Table 2.
Mental healthcare plan service delivery packagesa
| Awareness | Detection | Treatment | Recovery | Human resource |
|---|---|---|---|---|
| Specialist/district hospital | ||||
| Conduct small group meetings with individuals attending the hospital Screen audiovisual interventions/films in the hospital Display of posters in a designated space/ corner in the hospital |
History-taking, assessment and clinical diagnosis of priority disorders of individuals coming to the hospital/referred from facility |
Prescribe antidepressants and psychosocial interventions to individuals with depression as per mhGAP guidelines Management of psychosis as per mhGAP guidelines Management of alcohol dependence Provide psychoeducation to families of individuals with depression, alcohol use disorders and psychosis Facilitate referral of individuals with depression, alcohol use disorders and psychosis to higher centres for further management |
Link individuals with depression, alcohol use disorders and psychosis to community health centres (if required) for further follow-up and community-based rehabilitation |
District mental health team (psychiatrist and psychologist) Mental health case manager |
| Community health centres/ subdistrict hospital |
||||
| Conduct small group meetings with individuals attending the facility Screen audiovisual interventions/films in the facility Display of posters in a designated space/corner in the facility |
History-taking and assessment of priority disorders based on mhGAP guidelines, of individuals coming to the facility/referred by front-line workers |
Prescribe antidepressants and psychosocial interventions to individuals with mild to moderate depression as per mhGAP guidelines Manage acute episode of psychosis as per mhGAP guidelines Provide brief interventions to individuals with alcohol use disorders as per mhGAP guidelines Provide psychoeducation to families of individuals with depression, alcohol use disorders and psychosis Facilitate referral of individuals with depression, alcohol use disorders and psychosis to district level for further management |
Provide follow-up care including prescription of psychotropic medications and psychosocial interventions to individuals referred from the district hospital after initial consultation Link individuals with depression, alcohol use disorders and psychosis to front-line workers for further follow-up and community-based rehabilitation |
Medical officers and paramedical workers Mental health case manager |
| Community | ||||
| Conduct small group meetings with community members Screen audiovisual interventions/films in villages Display of posters at community meeting places such as village government offices (Gram Panchayat) and village health and nutritio centre (Anganwadi) |
Establish contact, interact and assess individuals based on symptoms/behavioural presentations |
Provide mental health first aid with emphasis on self-care strategies especially for depression Provide psychoeducation to families of individuals with psychosis and encourage referral Provide brief interventions to individuals with alcohol use disorders Conduct risk assessment for self-harm Facilitate referral to facility by accompanying the individual if possible |
Regular follow-up visits and advice on adherence support to individuals who have been prescribed drugs in the facility/advised psychosocial interventions Link individuals with psychosis (clinically stabilised) to rehabilitation agencies in the community Link individuals with alcohol use disorders to existing self-help groups such as Alcoholic Anonymous |
Front-line workers Mental health case manager |
mhGAP, World Health Organization Mental Health Gap Action Programme.
a.
Plain text indicates individuals who were responsible for implementing these packages during the design of the mental healthcare plan, whereas text in italics indicates individuals who need to play an important role in implementation of these packages in the modified MHCP post-pilot implementation.