Skip to main content
Top
Published in: Systematic Reviews 1/2017

Open Access 01-12-2017 | Protocol

Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol

Authors: Edith K. Wakida, Dickens Akena, Elialilia S. Okello, Alison Kinengyere, Ronald Kamoga, Arnold Mindra, Celestino Obua, Zohray M. Talib

Published in: Systematic Reviews | Issue 1/2017

Login to get access

Abstract

Background

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works.

Methods

This review will use the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework approach to identify experiences of mental health integration into PHC; the findings will be reported using the “Best fit” framework synthesis. PubMed, EMBASE, PsycINFO, and Cochrane Central Register of Controlled trials (CENTRAL) will be searched including other sources like the WHO website and OpenGrey database. Assessment of bias and quality will be done at study level using two separate tools to check for the quality of evidence presented.
Data synthesis will take on two synergistic approaches (qualitative and quantitative studies). Synthesizing evidence from countries across the globe will provide useful insights into the experiences of integrating mental health services into PHC and how the barriers and challenges have been handled. The findings will be useful to a wide array of stakeholders involved in the implementation of the mental health integration into PHC.

Discussion

The SPIDER framework has been chosen for this review because of its suitable application to qualitative and mixed methods research and will be used as a guide when selecting articles for inclusion. Data extracted will be synthesized using the “Best fit” framework because it has been used before and proved its suitability in producing new conceptual models for explaining decision-making and possible behaviors. Synthesizing evidence from countries across the globe will provide useful insights into the experiences of integrating mental health services into PHC and how the barriers and challenges have been handled.

