Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review

Graham Thornicroft; Shalini Ahuja; Sarah Barber; Daniel Chisholm; Pamela Y Collins; Sumaiyah Docrat; Lara Fairall; Heidi Lempp; Unaiza Niaz; Vicky Ngo; Vikram Patel; Inge Peterson; Martin Prince; Maya Semrau; Jurgen Unutzer; Huang Yueqin; Shuo Zhang

doi:10.1016/S2215-0366(18)30298-0

Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review

Graham Thornicroft, Shalini Ahuja, Sarah Barber, Daniel Chisholm, Pamela Y Collins, Sumaiyah Docrat, Lara Fairall, Heidi Lempp, Unaiza Niaz, Vicky Ngo, Vikram Patel, Inge Peterson, Martin Prince, Maya Semrau, Jurgen Unutzer, Huang Yueqin, Shuo Zhang

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Abstract

Integrated care is defined as health services that are managed and delivered so 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. This narrative review paper aims to describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, to assess the strength of evidence base for these models in high income countries (HICs) and in low- and middle-income countries (LMICs) through a conceptual overview and a structured narrative review, and to identify opportunities to further test the feasibility and impact of such integrated care models. The results of the review are presented in terms of; (i) the rationale for integrating care for people with mental disorders into chronic care; (ii) models of integrated care; (iii) evidence of the effects of integrating care in HICs and in LMICs; (iv) the key organisational challenges in LMICs to implement integrated chronic care; and (v) practical steps to realise a vision of integrated care in the future.

Original language	English
Pages (from-to)	174-186
Journal	The Lancet Psychiatry
Volume	6
Issue number	2
Early online date	15 Nov 2018
DOIs	https://doi.org/10.1016/S2215-0366(18)30298-0
Publication status	Published - 1 Feb 2019

Keywords

integrated care, chronic conditions, long-term conditions, non-communicable diseases, co-morbidity, multi-morbidity, mental health, mental illness, mental disorder

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10.1016/S2215-0366(18)30298-0

Integrated care for people_THORNICROFT_Accepted27July2018_GREEN AAM (CC BY-NC-ND)Accepted author manuscript, 631 KBLicence: CC BY-NC-ND

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Thornicroft, G., Ahuja, S., Barber, S., Chisholm, D., Collins, P. Y., Docrat, S., Fairall, L., Lempp, H., Niaz, U., Ngo, V., Patel, V., Peterson, I., Prince, M., Semrau, M., Unutzer, J., Yueqin, H., & Zhang, S. (2019). Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review. The Lancet Psychiatry, 6(2), 174-186. https://doi.org/10.1016/S2215-0366(18)30298-0

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abstract = "Integrated care is defined as health services that are managed and delivered so 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. This narrative review paper aims to describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, to assess the strength of evidence base for these models in high income countries (HICs) and in low- and middle-income countries (LMICs) through a conceptual overview and a structured narrative review, and to identify opportunities to further test the feasibility and impact of such integrated care models. The results of the review are presented in terms of; (i) the rationale for integrating care for people with mental disorders into chronic care; (ii) models of integrated care; (iii) evidence of the effects of integrating care in HICs and in LMICs; (iv) the key organisational challenges in LMICs to implement integrated chronic care; and (v) practical steps to realise a vision of integrated care in the future.",

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Thornicroft, G , Ahuja, S, Barber, S, Chisholm, D, Collins, PY, Docrat, S, Fairall, L, Lempp, H, Niaz, U, Ngo, V, Patel, V, Peterson, I, Prince, M, Semrau, M, Unutzer, J, Yueqin, H & Zhang, S 2019, 'Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review', The Lancet Psychiatry, vol. 6, no. 2, pp. 174-186. https://doi.org/10.1016/S2215-0366(18)30298-0

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T1 - Integrated care for people with long-term mental and physical conditions in low- and middle-income countries

T2 - narrative review

AU - Thornicroft, Graham

AU - Ahuja, Shalini

AU - Barber, Sarah

AU - Chisholm, Daniel

AU - Collins, Pamela Y

AU - Docrat, Sumaiyah

AU - Fairall, Lara

AU - Lempp, Heidi

AU - Niaz, Unaiza

AU - Ngo, Vicky

AU - Patel, Vikram

AU - Peterson, Inge

AU - Prince, Martin

AU - Semrau, Maya

AU - Unutzer, Jurgen

AU - Yueqin, Huang

AU - Zhang, Shuo

PY - 2019/2/1

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N2 - Integrated care is defined as health services that are managed and delivered so 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. This narrative review paper aims to describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, to assess the strength of evidence base for these models in high income countries (HICs) and in low- and middle-income countries (LMICs) through a conceptual overview and a structured narrative review, and to identify opportunities to further test the feasibility and impact of such integrated care models. The results of the review are presented in terms of; (i) the rationale for integrating care for people with mental disorders into chronic care; (ii) models of integrated care; (iii) evidence of the effects of integrating care in HICs and in LMICs; (iv) the key organisational challenges in LMICs to implement integrated chronic care; and (v) practical steps to realise a vision of integrated care in the future.

AB - Integrated care is defined as health services that are managed and delivered so 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. This narrative review paper aims to describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, to assess the strength of evidence base for these models in high income countries (HICs) and in low- and middle-income countries (LMICs) through a conceptual overview and a structured narrative review, and to identify opportunities to further test the feasibility and impact of such integrated care models. The results of the review are presented in terms of; (i) the rationale for integrating care for people with mental disorders into chronic care; (ii) models of integrated care; (iii) evidence of the effects of integrating care in HICs and in LMICs; (iv) the key organisational challenges in LMICs to implement integrated chronic care; and (v) practical steps to realise a vision of integrated care in the future.

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DO - 10.1016/S2215-0366(18)30298-0

M3 - Article

SN - 2215-0366

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SP - 174

EP - 186

JO - The Lancet Psychiatry

JF - The Lancet Psychiatry

IS - 2

ER -

Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review

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