Integration of mental health care into primary care

Chisholm, Daniel; James, Sarah; Kasi, Sekar; Kumar, Kishore; Murthy, R. Srinivasa; Saeed, Khalid; Mubbashar, Malik H.

doi:10.1192/bjp.176.6.581

Cited by 157 publications

(48 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Total scores of five and above screen for common mental disorders [28] and a score of eight and above identifies depression in community [29]. SRQ has been used to detect common mental disorders in primary care in India [30]; (iii) Client Service Receipt Inventory [31,32] to elicit the information of caregivers’ occupation, their absenteeism to provide care, their unpaid care time inputs and their income from all sources; (iv) Caregiver Activity Survey [33] to assess their time spent on ADL and on other care activities such as communication as well as supervision; (v) a structured proforma to assess caregiver’s socio-demographic and socioeconomic characteristics. We assessed one randomly selected co-resident family member of each older person, who is not dependent (n = 915), with SRQ and recorded their socio-demographic characteristics for further comparisons.…”

Section: Methodsmentioning

confidence: 99%

“…We assessed the dependent older participants with the following: (i) World Health Organization Disability Assessment Scale II (WHODAS II) [34] to measure the disability; (ii) Community Screening Instrument for Dementia (CSID) [35]; (iii) Neuro Psychiatric Inventory Questionnaire (NPI-Q) [36]; (iv) Geriatric Mental State (GMS) [37]; (v) History and Aetiology Schedule- Dementia Diagnosis and subtype (HAS-DDS) [38]; (vi) Client Socio-demographic and Service Receipt Inventory (CSSRI) [32] to assess the time spent on caregiver accompanied travel to various health services and time spent with health care personnel; (vii) structured questionnaire to assess the sociodemographic, socioeconomic, medical history and anthropometrics. Training of research staff involved the procedures for data collection and quality control, which were in accordance with the norms for 10/66 Dementia Research Group population studies [20,21].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Cost and burden of informal caregiving of dependent older people in a rural Indian community

Brinda

Rajkumar

Enemark

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundLack of state supported care services begets the informal caregiving by family members as the mainstay of care provided to the dependent older people in many Low and Middle Income Countries (LMICs), including India. Little is known about the time spent on caregiving, its cost and the burden experienced by these informal caregivers. We aimed to estimate the costs of informal caregiving and to evaluate the nature as well as correlates of caregivers’ burden in a rural Indian community.MethodsWe assessed 1000 people aged above 65 years, among whom 85 were dependent. We assessed their socioeconomic profiles, disability, health status and health expenditures. Their caregivers’ socio-demographic profiles, mental health, and the time spent on caregiving were assessed using standard instruments. Caregiver’s burden was evaluated using Zarit Burden Scale. We valued the annual informal caregiving costs using proxy good method. We employed appropriate non-parametric multivariate statistics to evaluate the correlates of caregivers’ burden.ResultsAverage time spent on informal caregiving was 38.6 (95% CI 35.3-41.9) hours/week. Estimated annual cost of informal caregiving using proxy good method was 119,210 US$ in this rural community. Mean total score of Zarit burden scale, measuring caregivers’ burden, was 17.9 (95% CI 15.6-20.2). Prevalence of depression among the caregivers was 10.6% (95% CI 4.1-17.1%). Cerebrovascular disease, Parkinson’s disease, higher disability, insomnia and incontinence of the dependent older people as well as the time spent on helping Activities of Daily Living and on supervision increased caregiver's burden significantly.ConclusionsCost and burden of informal caregiving are high in this rural Indian community. Many correlates of burden, experienced by caregivers, are modifiable. We discuss potential strategies to reduce this burden in LMICs. Need for support to informal caregivers and for management of dependent older people with chronic disabling diseases by multidisciplinary community teams are highlighted.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cost and burden of informal caregiving of dependent older people in a rural Indian community

Brinda

Rajkumar

Enemark

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…25,31,32 Two key categories of costs were estimated: health-system costs (including those related to the intervention itself, comprising the costs of inpatient and outpatient care, medications and clinical investigations) and the "time costs" for the subjects and their families (i.e. the opportunity costs of time spent travelling to, waiting for or receiving care, plus the wages from any days of work lost).…”

Section: Costsmentioning

confidence: 99%

Economic evaluation of a task-shifting intervention for common mental disorders in India

Buttorff¹,

Hock²,

Weiss³

et al. 2012

Bull World Health Org

143

139

View full text Add to dashboard Cite

“…In India and Pakistan [63], a naturalistic demonstration study argued that integrating mental health into primary care is likely to be cost effective. Chisholm et al [64] international have since estimated the population level cost effectiveness of evidence based depression interventions and their contribution towards reducing the current burden of depression.…”

Section: Discussionmentioning

confidence: 99%

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Jenkins¹,

Othieno

Okeyo

et al. 2013

Int J Ment Health Syst

View full text Add to dashboard Cite

Trial designA pragmatic cluster randomised controlled trial.MethodsParticipants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment.ResultsNumbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified.ConclusionThe training programme did not result in significantly improved recorded diagnostic rates of mental disorders in the routine clinic consultation register, but did have significant effects on patient outcomes in routine clinical practice.Trial registrationInternational Standard Randomised Controlled Trial Number Register ISRCTN53515024.

show abstract

Integration of mental health care into primary care

Cited by 157 publications

References 13 publications

Cost and burden of informal caregiving of dependent older people in a rural Indian community

Cost and burden of informal caregiving of dependent older people in a rural Indian community

Economic evaluation of a task-shifting intervention for common mental disorders in India

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Contact Info

Product

Resources

About