Systematic review registration

PROSPERO CRD42016052000
Appendix
Available only for authorised users
Literature
2.
go back to reference World Health Organization. Comprehensive mental health action plan 2013–2020. Geneva: World Health Organization; 2013. World Health Organization. Comprehensive mental health action plan 2013–2020. Geneva: World Health Organization; 2013.
3.
go back to reference Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet. 2007;370(9593):1164–74.CrossRefPubMed Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet. 2007;370(9593):1164–74.CrossRefPubMed
4.
go back to reference World Health Organization. Mental health policy, planning & service develop integrating systems & services, integrating people. Geneva: World Health Organization; 2007. World Health Organization. Mental health policy, planning & service develop integrating systems & services, integrating people. Geneva: World Health Organization; 2007.
5.
go back to reference Charlson FJ, Diminic S, Lund C, Degenhardt L, Whiteford HA. Mental and substance use disorders in sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years. PLoS One. 2014;9(10):e110208.CrossRefPubMedPubMedCentral Charlson FJ, Diminic S, Lund C, Degenhardt L, Whiteford HA. Mental and substance use disorders in sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years. PLoS One. 2014;9(10):e110208.CrossRefPubMedPubMedCentral
6.
go back to reference Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. Global Burden of Mental, Neurological, and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010. In: Patel V, Chisholm D, Dua T, Laxminarayan R, Medina-Mora ME, editors. Mental, Neurological, and Substance Use Disorders: Disease Control Priorities, Third Edition (Volume 4). Washington (DC): The International Bank for Reconstruction and Development/The World Bank. (c) 2016 International Bank for Reconstruction and Development/The World Bank; 2016. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. Global Burden of Mental, Neurological, and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010. In: Patel V, Chisholm D, Dua T, Laxminarayan R, Medina-Mora ME, editors. Mental, Neurological, and Substance Use Disorders: Disease Control Priorities, Third Edition (Volume 4). Washington (DC): The International Bank for Reconstruction and Development/The World Bank. (c) 2016 International Bank for Reconstruction and Development/The World Bank; 2016.
7.
go back to reference World Health Organization. The world health report 2008: primary health care now more than ever. 2008. World Health Organization. The world health report 2008: primary health care now more than ever. 2008.
8.
go back to reference Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet (London, England). 2013;382(9904):1575–86.CrossRef Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet (London, England). 2013;382(9904):1575–86.CrossRef
9.
go back to reference World Health Organization, World Organization of National Colleges Academies, Academic Associations of General Practitioners/Family Physicians. Integrating mental health into primary care: a global perspective. In: Organization WH, editor. Geneva: WHO Press; 2008. World Health Organization, World Organization of National Colleges Academies, Academic Associations of General Practitioners/Family Physicians. Integrating mental health into primary care: a global perspective. In: Organization WH, editor. Geneva: WHO Press; 2008.
10.
go back to reference World Health Organization. Declaration of alma-ata: World Health Organization, Regional Office for Europe; 2004. World Health Organization. Declaration of alma-ata: World Health Organization, Regional Office for Europe; 2004.
11.
go back to reference World Health Organization, Unicef. Primary health care: a joint report. 1978. World Health Organization, Unicef. Primary health care: a joint report. 1978.
12.
go back to reference TO A. Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries. Med J Aust. 2003;178(1):17–20. TO A. Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries. Med J Aust. 2003;178(1):17–20.
13.
go back to reference Hall JJ, Taylor R. Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries. Med J Aust. 2003;178(1):17–20.PubMed Hall JJ, Taylor R. Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries. Med J Aust. 2003;178(1):17–20.PubMed
14.
go back to reference World Health Organization. Improving health systems and services for mental health. 2009. World Health Organization. Improving health systems and services for mental health. 2009.
16.
go back to reference Kakuma R, Minas H, van Ginneken N, Dal Poz MR, Desiraju K, Morris JE, et al. Human resources for mental health care: current situation and strategies for action. Lancet. 2011;378(9803):1654–63.CrossRefPubMed Kakuma R, Minas H, van Ginneken N, Dal Poz MR, Desiraju K, Morris JE, et al. Human resources for mental health care: current situation and strategies for action. Lancet. 2011;378(9803):1654–63.CrossRefPubMed
17.
go back to reference Force CPST. Recommendation from the community preventive services task force for use of collaborative care for the management of depressive disorders. Am J Prev Med. 2012;42(5):521–4.CrossRef Force CPST. Recommendation from the community preventive services task force for use of collaborative care for the management of depressive disorders. Am J Prev Med. 2012;42(5):521–4.CrossRef
18.
go back to reference Davis K. Costs and consequences of enhanced primary care for depression: systematic review of randomised economic evaluations. Primary Health Care. 2007;17(1):34.CrossRef Davis K. Costs and consequences of enhanced primary care for depression: systematic review of randomised economic evaluations. Primary Health Care. 2007;17(1):34.CrossRef
19.
go back to reference Petersen I, Marais D, Abdulmalik J, Ahuja S, Alem A, Chisholm D, et al. Strengthening mental health system governance in six low-and middle-income countries in Africa and South Asia: challenges, needs and potential strategies. Health Policy Plan. 2017;32(5):699–709.CrossRefPubMedPubMedCentral Petersen I, Marais D, Abdulmalik J, Ahuja S, Alem A, Chisholm D, et al. Strengthening mental health system governance in six low-and middle-income countries in Africa and South Asia: challenges, needs and potential strategies. Health Policy Plan. 2017;32(5):699–709.CrossRefPubMedPubMedCentral
20.
go back to reference Sheikh K, Gilson L, Agyepong IA, Hanson K, Ssengooba F, Bennett S. Building the field of health policy and systems research: framing the questions. PLoS Med. 2011;8(8):e1001073.CrossRefPubMedPubMedCentral Sheikh K, Gilson L, Agyepong IA, Hanson K, Ssengooba F, Bennett S. Building the field of health policy and systems research: framing the questions. PLoS Med. 2011;8(8):e1001073.CrossRefPubMedPubMedCentral
21.
go back to reference Barraclough F, Longman J, Barclay L. Integration in a nurse practitioner-led mental health service in rural Australia. Aust J Rural Health. 2016;24(2):144–50.CrossRefPubMed Barraclough F, Longman J, Barclay L. Integration in a nurse practitioner-led mental health service in rural Australia. Aust J Rural Health. 2016;24(2):144–50.CrossRefPubMed
