Integrating Mental Health Services in Existing Healthcare System in Pakistan: A Public Mental Health Approach

Abstract

AbstractThis study intended to implement the Comprehensive Mental Health Services Plan (CMHSP); a cost-efficient, evidence-based, sustainable model of mental health services within the existing healthcare system in Khyber Pakhtunkhwa (KP) province of Pakistan. The CMHSP defined a package of mental health services based on the WHO Mental Health Action Plan (2013–2030) and Interagency Standing Committee (IASC) Guidelines. The study aimed to improve access to mental health services in a lower-middle-income country with limited resources. The study was informed by the Active Implementation Framework (AIF) to ensure replicability in similar contexts. The efficacy of the CMHSP is demonstrated through the constructs of the AIF model including a) exploration and adoption, b) program installation, c) initial implementation, and d) full implementation. The baseline and end-line data were collected through a mixed-method design. It was observed that following the implementation of the intervention for three years, the prevalence of Depression, Anxiety, Trauma, stress-related disorders, and somatic disorders were reduced by almost 25%. The at-risk groups identified in the community were children, adolescents, women, and first responders. And the protective factors were identified as help-seeking behavior, community support, religion, awareness of healthcare workers, and the availability of mental health services. This study is significant in answering the mental health challenges of Low- and Middle-Income Countries (LMICs), regarding the delivery of evidence-based mental health services in an integrated and culturally sensitive manner in a low-resource setting. KeywordsMental HealthDepressionAnxietyTraumaPakistanLMICsPublic Mental HealthImplementation ResearchMental Health Action PlanHealthcare systemEvidence-basedCulturally sensitive