Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2022

Open Access 01-12-2022 | Mood Disorders | Research

Adapting the depression component of WHO Mental Health Gap Intervention Guide (mhGAP-IG.v2) for primary care in Shenzhen, China: a DELPHI study

Authors: Kendall Searle, Grant Blashki, Ritsuko Kakuma, Hui Yang, Shurong Lu, Baoqi Li, Yingying Xiao, Harry Minas

Published in: International Journal of Mental Health Systems | Issue 1/2022

Login to get access

Abstract

Background

Primary care doctors in Shenzhen, China are increasingly expected to identify and prevent depressive disorder; however, they have received limited mental health training and community healthcare centres (CHC) do not provide standardised protocols for the diagnosis and care of depressive disorder. The World Health Organization’s mental health gap intervention guide, version 2 (mhGAP-IG.v2) is a decision support tool for non-specialists for the assessment, management and follow-up of mental, neurological and substance use disorders (including depressive disorder). Given that mhGAP-IG.v2 is a generic tool, it requires adaptation to take account of cultural differences in depression presentation and unique characteristics of China’s emergent mental health system.

Methods

A two-round, web-based, Delphi survey was conducted. A panel of primary care doctors from Shenzhen, were invited to score their level of agreement with 199 statements (arranged across 10 domains) proposing changes to the content and structure of mhGAP-IG.v2 for use in Shenzhen. Consensus was predefined as 80% panelists providing a rating of either “somewhat agree/definitely agree”, or “definitely disagree/somewhat disagree” on a five-point scale for agreement.

Results

79% of statements received consensus with a mean score of 4.26 (i.e. “somewhat agree”). Agreed adaptations for mhGAP-IG.v2 included:- an assessment approach which considers a broader spectrum of depression symptoms and reflects the life course of disease; incorporating guidance for screening tool usage; clarifying physicians’ roles and including referral pathways for intersectorial care with strong family involvement; aligning drug treatment with national formularies; stronger emphasis of suicide prevention throughout all sections of the guide; contextualizing health education; reflecting a person-centred approach to care. Panelists chose to maintain diagnostic and treatment advice for bipolar patients experiencing a depressive episode as in the current guide.

