Efficacy and cost-effectiveness of drug and psychological treatments for common mental disorders in general health care in Goa, India: a randomised, controlled trial

Common mental disorders in Petrópolis-RJ: a challenge to integrate mental health into primary care strategies

“…Nonetheless, Patel et al stressed, in a recent narrative review, that there is strong evidence from low and middle income (LAMI) countries of effective options for treating depression with both drugs and psychological treatments. 33 These trials are from Chile, 34 India, 35 39 highlighted the role of training primary care professionals, structuring care pathways and organizing an approach involving community mental health centers in order to obtain effective prescriptions and psychosocial treatments in primary care. Therefore, training primary care professionals to assess and manage mental health conditions is essential and should involve additional skills other than simply diagnosing and medicating mental disorders.…”

“…Family Health Strategy teams can assist women with CMD to overcome the vicious circle of poverty and mental disorders as has been done in other countries. [34][35][36][37][38] Integrating FHP and MH teams is being considered a priority in public health policy for the next years. The Brazilian National Mental Health Policy considers expanding the integration of primary care and mental health professionals a strategic priority and, in order to do so, it created the Núcleos de Apoio à Saúde da Família in 2008.…”

Barriers in the mind: promoting an economic case for mental health in low‐ and middle‐income countries

“…Increasingly, economic analyses are being undertaken in low-and middle-income countries (27)(28)(29)(30)(31), but the overwhelming majority of studies are from high-income countries. This is not surprising: between 1992 and 2001 only 4% of articles in journals on the ISI Web of Science databases were on mental health issues; of these a mere 6% were from low-and middle-income countries (32).…”

Integrating evidence‐based treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa, India

“…Although substantial proportions of primary care attenders in LAMIC suffer from a CMD -estimates vary from 10 to 30% (1,5) -the vast majority of patients do not receive effective treatments (6). This treatment gap persists even as a growing evidence base demonstrates that there are efficacious treatments that are feasible in LAMIC settings (7)(8)(9)(10). To address this treatment gap, integration of mental health services into primary care is widely acknowledged as the most feasible strategy (11).…”

“…The original intervention plan was based on two principles: first, the treatments selected would be based on evidence from published trials in LAMIC and, thus, include psychoeducation (24,25), antidepressants (7,9) and group interpersonal therapy (IPT) (8,10); and, second, the intervention would address the challenges highlighted earlier and be based on the best global evidence available (13). The intervention would involve a reconfiguration of both the human resources and the principles of care delivery in primary care.…”