Level of Mental Health Service Integration in Primary Health Care Units in Debre Markos Town, Ethiopia, 2014
Science Journal of Public Health
Volume 3, Issue 2, March 2015, Pages: 181-190
Received: Jan. 28, 2015;
Accepted: Feb. 10, 2015;
Published: Feb. 16, 2015
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Celia Sanchez, Public health department, Touro University, California, USA
Nurilign Abebe Moges, Public health department, Medicine and Health Sciences College, Debre Markos University, Debre Markos, Ethiopia
Introduction: Mental health disorders in low and middle income countries contribute to roughly 10% of the global burden of disease. In rural areas especially, lower access to care and lack of health services contributes to failure to get proper care and treatment for conditions such as schizophrenia, depression, anxiety, and even suicidal ideation. In settings where resources are low, mental health services from primary health care settings would allow for better detection and intervention strategies. Thus, this study aims to assess the current level of mental health integration in the primary care setting as a baseline for future improvement. Methods: A cross sectional study design using a literature review was conducted on the current mental health status of Ethiopia as well as previous strategies for integration of mental health in primary care. Next, quantitative data was collected from 2 primary care units in Debre Markos town in order to determine mental health utilization under the current health strategies. Program information was collected from a health professional within each primary health care unit along with observational data and document review. Referral data from the Debre Markos reference hospital was also collected in order to assess referral utilization. Results: Attempts for mental health integration into the primary care system are evident through policies of the Federal Democratic Republic of Ethiopia. However, the implementation is recent and the capacity for training and services is low. Low levels of mental health integration were recorded in the primary care setting. Areas of improvement include education and training for primary health care worker and communication between primary and secondary health care systems. Conclusion and Recommendations: Training for mental health services in primary care units is poor. It is recommended greater education and training for the various disorders including epilepsy, substance abuse, and depression are addressed. In addition, funding is necessary to increase utilization, education, and to reduce stigma among mental health patients.
Nurilign Abebe Moges,
Level of Mental Health Service Integration in Primary Health Care Units in Debre Markos Town, Ethiopia, 2014, Science Journal of Public Health.
Vol. 3, No. 2,
2015, pp. 181-190.
WHO, Mental Health Gap Action Programme (mhGAP): Scaling up care for mental, neurological and substance use disorders. . 2013.
Bitew, T., Prevalence and risk factors of depression in Ethiopia: A review. Ethiopia Journal of Health Sciences, 2014. 24(2).
Worku, D., Epilepsy in Ethiopia. Neurology. 80(3): p. 127.
WHO, Mental health and substance abuse. 2014, World Health Organization.
WHO, WHO-AIMS Report on mental health system in Ethiopia. 2006: Addis Ababa.
WONCA, W.a. Integrating mental health into primary care, A global perspective. 2008.
Kibour, Y.P., Mind the Gap: Personal Reflections on the Mental Health Infrastructure of Ethiopia. American Psychological Association, 2010.
WHO, Comprehensive mental health action plan 2013-2020. 2013.
WHO, Mental Health Atlas 2011. 2011: Italy.
Ervin, D.A.W., Ashley; Merrick, Joav, Primary care: mental and behavioral health and persons with intellectual and developmental disabilities. Frontiers in Public Health, 2014. 2(76).
Shannon, P.J., Refugees' advice to physicians: how to ask about mental health. Family Practice, 2014. 31(4): p. 462-466.
Mousley, E.e.a., The impact of podoconiosis and quality of life. Health and Quality of Life Outcomes, 2013. 11(1): p. 122.
Bifftu, B.B.e.a., Stigma resistance among people with schizophrenia at Amanuel Mental Specialized Hospital Addis Ababa, Ethiopia: a cross-sectional institution based study. BMC Psychiatry, 2014. 14(259).
Girma, E.e.a., Self-stigma among caregivers of people with mental illness: toward caregivers’ empowerment. Journal of Multidisciplinary Healthcare, 2014. 2014(7): p. 37-43.
Thornicroft, G. Shunned: discrimination against people with mental illness. 2006 [cited 2014 10/03].
Deribe, K.e.a., Defaulters from antiretroviral treatment in Jimma University Specialized Hospital, Southwest Ethiopia. Tropical Medicine and International Health, 2008. 13(3).
Girma, E.e.a., Public Stigma against People with Mental Illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. PLoS ONE, 2013. 8(12).
Tsigebrhan, R.e.a., Violence and violent victimization in people with severe mental illness in a rural low-income country setting: A comparative cross-sectional community study. 2013.
University, D.M. Short History of Debre Markos Town. 2014; Available from: http://web.dmu.edu.et/test-dmu-site/index.php/category-comments/debre-markos.
Clinic, M. Diseases and Conditions: Mental Illness Definition. 2014 [cited 2014 10/05]; Available from: http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/definition/con-20033813
Butler, M.e.a., Integrating Mental Health/Substance-Abuse and Primary Care. 2008.
FMOH, National Mental Health Strategy, E. Federal Ministry of Health, Editor. 2012.
Fekadu , A., Graham Thornicroft, Global Mental Health: Perspectives from Ethiopia. Global Health Action, 2014. 7(25447).
Teferra, S.e.a., Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers. BMC Psychiatry, 2013. 13(168).
Tesfaye, M.e.a., The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia. Child & Adolescence Psychiatry & Mental Health, Biomed Central 2014. 8(6).
Center, T.C. Mental Health. 2014 11/1/2014]; Available from: http://www.cartercenter.org/health/mental_health/index.html.
Fricchione, G.L.e.a., Capacity Building in Global Mental Health: Professional Training. Harv Ref Psychiatry, 2011. 2012(20): p. 47-57.
Hanlon, C.e.a., Challenges and Opportunities for Implementing Integrated Mental Health Care: A District Level Situation Analysis from Five Low- and Middle-Income Countries. PLoS ONE, 2014. 9(2).
Chemali , Z.N., Christina PC Borba, Tanya E. Henderson, Markos Tesfay, Making strides in women’s mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006–2008). International Journal of Womens Health, 2013. 2013(5): p. 413-419.