Conclusions

An adapted mhGAP-IG.v2 for depression recognises China’s cultural and contextual needs for assessment guidance; unique primary healthcare system organization, priorities and treatment availability; and diverse psychosocial educational needs. An adapted mhGAP-IG.v2 could both inform the future training programs for primary care in Shenzhen and also offer an additional mental health resource for non-specialists in other countries.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Minas H. Chapter 9, The national mental health work plan 2015–2020. Anthony J. Marsella A, GA, USA, editor. USA: Springer; 2021.
4.
9th Global Conference on Health Promotion S. Healthy China 2030 (from vision to action). 2016.
5.
Morton S, Pencheon D, Squires N. Sustainable Development Goals (SDGs), and their implementation: a national global framework for health, development and equity needs a systems approach at every level. Br Med Bull. 2017;124(1):81–90.PubMed
6.
Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196–252.PubMedPubMedCentralCrossRef
7.
Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–98.PubMedCrossRef
8.
Liu Z, Buijsen M. Legal reflections on the evolving role of general practitioners in China’s primary care: an assessment of regulatory strategies. Prim Health Care Res Dev. 2019;20:e9.PubMedCrossRef
9.
China Joint Study Partnership. Deepening health reform in China (Policy Summary): World Bank Group; World Health Organization; Ministry of Finance; National Health and Family Planning Commission; Ministry of Human Resources and Social Security; 2016.
10.
Charlson FJ, Baxter AJ, Cheng HG, Shidhaye R, Whiteford HA. The burden of mental, neurological, and substance use disorders in China and India: a systematic analysis of community representative epidemiological studies. Lancet. 2016;388(10042):376–89.PubMedCrossRef
11.
Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet. 2009;373(9680):2041–53.PubMedCrossRef
12.
Li B. Tutorial for outline of the healthy China 2030 plan: National Health Commission of the People’s Republic of China. Singapore: Springer Nature and People’s Medical Publishing House; 2020.CrossRef
13.
Shenzhen Statistics Bureau. Report of the 7th Population Census. Peoples' Republic China; 2020.
14.
Ni PF, Kamiya M. Chapter 1: The global value chain in Shenzhen and the Pearl Delta region. The story of Shenzhen: its economic, social and environmental transformation. Nairobi: United Nations Human Settlements Programme (UN-Habitat); 2019.
15.
Mosha AC. Chapter 2: Financing the city, financing th firms and financing entrepreneurship. The story of Shenzhen: its economic, social and environmental transformation: United Nations Human Settlements Programme (UN-Habitat); 2019.
16.
17.
Wang F, Zhang QE, Zhang L, Ng CH, Ungvari GS, Yuan Z, et al. Prevalence of major depressive disorder in older adults in China: a systematic review and meta-analysis. J Affect Disord. 2018;241:297–304.PubMedCrossRef
18.
Zhang D, Mou J, Cheng JQ, Griffiths SM. Public health services in Shenzhen: a case study. Public Health. 2011;125(1):15–9.PubMedCrossRef
19.
Tang X, Tang S, Ren Z, Wong DFK. Prevalence of depressive symptoms among adolescents in secondary school in mainland China: a systematic review and meta-analysis. J Affect Disord. 2019;245:498–507.PubMedCrossRef
20.
Wang Q, Tian W. Prevalence, awareness, and treatment of depressive symptoms among the middle-aged and elderly in China from 2008 to 2015. Int J Health Plann Manage. 2018;33(4):1060–70.PubMedCrossRef
21.
He X, Wong DFK. A comparison of female migrant workers’ mental health in four cities in China. Int J Soc Psychiatry. 2013;59(2):114–22.PubMedCrossRef
22.
Mou J, Cheng J, Griffiths SM, Wong SYS, Hillier S, Zhang D. Internal migration and depressive symptoms among migrant factory workers in Shenzhen, China. J Community Psychol. 2011;39(2):212.CrossRef
23.
