An Innovative Mental Health Outreach Program in Southern Sri Lanka: Successes and Lessons Learnt
European Journal of Preventive Medicine
Volume 3, Issue 2-1, March 2015, Pages: 24-30
Received: Dec. 20, 2014;
Accepted: Jan. 10, 2015;
Published: Feb. 14, 2015
Views 3477 Downloads 182
Chandrasiri P. A. A., Post Graduate Institute of Medicine, University of Colombo, Matara, Sri Lanka
De Silva P. V., Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara ,Sri Lanka
Karunarathne A. D. U., Office of the Regional Director of Health Services, Hambantota, Sri Lanka
Ruban R., Teaching Hospital, Karapitiya, Sri Lanka
Madiwaka M. W. M. K., General Hospital, Hambantota, Sri Lanka
Suveendran T., Country Office of World Health Organization, Colombo, Sri Lanka
Follow on us
Psychiatric illnesses has emerged as an important disease category as prevalence of mental disorders is being rising sharply. The disease burden due to mental illnesses is rising in Sri Lanka as well. Provision of care for those who are psychiatrically ill poses a significant challenge to health care systems. In this circumstances a community based our reach program becomes an important and effective strategy to improve psychiatric services provided for patients. Community support officers (CSO) program was launched in 2006 in district of Hambantota, Southern Sri Lanka to serve this purpose. Objective of this article is to describe the program in relation to its objectives, initiation, main activities, coordination, technical guidance, funding, monitoring and evaluation. Then we intended to evaluate the success by analyzing performance data and impact made. Finally we critically analyzed the program to discuss strengths and weaknesses in view of providing a guidance to replicate it in other settings. Program documents were reviewed and key informant interviews were done with leading characters of the program. Periodical progress reports and reports on performance review meetings also retrieved. Recruitment of CSO’s was done according to set criteria. They were given a special training and skills were developed on identification of common psychiatric illnesses at field level, communication skills and crisis intervention. Lecture discussions and role plays were used as teaching methods and consultant psychiatrists conducted the program. Organizational structure of the program was laid down within the existing administrative framework of primary health care system in the country. Main functions of CSO’s were Surveying the community to detect mentally ill people, Guiding and directing patients to seek psychiatric care, following up those patients, Conducting, contributing and participating in community mental health promotion programs. Supervision and monitoring was done at various levels and periodical progress review meetings were held. It was based on inbuilt information system. This program was concluded by the end of 2010. Follow up responsibilities were handed over to primary health staff at MOH offices. CSO program is a classic example for how community level workers can be empowered and utilized as an effective workforce to deliver mental health services at grass root level where existing system can’t penetrate. Carefully planned recruitment criteria, training given by technical experts, linking with existing primary health care system and monitoring done by regional health authorities were responsible for the success of this program.
Mental Health, Outreach Program, Southern Sri Lanka
To cite this article
Chandrasiri P. A. A.,
De Silva P. V.,
Karunarathne A. D. U.,
Madiwaka M. W. M. K.,
An Innovative Mental Health Outreach Program in Southern Sri Lanka: Successes and Lessons Learnt, European Journal of Preventive Medicine. Special Issue: New Frontiers of Public Health from the Pearl of Indian Ocean, Sri Lanka.
Vol. 3, No. 2-1,
2015, pp. 24-30.
WHO. Mental Disorders. World Health Organization; 2014 [cited 2014 05th September 2014]; Available from: http://www.who.int/topics/mental_disorders/en/.
Kessler RC, Gaxiola SA, Alonso J. The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys. National Institute of Health2011. p. 23-33.
Sri Lanka Sumithrayo. Statistics and Data of Suicides. Sri Lanka Sumithrayo; 2010 [updated 05th September 2011; cited 2011 05th September ]; Available from: http://srilankasumithrayo.org/statistics-a-data.
Harriet AB, Sisira HS, Yulia K, Glozier N, Sumathipala A. Epidemiology and symptomatology of depression in Sri Lanka: A cross-sectional population-based survey in Colombo District. Journal of Affected Disorders 2010:188-96.
Jenkins R, Mendis J, Cooray S, Cooray M. Integration of mental health into primary care in Sri Lanka. World Psychiatry. 2010.
Sadock B, Sadock V, editors. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10 ed: Lippincott,Williams and wilkins 2007.
Regional Director of Health Services Hambantota. Annual Mental Health Report 2010. 2010:4.