrating mental health into primary care

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org


 *Integrating mental health into primary care*

*A global perspective*



Michelle Funk, Department of Mental Health and Substance Abuse, World Health
Organization

Gabriel Ivbijaro, Wonca Working Party on Mental Health, London UK

*World Health Organization and World Organization of Family Doctors (Wonca)
2008*



Available online PDF file [224p] at:
http://www.who.int/mental_health/policy/Mental%20health%20+%20primary%20care-%20final%20low-res%20140908.pdf



"….This report presents the justification and advantages of providing mental
health services in primary care. At the same time, it provides advice on how
to implement and scale-up primary care for mental health, and describes how
a range of health systems have successfully undertaken this transformation.

Mental disorders affect hundreds of millions of people and, if left
untreated, create an enormous toll of suffering, disability and economic
loss. Yet despite the potential to successfully treat mental disorders, only
a small minority of those in need receive even the most basic treatment.



Integrating mental health services into primary care is the most viable way
of closing the treatment gap and ensuring that people get the mental health
care they need. Primary care for mental health is affordable, and
investments can bring important benefits.



*Key Messages:
*1. Mental disorders affect hundreds of millions of people and, if left
untreated, create an enormous toll of suffering, disability and economic
loss.

2. Despite the potential to successfully treat mental disorders, only a
small minority of those in need receive even the most basic treatment.

3. Integrating mental health services into primary care is the most viable
way of closing the treatment gap and ensuring that people get the mental
health care they need.

4. Primary care for mental health is affordable, and investments can bring
important benefits.

5. Certain skills and competencies are required to effectively assess,
diagnose, treat, support and refer people with mental disorders; it is
essential that primary care workers are adequately prepared and supported in
their mental health work.

6. There is no single best practice model that can be followed by all
countries. Rather, successes have been achieved through sensible local
application of broad principles.

7. Integration is most successful when mental health is incorporated into
health policy and legislative frameworks and supported by senior leadership,
adequate resources, and ongoing governance.

8. To be fully effective and efficient, primary care for mental health must
be coordinated with a network of services at different levels of care and
complemented by broader health system development.

9. Numerous low- and middle-income countries have successfully made the
transition to integrated primary care for mental health.

10. Mental health is central to the values and principles of the Alma Ata
Declaration; holistic care will never be achieved until mental health is
integrated into primary care…."





*Content:*



Executive summary

Introduction

*
PART 1: Primary care for mental health in context*

Chapter 1: Primary care for mental health withina pyramid of health care

Chapter 2: Seven good reasons for integrating mental health into primary
care

*
PART 2: Primary care for mental health in practice

*

10 principles for integrating mental health into primary care

*Argentina*: Physician-led primary care for mental health in Neuquén
province, Patagonia region

*Australia*: Integrated mental health care for older people in general
practices of inner-city Sydney

*Belize*: Nationwide district-based mental health care.

*Brazil*: Integrated primary care for mental health in the city of Sobral

*Chile*: Integrated primary care for mental health in the Macul district of
Santiago.

*India*: Integrated primary care for mental health in the Thiruvananthapuram
District, Kerala State.

*Islamic Republic of Iran*: Nationwide integration of mental health into
primary care

*Saudi Arabia*: Integrated primary care for mental health in the Eastern
Province

*South Africa*: Integrated primary care services and a partnership for
mental health primary care – Ehlanzeni District, Mpumalanga Province, and
Moorreesburg District, Western Cape Province.

*Uganda**:* Integrated primary care for mental health in the Sembabule
District

*United Kingdom of Great Britain and Northern Ireland*: Primary care for
mental health for disadvantaged communities in London


*Report conclusions*

*Annex 1*: Improving the practice of primary care for mental health
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