Ren F, Yu X, Dang W, Niu W, Zhou T, Lin Y, et al. Depressive symptoms in Chinese assembly-line migrant workers: a case study in the shoe-making industry. Asia Pac Psychiatry. 2019;11(2):e12332.PubMedCrossRef
24.
Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24.PubMedCrossRef
25.
Li X, Lu J, Hu S, Cheng KK, De Maeseneer J, Meng Q, et al. The primary health-care system in China. Lancet. 2017;390(10112):2584–94.PubMedCrossRef
26.
Li L, Hu H, Zhou H, He C, Fan L, Liu X, et al. Work stress, work motivation and their effects on job satisfaction in community health workers: a cross-sectional survey in China. BMJ Open. 2014;4(6):e004897.PubMedPubMedCentralCrossRef
27.
Blashki G, Yang H, Piterman L. General practice training in China: a multimodal experiential program provided by Australian educators. Fam Med Community Health. 2018;6(1):14–9.CrossRef
28.
Rao X, Lai J, Wu H, Li Y, Xu X, Browning CJ, et al. The development of a competency assessment standard for general practitioners in China. Front Public Health. 2020;8(23):1–7.
29.
Xiong W, Phillips MR. Translated and annotated version of the 2015–2020 National Mental Health Work Plan of the People’s Republic of China. Shanghai Arch Psychiatry. 2016;28(1):4–17.PubMedPubMedCentral
30.
Searle K, Blashki G, Kakuma R, Yang H, Zhao Y, Minas H. Current needs for the improved management of depressive disorder in community healthcare centres, Shenzhen, China: a view from primary care medical leaders. Int J Ment Health Syst. 2019;13:47.PubMedPubMedCentralCrossRef
31.
Harrison MB, Légaré F, Graham ID, Fervers B. Adapting clinical practice guidelines to local context and assessing barriers to their use. CMAJ. 2010;182(2):E78-84.PubMedPubMedCentralCrossRef
32.
Fervers B, Burgers JS, Haugh MC, Latreille J, Mlika-Cabanne N, Paquet L, et al. Adaptation of clinical guidelines: literature review and proposition for a framework and procedure. Int J Qual Health Care. 2006;18(3):167–76.PubMedCrossRef
33.
Ollenschläger G, Marshall C, Qureshi S, Rosenbrand K, Burgers J, Mäkelä M, et al. Improving the quality of health care: using international collaboration to inform guideline programmes by founding the Guidelines International Network (G-I-N). Qual Saf Health Care. 2004;13(6):455–60.PubMedPubMedCentralCrossRef
34.
Squires JE, Graham ID, Hutchinson AM, Linklater S, Brehaut JC, Curran J, et al. Understanding context in knowledge translation: a concept analysis study protocol. J Adv Nurs. 2015;71(5):1146–55.PubMedCrossRef
35.
World Health Organization. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Geneva: World Health Organization; 2010.
36.
Barbui C, Dua T, van Ommeren M, Yasamy MT, Fleischmann A, Clark N, et al. Challenges in developing evidence-based recommendations using the GRADE approach: the case of mental, neurological, and substance use disorders. PLoS Med. 2010;7(8):e1000322.PubMedPubMedCentralCrossRef
37.
Dua T, Barbui C, Clark N, Fleischmann A, Poznyak V, van Ommeren M, et al. Evidence-based guidelines for mental, neurological, and substance use disorders in low- and middle-income countries: summary of WHO recommendations. PLoS Med. 2011;8(11):e1001122.PubMedPubMedCentralCrossRef
38.
Abdulmalik J, Kola L, Fadahunsi W, Adebayo K, Yasamy MT, Musa E, et al. Country contextualization of the mental health gap action programme intervention guide: a case study from Nigeria. PLoS Med. 2013;10(8):e1001501.PubMedPubMedCentralCrossRef
39.
Keynejad RC, Dua T, Barbui C, Thornicroft G. WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries. Evid Based Ment Health. 2018;21(1):30–4.PubMedCrossRef
40.
World Health Organization. mhGAP intervention guide for mental, neurological and substance use disorder in non-specialised health settings Version 2.0. Geneva: World Health Organization; 2016.
41.
May C, Finch T, Mair F, Ballini L, Dowrick C, Eccles M, et al. Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Serv Res. 2007;7:148.PubMedPubMedCentralCrossRef
