136 lines
4.5 KiB
YAML
136 lines
4.5 KiB
YAML
abstract: 'BackgroundIntegrating evidence-based mental health services into primary
|
|
|
|
care has been identified as one strategy for overcoming the treatment
|
|
|
|
gap in low and middle-income countries, yet their uptake into standard
|
|
|
|
practice remains poor. The purpose of this study was to understand
|
|
|
|
stakeholder perspectives regarding barriers and facilitators to
|
|
|
|
integration of mental health services into primary care settings in
|
|
|
|
Northern Iraq.MethodsUsing a convergent mixed methods study design,
|
|
|
|
quantitative and qualitative questionnaires assessed respondent
|
|
|
|
perceptions of implementation factors under the domains of Autonomy,
|
|
|
|
Acceptability, Appropriateness, Feasibility, Penetration/Accessibility,
|
|
|
|
Sustainability, and Organizational Climate. We interviewed four types of
|
|
|
|
stakeholders: clients, providers of mental health services, non-mental
|
|
|
|
health (MH) staff working at the centers, and center directors.
|
|
|
|
Interviews were conducted with clients at the completion of services,
|
|
|
|
and with all other stakeholder groups in the latter half of the first
|
|
|
|
year of program implementation, by Kurdish-speaking interviewer pairs.
|
|
|
|
Qualitative and quantitative data were analyzed separately and merged
|
|
|
|
using qualitative data transformation to quantify frequency of theme and
|
|
|
|
integrate with quantitative findings through woven narrative.Results123
|
|
|
|
clients, 26 providers, 40 non-MH staff, and 12 directors provided data.
|
|
|
|
Positive perceptions of the program''s acceptability, appropriateness,
|
|
|
|
feasibility, and positive impacts were reported across all stakeholder
|
|
|
|
levels. Providers reported that the program length (8-12 sessions) was a
|
|
|
|
challenge. Clients described logistical challenges (e.g.:
|
|
|
|
transportation, childcare, home duties); support from family and friends
|
|
|
|
appeared to be critical. Lack of private space, insufficient staffing,
|
|
|
|
and need for greater government support were also important
|
|
|
|
issues.ConclusionsThis mixed methods study is unique in its inclusion of
|
|
|
|
non-MH staff and director perspectives on integration of mental health
|
|
|
|
services in primary care clinics. Their inclusion proved vital since
|
|
|
|
they included critical human resource barriers to feasibility. Providers
|
|
|
|
reported generally positive integration experiences but that some
|
|
|
|
colleagues (clinic staff not involved in mental health services) were
|
|
|
|
unsupportive. Most non-MH staff were supportive, but some did report
|
|
|
|
negative impacts on their working environment. Future studies of
|
|
|
|
integration of mental health services into other service platforms
|
|
|
|
should include the perspectives of stakeholders not involved in
|
|
|
|
provision of mental health services.'
|
|
affiliation: 'Nguyen, AJ (Corresponding Author), Univ Virginia, Curry Sch Educ \&
|
|
Human Dev, Dept Human Serv, Charlottesville, VA 22904 USA.
|
|
|
|
Nguyen, Amanda J., Univ Virginia, Curry Sch Educ \& Human Dev, Dept Human Serv,
|
|
Charlottesville, VA 22904 USA.
|
|
|
|
Rykiel, Natalie, Johns Hopkins Univ, Sch Med, Div Pulm \& Crit Care, Baltimore,
|
|
MD 21205 USA.
|
|
|
|
Murray, Laura; Haroz, Emily, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental
|
|
Hlth, Baltimore, MD 21205 USA.
|
|
|
|
Amin, Ahmed, Wchan Org Victims Human Rights Violat, Sulaymaniyah, Iraq.
|
|
|
|
Amin, Ahmed, Sulaimani Polytech Univ, Tech Coll Hlth, Sulaymaniyah, Iraq.
|
|
|
|
Lee, Catherine; Bolton, Paul, Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth,
|
|
Baltimore, MD 21205 USA.'
|
|
author: Nguyen, Amanda J. and Rykiel, Natalie and Murray, Laura and Amin, Ahmed and
|
|
Haroz, Emily and Lee, Catherine and Bolton, Paul
|
|
author-email: ajnguyen@virginia.edu
|
|
author_list:
|
|
- family: Nguyen
|
|
given: Amanda J.
|
|
- family: Rykiel
|
|
given: Natalie
|
|
- family: Murray
|
|
given: Laura
|
|
- family: Amin
|
|
given: Ahmed
|
|
- family: Haroz
|
|
given: Emily
|
|
- family: Lee
|
|
given: Catherine
|
|
- family: Bolton
|
|
given: Paul
|
|
da: '2023-09-28'
|
|
doi: 10.1186/s13033-019-0330-7
|
|
files: []
|
|
issn: 1752-4458
|
|
journal: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS
|
|
keywords: Mental health; Implementation; Iraq; Primary care
|
|
keywords-plus: 'INCOME; ACCEPTABILITY; INTERVENTIONS; FEASIBILITY; DEPRESSION;
|
|
|
|
KURDISTAN; ISSUES; IMPACT'
|
|
language: English
|
|
month: DEC 28
|
|
number: '1'
|
|
number-of-cited-references: '52'
|
|
papis_id: 7b842faee3eb84516f7f57539c107768
|
|
ref: Nguyen2019stakeholderperspecti
|
|
times-cited: '5'
|
|
title: 'Stakeholder perspectives on integration of mental health services into primary
|
|
care: a mixed methods study in Northern Iraq'
|
|
type: article
|
|
unique-id: WOS:000513509700001
|
|
usage-count-last-180-days: '1'
|
|
usage-count-since-2013: '3'
|
|
volume: '13'
|
|
web-of-science-categories: Psychiatry
|
|
year: '2019'
|