Level of Mental Health Service Integration in Primary Health Care Units in Debre Markos Town, Ethiopia, 2014

Abstract

Introduction: Mental health disorders in low and middle income countries contribute to roughly 10% of the global burden of disease. In rural areas especially, lower access to care and lack of health services contributes to failure to get proper care and treatment for conditions such as schizophrenia, depression, anxiety, and even suicidal ideation. In settings where resources are low, mental health services from primary health care settings would allow for better detection and intervention strategies. Thus, this study aims to assess the current level of mental health integration in the primary care setting as a baseline for future improvement. Methods: A cross sectional study design using a literature review was conducted on the current mental health status of Ethiopia as well as previous strategies for integration of mental health in primary care. Next, quantitative data was collected from 2 primary care units in Debre Markos town in order to determine mental health utilization under the current health strategies. Program information was collected from a health professional within each primary health care unit along with observational data and document review. Referral data from the Debre Markos reference hospital was also collected in order to assess referral utilization. Results: Attempts for mental health integration into the primary care system are evident through policies of the Federal Democratic Republic of Ethiopia. However, the implementation is recent and the capacity for training and services is low. Low levels of mental health integration were recorded in the primary care setting. Areas of improvement include education and training for primary health care worker and communication between primary and secondary health care systems. Conclusion and Recommendations: Training for mental health services in primary care units is poor. It is recommended greater education and training for the various disorders including epilepsy, substance abuse, and depression are addressed. In addition, funding is necessary to increase utilization, education, and to reduce stigma among mental health patients.