Implementing mhGAP training to strengthen mental health in primary health care centers in Brazil

Abstract

Abstract Introduction Although it is already known that 14% of the global disease burden is attributed to Mental, neurological and substance use disorders, three quarters of people affected by mental disorders in low-income countries do not access treatment. Launched by WHO in 2008, the mhGAP Intervention Guide is a simple technical tool based on scientific evidence which facilitates the management of priority mental health conditions, using protocols for clinical decision in the PHC centers. Objective This work aims to describe the methodology of training the primary care staff and specialized mental health workers from São Paulo, Brazil, in the mhGAP Intervention Guide. Methods The training was designed in three steps. In the first step, mhGAP Training of Trainers and Supervisors (ToTS) capacitated 76 trainers. In the second a working group (WG) responsible for planning the replication for 100% of the technical staff of 13 PHC centers and 3 mental health community services was formed. The WG defined that the trainers should attend in two alignment moments to guarantee uniformity. And the third stage is the replication, divided in nine groups with forty participants, throughout the year 2020. Results The training promotes the exchange of experiences between the participants, who share their personal experiences, enriching the discussions. They also approximate the relationship between PHC and Mental Health services, as well as favors the interdisciplinary and collaborative practice. The PHC workers are more aware of their responsibility in mental health care and feel more empowered. As a challenge, the PHC professionals showed insecurity and reluctance to give the training. Conclusions The training provides evidence-based tools for the assessment and integrated management of priority mental disorders by PHC professionals. Key messages The mhGAP Intervention Guide training strengths the relationship between Primary Care and Mental Health services and improves Mental Health treatment access. The training improves integrated management of priority mental disorders by PHC professionals.