42.
Shidhaye R. Implementation Science for closing the treatment gap for mental disorders by translating evidence base into practice: experiences from the PRIME project. Australas Psychiatry. 2015;23(6 Suppl):35–7.PubMedCrossRef
43.
Rathod S, Persaud A, Naeem F, Pinninti N, Tribe R, Eylem Ö, Gorczynski P, Phiri P, Husain N, Muzaffar S, Irfan M. Culturally adapted interventions in mental health: global position statement. World Cult Psychiatry Res Rev. 2020;14(1–2):21–9.
44.
Gavlak D. Learning to heal minds in the eastern Mediterranean. Bull World Health Organ. 2016;94(10):714–5.CrossRef
45.
Jha A, Sapkota N. Dementia assessment and management protocol for doctors in Nepal. JNMA J Nepal Med Assoc. 2013;52(189):292–8.PubMedCrossRef
46.
Beaglehole R, Epping-Jordan J, Patel V, Chopra M, Ebrahim S, Kidd M, et al. Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care. Lancet. 2008;372(9642):940–9.PubMedCrossRef
47.
Johnstone A, Goldberg D. Psychiatric screening in general practice. A controlled trial. Lancet. 1976;1(7960):605–8.PubMedCrossRef
48.
Meng Q, Yang H, Chen W, Sun Q, Liu X. People’s Republic of China health system review. Health systems in transition, Asia Pacific observatory on health systems and policies. WHO South East Asia J Public Health. 2015;5(7):5–12.
49.
Chen H, Phillips M, Cheng H, Chen Q, Chen X, Fralick D, et al. Mental Health Law of the People’s Republic of China (English translation with annotations): translated and annotated version of China’s new Mental Health Law. Shanghai Arch Psychiatry. 2012;24(6):305–21.PubMedPubMedCentral
50.
Wang X, Sun X, Birch S, Gong F, Valentijn P, Chen L, et al. People-centred integrated care in urban China. Bull World Health Organ. 2018;96(12):843–52.PubMedPubMedCentralCrossRef
51.
Cheng HG, Shidhaye R, Charlson F, Deng F, Lyngdoh T, Chen S, et al. Social correlates of mental, neurological, and substance use disorders in China and India: a review. Lancet Psychiatry. 2016;3(9):882–99.PubMedCrossRef
52.
Kleinman A. Introduction: remaking the moral person in a new China. In Deep China: The moral life of the person, by Arthur Kleinman, Yunxiang Yan, Jing Jun, Sing Lee, Everett Zhang, Pan Tianshu, Wu Fei, Jinhua Guo: University of California Press; 2011.
53.
Parker G, Gladstone G, Chee KT. Depression in the planet’s largest ethnic group: the Chinese. Am J Psychiatry. 2001;158(6):857–64.PubMedCrossRef
54.
Sing L. Chapter five: depression: coming of age in China. In the moral life of the person, by Arthur Kleinman, Yunxiang Yan, Jing Jun, Sing Lee, Everett Zhang, Pan Tianshu, Wu Fei, Jinhua Guo Uniersity of California Press; 2011.
55.
Lund C, Tomlinson M, Patel V. Integration of mental health into primary care in low- and middle-income countries: the PRIME mental healthcare plans. Br J Psychiatry. 2016;208(Suppl 56):s1-3.PubMedPubMedCentralCrossRef
56.
Hanlon C, Fekadu A, Jordans M, Kigozi F, Petersen I, Shidhaye R, et al. District mental healthcare plans for five low- and middle-income countries: commonalities, variations and evidence gaps. Br J Psychiatry. 2016;208(Suppl 56):s47-54.PubMedPubMedCentralCrossRef
57.
Bitta MA, Kariuki SM, Omar A, Nasoro L, Njeri M, Kiambu C, et al. Contextualizing and pilot testing the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) to primary healthcare workers in Kilifi, Kenya. Glob Ment Health (Camb). 2020;7:e11.PubMedPubMedCentralCrossRef
58.
Spagnolo J, Champagne F, Leduc N, Melki W, Guesmi I, Bram N, et al. Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations. Glob Ment Health (Camb). 2018;5:e17.PubMedPubMedCentralCrossRef
59.
Mutiso VN, Gitonga I, Musau A, Musyimi CW, Nandoya E, Rebello TJ, et al. A step-wise community engagement and capacity building model prior to implementation of mhGAP-IG in a low- and middle-income country: a case study of Makueni County, Kenya. Int J Ment Health Syst. 2018;12:57.PubMedPubMedCentralCrossRef
