Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries.
Journal: The lancet. Psychiatry
Volume: 6
Issue: 2
Year of Publication: 2019
Affiliated Institutions:
Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Electronic address: graham.thornicroft@kcl.ac.uk.
Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Public Health Foundation of India, New Delhi, India.
Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Division for Non-Communicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe, Copenhagen, Denmark.
Department of Psychiatry and Behavioral Sciences, and Department of Global Health, University of Washington, Seattle, WA, USA.
Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa; Department of Medicine, University of Cape Town, Cape Town, South Africa.
School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
University of Health Sciences, Lahore, Pakistan; Dow University of Health Sciences, Karachi, Pakistan.
RAND Corporation, Santa Monica, CA, USA.
Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA; London School of Hygiene & Tropical Medicine, London, UK; Sangath, Porvorim, Goa, India; Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India.
Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa.
Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Global Health and Infection Department, Brighton and Sussex Medical School, Brighton, UK.
Peking University Sixth Hospital, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Centre for Mental Disorders, Beijing, China.
Abstract summary
Integrated care is defined as health services that are managed and delivered such that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector and, according to their needs, throughout the life course. In this Review, we describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, provide a conceptual overview and a narrative review of the strength of the evidence base for these models in high-income countries and in low-income and middle-income countries, and identify opportunities to test the feasibility and effects of such integrated care models. We discuss the rationale for integrating care for people with mental disorders into chronic care; the models of integrated care; the evidence of the effects of integrating care in high-income countries and in low-income and middle-income countries; the key organisational challenges to implementing integrated chronic care in low-income and middle-income countries; and the practical steps to realising a vision of integrated care in the future.
Authors & Co-authors:
Thornicroft Graham G
Ahuja Shalini S
Barber Sarah S
Chisholm Daniel D
Collins Pamela Y PY
Docrat Sumaiyah S
Fairall Lara L
Lempp Heidi H
Niaz Unaiza U
Ngo Vicky V
Patel Vikram V
Petersen Inge I
Prince Martin M
Semrau Maya M
Unützer Jürgen J
Yueqin Huang H
Zhang Shuo S
Study Outcome
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