Integrating mental health into primary care in Nigeria: Implementation outcomes and clinical impact of the intervention.

Journal: Global mental health (Cambridge, England)

Volume: 11

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA. Department of Medicine, Imo State University, Owerri, Nigeria.

Abstract summary 

The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS () intervention is a multicomponent, community-based, mobile technology-supported intervention that integrates mental health into primary health care centers in Nigeria using the World Health Organization's Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG). This study evaluates its implementation and patient-level clinical impact using a quasi-experimental design (single cohort with pre- and post-measures).The HAPPINESS intervention implementation demonstrated high feasibility with 84% adoption rate (% of participating primary health centers that completed its roll out) and 81% fidelity (% of clinicians who completed required intervention components according to the protocol). Retention rate in care at 12 months was 86%. Among patients with complete clinical records analyzed ( = 178), there was a statistically significant reduction in 9-item Patient Health Questionnaire scores from baseline ( = 9.5) to 6 months ( = 3.0) post-intervention ( = 80.5,  < 0.001), with a large effect size ( = 0.8) and statistically significant reduction in Brief Psychiatric Rating Scale scores from baseline ( = 36.0) to 6 months ( = 17.0) post-intervention ( = 128.5,  < 0.001), with a large effect size ( = 0.9).Mobile technology-enhanced, mhGAP-IG-based efforts to scale-up mental health services in Nigeria are feasible and effective.

Authors & Co-authors:  Iheanacho Theddeus T Chu Casey C Aguocha Chinyere M CM Nwefoh Emeka E Dike Charles C

Study Outcome 

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Citations :  Abdulmalik J, Kola L, Fadahunsi W, Adebayo K, Yasamy MT, Musa E and Gureje O (2013) Country contextualization of the Mental Health Gap Action Programme-Intervention Guide: A case study from Nigeria. PLoS Medicine 10(8), e1001501.
Authors :  5
Identifiers
Doi : e9
SSN : 2054-4251
Study Population
Male,Female
Mesh Terms
Other Terms
Nigeria;implementation;mental health;mhGAP;primary care
Study Design
Cohort Study,Cross Sectional Study,Quasi Experimental Study
Study Approach
Country of Study
Niger
Publication Country
England