22.
go back to reference Bindman J, Johnson S, Wright S, Szmukler G, Bebbington P, Kuipers E, et al. Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views. Br J Psychiatry. 1997;171:169–74.CrossRefPubMed Bindman J, Johnson S, Wright S, Szmukler G, Bebbington P, Kuipers E, et al. Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views. Br J Psychiatry. 1997;171:169–74.CrossRefPubMed
23.
go back to reference Chowdhury N. Integration between mental health-care providers and traditional spiritual healers: contextualising islam in the twenty-first century. J Relig Health. 2016;55(5):1665–71.CrossRefPubMed Chowdhury N. Integration between mental health-care providers and traditional spiritual healers: contextualising islam in the twenty-first century. J Relig Health. 2016;55(5):1665–71.CrossRefPubMed
24.
go back to reference Bhana A, Petersen I, Baillie KL, Flisher AJ. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry. 2010;22(6):599–610.CrossRefPubMed Bhana A, Petersen I, Baillie KL, Flisher AJ. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry. 2010;22(6):599–610.CrossRefPubMed
25.
go back to reference Bhana A, Petersen I, Baillie KL, Flisher AJ. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry (Abingdon, England). 2010;22(6):599–610.CrossRef Bhana A, Petersen I, Baillie KL, Flisher AJ. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry (Abingdon, England). 2010;22(6):599–610.CrossRef
26.
go back to reference Abera M, Tesfaye M, Belachew T, Hanlon C. Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia. BMC Health Serv Res. 2014;14:113.CrossRefPubMedPubMedCentral Abera M, Tesfaye M, Belachew T, Hanlon C. Perceived challenges and opportunities arising from integration of mental health into primary care: a cross-sectional survey of primary health care workers in south-west Ethiopia. BMC Health Serv Res. 2014;14:113.CrossRefPubMedPubMedCentral
27.
go back to reference Ackerman B, Pyne JM, Fortney JC. Challenges associated with being an off-site depression care manager. J Psychosoc Nurs Ment Health Serv. 2009;47(4):43–9.CrossRefPubMed Ackerman B, Pyne JM, Fortney JC. Challenges associated with being an off-site depression care manager. J Psychosoc Nurs Ment Health Serv. 2009;47(4):43–9.CrossRefPubMed
29.
go back to reference Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, et al. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database Syst Rev. 2013(10). Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, et al. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database Syst Rev. 2013(10).
30.
go back to reference The SURE Collaboration. SURE guides for preparing and using evidence-based policy briefs: identifying and addressing barriers to implementing policy options. Version 2.1 [updated November 2011]. The SURE Collaboration; 2011. Available from www.evipnet.org/sure. The SURE Collaboration. SURE guides for preparing and using evidence-based policy briefs: identifying and addressing barriers to implementing policy options. Version 2.1 [updated November 2011]. The SURE Collaboration; 2011. Available from www.​evipnet.​org/​sure.​
31.
go back to reference Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.CrossRefPubMed Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.CrossRefPubMed
32.
go back to reference Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ (Clinical research ed). 2015;349:g7647. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ (Clinical research ed). 2015;349:g7647.
33.
go back to reference Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012;22(10):1435–43.CrossRefPubMed Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012;22(10):1435–43.CrossRefPubMed
34.
go back to reference Carroll C, Booth A, Leaviss J, Rick J. “Best fit” framework synthesis: refining the method. BMC medical research methodology. 2013;13(1):37. Carroll C, Booth A, Leaviss J, Rick J. “Best fit” framework synthesis: refining the method. BMC medical research methodology. 2013;13(1):37.
35.
go back to reference Verboom B, Montgomery P, Bennett S. What factors affect evidence-informed policymaking in public health? Protocol for a systematic review of qualitative evidence using thematic synthesis. Syst Rev. 2016;5(1):61.CrossRefPubMedPubMedCentral Verboom B, Montgomery P, Bennett S. What factors affect evidence-informed policymaking in public health? Protocol for a systematic review of qualitative evidence using thematic synthesis. Syst Rev. 2016;5(1):61.CrossRefPubMedPubMedCentral
36.
go back to reference Noyes J, Popay J. Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta-synthesis. J Adv Nurs. 2007;57(3):227–43.CrossRefPubMed Noyes J, Popay J. Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta-synthesis. J Adv Nurs. 2007;57(3):227–43.CrossRefPubMed
37.
go back to reference Carroll C, Booth A, Lloyd-Jones M. Should we exclude inadequately reported studies from qualitative systematic reviews? An evaluation of sensitivity analyses in two case study reviews. Qual Health Res. 2012;22(10):1425–34.CrossRefPubMed Carroll C, Booth A, Lloyd-Jones M. Should we exclude inadequately reported studies from qualitative systematic reviews? An evaluation of sensitivity analyses in two case study reviews. Qual Health Res. 2012;22(10):1425–34.CrossRefPubMed
38.
go back to reference Thomas H. Quality assessment tool for quantitative studies. Toronto: McMaster University; 2003. Thomas H. Quality assessment tool for quantitative studies. Toronto: McMaster University; 2003.
39.
go back to reference Thomas H. Quality assessment tool for quantitative studies. Toronto: Effective Public Health Practice Project McMaster University; 2003. Thomas H. Quality assessment tool for quantitative studies. Toronto: Effective Public Health Practice Project McMaster University; 2003.
40.
go back to reference Kay-Lambkin FJ, Thornton L, Lappin JM, Hanstock T, Sylvia L, Jacka F, et al. Study protocol for a systematic review of evidence for lifestyle interventions targeting smoking, sleep, alcohol/other drug use, physical activity, and healthy diet in people with bipolar disorder. Syst Rev. 2016;5(1):106.CrossRefPubMedPubMedCentral Kay-Lambkin FJ, Thornton L, Lappin JM, Hanstock T, Sylvia L, Jacka F, et al. Study protocol for a systematic review of evidence for lifestyle interventions targeting smoking, sleep, alcohol/other drug use, physical activity, and healthy diet in people with bipolar disorder. Syst Rev. 2016;5(1):106.CrossRefPubMedPubMedCentral
41.
go back to reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.CrossRefPubMedPubMedCentral Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.CrossRefPubMedPubMedCentral
Metadata
Title
Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol
Authors
Edith K. Wakida
Dickens Akena
Elialilia S. Okello
Alison Kinengyere
Ronald Kamoga
Arnold Mindra
Celestino Obua
Zohray M. Talib
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2017
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-017-0561-0

Other articles of this Issue 1/2017

Systematic Reviews 1/2017 Go to the issue