@article{336c9ff98aaa43f5b774207ffebe25a5,
title = "Experience of implementing new mental health indicators within information systems in six low- And middle-income countries",
abstract = "BackgroundSuccessful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking.AimsTo assess the acceptability, feasibility, perceived costs and sustainability of implementing indicators relating to integrated mental health service coverage in six South Asian (India, Nepal) and sub-Saharan African countries (Ethiopia, Nigeria, South Africa, Uganda).MethodA qualitative study using semi-structured key informant interviews (n = 128) was conducted. The 'Performance of Routine Information Systems' framework served as the basis for a coding framework covering three main categories related to the performance of new tools introduced to collect data on mental health indicators: (1) technical; (2) organisation; and (3) behavioural determinants.ResultsMost mental health indicators were deemed relevant and potentially useful for improving care, and therefore acceptable to end users. Exceptions were indicators on functionality, cost and severity. The simplicity of the data-capturing formats contributed to the feasibility of using forms to generate data on mental health indicators. Health workers reported increasing confidence in their capacity to record the mental health data and minimal additional cost to initiate mental health reporting. However, overstretched primary care staff and the time-consuming reporting process affected perceived sustainability.ConclusionsUse of the newly developed, contextually appropriate mental health indicators in health facilities providing primary care services was seen largely to be feasible in the six Emerald countries, mainly because of the simplicity of the forms and continued support in the design and implementation stage. However, approaches to implementation of new forms generating data on mental health indicators need to be customised to the specific health system context of different countries. Further work is needed to identify ways to utilise mental health data to monitor and improve the quality of mental health services.Declaration of interestNone. ",
keywords = "Health information system, Indicators, Low- and middle-income settings, Mental healthcare, Primary healthcare",
author = "Shalini Ahuja and Charlotte Hanlon and Dan Chisholm and Maya Semrau and Dristy Gurung and Jibril Abdulmalik and James Mugisha and Ntokozo Mntambo and Fred Kigozi and Inge Petersen and Rahul Shidhaye and Nawaraj Upadhaya and Crick Lund and Sara Evans-Lacko and Graham Thornicroft and Oye Gureje and Mark Jordans",
note = "Funding Information: S.A. is supported by Emerald project, funded under the European Commission's Seventh Framework programmes. S.A. acknowledges the financial support from the Psychiatric Research Trust and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London NHS Foundation Trust. This study is supported by the European Union Seventh Framework Programme (FP7/2007-2013) Emerald project. G.T. is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London and by the NIHR Applied Research Centre (ARC) at King's College London NHS Foundation Trust, and the NIHR Applied Research and the NIHR Asset Global Health Unit award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. G.T. receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). G.T. is supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. D.C. is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization. M.S. is supported by the NIHR Global Health Research Unit for Neglected Tropical Diseases at the Brighton and Sussex Medical School. G.T., C.H., I.P. and C.L. are funded by the NIHR Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King's College London (GHRU 16/136/54) using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. C.H. additionally receives support from AMARI as part of the DELTAS Africa Initiative (DEL-15-01). Funding Information: S.A. is supported by Emerald project, funded under the European Commission's Seventh Framework programmes. S.A. acknowledges the financial support from the Psychiatric Research Trust and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College London NHS Foundation Trust. This study is supported by the European Union Seventh Framework Programme (FP7/2007–2013) Emerald project. G.T. is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London and by the NIHR Applied Research Centre (ARC) at King{\textquoteright}s College London NHS Foundation Trust, and the NIHR Applied Research and the NIHR Asset Global Health Unit award. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. G.T. receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). G.T. is supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. D.C. is a staff member of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization. M.S. is supported by the NIHR Global Health Research Unit for Neglected Tropical Diseases at the Brighton and Sussex Medical School. G.T., C.H., I.P. and C.L. are funded by the NIHR Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King's College London (GHRU 16/136/54) using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. C.H. additionally receives support from AMARI as part of the DELTAS Africa Initiative (DEL-15-01). Publisher Copyright: Copyright {\textcopyright} The Royal College of Psychiatrists 2019.",
year = "2019",
month = sep,
day = "1",
doi = "10.1192/bjo.2019.29",
language = "English",
volume = "5",
journal = "BJPsych Open",
issn = "2056-4724",
publisher = "Cambridge University Press",
number = "5",
}