60.
Akins RB, Tolson H, Cole BR. Stability of response characteristics of a Delphi panel: application of bootstrap data expansion. BMC Med Res Methodol. 2005;5:37.PubMedPubMedCentralCrossRef
61.
Okoli C, Pawlowski S. The Delphi method as a research tool: an example, design considerations and applications. Inf Manag. 2004;42:15–29.CrossRef
62.
Surowiecki J. The wisdom of crowds: why the many are smarter than the few. London: Abacus; 2004.
63.
Jorm AF. Using the Delphi expert consensus method in mental health research. Aust N Z J Psychiatry. 2015;49(10):887–97.PubMedCrossRef
64.
Goodyear M, Hill TL, Allchin B, McCormick F, Hine R, Cuff R, et al. Standards of practice for the adult mental health workforce: meeting the needs of families where a parent has a mental illness. Int J Ment Health Nurs. 2015;24(2):169–80.PubMedCrossRef
65.
Ross A, Hart L, Jorm A, et al. Development of key messages for adolesents on providing basic mental health first aid to peers: a Delphi consensus study. Early Interv Psychiatry. 2012;6:229–38.PubMedCrossRef
66.
de Mello G, Fraser F, Nicoll P, Ker J, Green G, Laird C. Mental health care training for practitioners in remote and rural areas. Clin Teach. 2013;10(6):384–8.PubMedCrossRef
67.
68.
McGorry P, van Os J. Redeeming diagnosis in psychiatry: timing versus specificity. Lancet. 2013;381(9863):343–5.PubMedCrossRef
69.
Phillips MR. Can China’s new mental health law substantially reduce the burden of illness attributable to mental disorders? Lancet. 2013;381(9882):1964–6.PubMedCrossRef
70.
Tong Y, Phillips MR, Yin Y, Lan Z. Relationship of the high proportion of suicidal acts involving ingestion of pesticides to the low male-to-female ratio of suicide rates in China. Epidemiol Psychiatr Sci. 2020;29:e114.PubMedPubMedCentralCrossRef
71.
Jiang H, Niu L, Hahne J, Hu M, Fang J, Shen M, et al. Changing of suicide rates in China, 2002–2015. J Affect Disord. 2018;240:165–70.PubMedCrossRef
72.
Lu S, Li W, Oldenburg B, Wang Y, Jorm AF, He Y, et al. Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide to China: a Delphi expert consensus study. BMC Psychiatry. 2020;20(1):454.PubMedPubMedCentralCrossRef
73.
Ferenchick EK, Ramanuj P, Pincus HA. Depression in primary care: part 1-screening and diagnosis. BMJ. 2019;365:l794.PubMedCrossRef
74.
Zhang L, Cao XL, Wang SB, Zheng W, Ungvari GS, Ng CH, et al. The prevalence of bipolar disorder in China: a meta-analysis. J Affect Disord. 2017;207:413–21.PubMedCrossRef
75.
Chen PL, Li F, Harmer P. Healthy China 2030: moving from blueprint to action with a new focus on public health. Lancet. 2019;4:e447.
76.
Minas S. Chapter 8, China’s mental health law. Anthony J. Marsella A, GA, USA, editor. USA: Springer; 2021.
77.
Dixon LB, Schwarz EC. Fifty years of progress in community mental health in US: the growth of evidence-based practices. Epidemiol Psychiatr Sci. 2014;23(1):5–9.PubMedCrossRef
78.
79.
Liang C, Mei J, Liang Y, Hu R, Li L, Kuang L. The effects of gatekeeping on the quality of primary care in Guangdong Province, China: a cross-sectional study using primary care assessment tool-adult edition. BMC Fam Pract. 2019;20(1):93.PubMedPubMedCentralCrossRef
80.
Lu S, Li W, Oldenburg B, Wang Y, Jorm AF, He Y, et al. Cultural adaptation of the mental health first aid guidelines for depression used in English-speaking countries for China: a Delphi expert consensus study. BMC Psychiatry. 2020;20(1):336.PubMedPubMedCentralCrossRef
81.
Atsmon Y, Magni M. Meet the Chinese consumer of 2020. McKinsey Quarterly. 2012.
82.
Wu Z, Fang Y. Comorbidity of depressive and anxiety disorders: challenges in diagnosis and assessment. Shanghai Arch Psychiatry. 2014;26(4):227–31.PubMedPubMedCentral
83.
World Health Organization. Framework on integrated, people-centred health services. WHO; 2016.
84.
85.
