<br><div class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br>crossposted from: <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p style="margin-left: 0.5in;"><b><font color="maroon" face="Arial" size="2"><span style="font-size: 11pt; font-family: Arial; color: maroon; font-weight: bold;">Integrating mental health into primary care</span></font></b></p>
<p style="margin-left: 0.5in;"><b><font color="maroon" face="Arial" size="2"><span style="font-size: 11pt; font-family: Arial; color: maroon; font-weight: bold;">A global perspective</span></font></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Michelle Funk, Department of Mental Health and Substance Abuse, World
Health Organization</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Gabriel Ivbijaro, Wonca Working Party on Mental Health, London UK</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">World Health Organization and World Organization
of Family Doctors (Wonca) 2008</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"></span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Available online PDF file
[224p] at:<br>
</span></font><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;"><a href="http://www.who.int/mental_health/policy/Mental%20health%20+%20primary%20care-%20final%20low-res%20140908.pdf" target="_blank"><font color="navy"><span style="color: navy;">http://www.who.int/mental_health/policy/Mental%20health%20+%20primary%20care-%20final%20low-res%20140908.pdf</span></font></a>
</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">"….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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy; font-weight: bold;">Key Messages: <br>
</span></font></b><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">1. Mental disorders affect hundreds of
millions of people and, if left untreated, create an enormous toll of
suffering, disability and economic loss.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">2. Despite the potential
to successfully treat mental disorders, only a small minority of those in need
receive even the most basic treatment.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">4. Primary care for mental
health is affordable, and investments can bring important benefits.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">9. Numerous low- and
middle-income countries have successfully made the transition to integrated
primary care for mental health.</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">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…."</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Content:</span></font></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Executive summary</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Introduction</span></font></p>
<p style="margin-left: 0.5in;"><b><i><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold; font-style: italic;"><br>
PART 1: Primary care for mental health in context</span></font></i></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Chapter 1: Primary care
for mental health withina pyramid of health care</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">Chapter 2: Seven good
reasons for integrating mental health into primary care</span></font></p>
<p style="margin-left: 0.5in;"><b><i><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold; font-style: italic;"><br>
PART 2: Primary care for mental health in practice<br>
<br>
</span></font></i></b></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">10 principles for integrating
mental health into primary care</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Argentina</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Physician-led primary care for mental health in Neuquén province,
Patagonia region</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Australia</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Integrated mental health care for older people in general
practices of inner-city Sydney</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Belize</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Nationwide district-based mental health care. </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Brazil</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Integrated primary care for mental health in the city of Sobral</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Chile</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Integrated primary care for mental health in the Macul district
of Santiago. </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">India</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Integrated primary care for mental health in the
Thiruvananthapuram District, Kerala
State. </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Islamic Republic
of Iran</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Nationwide integration of mental health into primary care</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Saudi Arabia</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Integrated primary care for mental health in the Eastern Province</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">South Africa</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: </span></font><font color="navy" face="Arial" size="1"><span style="font-size: 9pt; font-family: Arial; color: navy;">Integrated primary care
services and a partnership for mental health primary care – Ehlanzeni District, Mpumalanga
Province, and Moorreesburg District,
Western Cape Province.</span></font><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"> </span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Uganda</span></font></b><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">:</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">
Integrated primary care for mental health in the Sembabule District</span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">United Kingdom of Great Britain and Northern Ireland</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Primary care for mental health for disadvantaged communities in London</span></font></p>
<p style="margin-left: 0.5in;"><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;"><br>
<b><span style="font-weight: bold;">Report conclusions</span></b></span></font></p>
<p style="margin-left: 0.5in;"><b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy; font-weight: bold;">Annex 1</span></font></b><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;">: Improving the practice
of primary care for mental health</span></font></p>
<p style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p><font color="navy" face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial; color: navy;" lang="EN"> </span></font></p></div></div></div><br>