Luo H, McNeil EB, Feng Q, Li H, Chen Q, Qin X, et al. Utilization of psychiatric rehabilitation services and influencing factors among people with psychotic disorders in rural communities of Guangxi, China. Int J Ment Heal Syst. 2018;12(1):17.CrossRef
86.
87.
Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMedCrossRef
88.
Mercer SW, Neumann M, Wirtz M, Fitzpatrick B, Vojt G. General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland–a pilot prospective study using structural equation modeling. Patient Educ Couns. 2008;73(2):240–5.PubMedCrossRef
89.
Li D, Xu H, Kang M, Ma S. Empathy in Chinese eight-year medical program students: differences by school year, educational stage, and future career preference. BMC Med Educ. 2018;18(1):241.PubMedPubMedCentralCrossRef
90.
Pun JKH, Chan EA, Wang S, Slade D. Health professional-patient communication practices in East Asia: an integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China. Patient Educ Couns. 2018;101(7):1193–206.PubMedCrossRef
91.
Zou G, Wei X. A qualitative study of two management models of community health centres in two Chinese megacities. Glob Public Health. 2018;13(11):1612–24.PubMedCrossRef
92.
Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis. 2020;20(8):911–9.PubMedPubMedCentralCrossRef
93.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–207.PubMedPubMedCentralCrossRef
94.
World Health Organization. COVID-19 Public Health Emergency of International Concern (PHEIC) Global research and innovation forum. 2020 12/02/2020.
95.
Zou H, Shu Y, Feng T. How Shenzhen, China avoided widespread community transmission: a potential model for successful prevention and control of COVID-19. Infect Dis Poverty. 2020;9(1):89.PubMedPubMedCentralCrossRef
96.
97.
Doran M, Henderson A. Scott Morrison defends Peter Dutton's calls for transparency from China over the origins of coronavirus. ABC News. 2020 23/04/2020.
98.
ABC. China warns citizens not to travel to Australia amid 'increased' racismsince coronavirus outbreak. ABC News. 2020 6/06/2020.
99.
Tan S. Why has the China–Australia relationship deteriorated into ‘trade war 2.0’? South Morning China Post, The. 2020 1/07/2020.
100.
Howarth E, Vainre M, Humphrey A, Lombardo C, Hanafiah AN, Anderson JK, et al. Delphi study to identify key features of community-based child and adolescent mental health services in the East of England. BMJ Open. 2019;9(6):e022936.PubMedPubMedCentralCrossRef
101.
Tyler N, Wright N, Grundy A, Waring J. Developing a core outcome set for interventions to improve discharge from mental health inpatient services: a survey, Delphi and consensus meeting with key stakeholder groups. BMJ Open. 2020;10(5):e034215.PubMedPubMedCentralCrossRef
Metadata
Title
Adapting the depression component of WHO Mental Health Gap Intervention Guide (mhGAP-IG.v2) for primary care in Shenzhen, China: a DELPHI study
Authors
Kendall Searle
Grant Blashki
Ritsuko Kakuma
Hui Yang
Shurong Lu
Baoqi Li
Yingying Xiao
Harry Minas
Publication date
01-12-2022
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2022
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-022-00523-0

Other articles of this Issue 1/2022

International Journal of Mental Health Systems 1/2022 Go to the issue

Debate

Missing in action: the right to the highest attainable standard of mental health care

Research

Lessons to be learned: identifying high-risk medication and circumstances in patients at risk for suicidal self-poisoning

Research

Mental health stigma at primary health care centres in Lebanon: qualitative study

Research

The impacts of implementing recovery innovations: a conceptual framework grounded in qualitative research

Research

The impact of Timothy's Law on hospitalization among patients with mental health conditions in New York State

Research

Learn, Engage, Act, Dedicate (LEAD): development and feasibility testing of a task-shifted intervention to improve alcohol use, depression and family engagement for fathers