Table 4.

Theory of change (ToC) indicators at facility and community levels

ToC outcome	Indicator(s)	Study design
f. Service providers in post	Adequate numbers of human resources as per the mental healthcare plan are available at primary and community levels	Case study: facility profile
g. Service providers able to diagnose and treat     priority mental disorders	Change in knowledge and attitudes pre- and post-training	Case study: training and supervision evaluation
h. Psychosocial interventions available	Staff trained in psychosocial interventions are available at the facility	Case study: facility profile
i. People with mental disorders are identified     and/or diagnosed in facilities	Increased number and proportion of people correctly identified/ diagnosed with depression and alcohol use and treated with evidence-based interventions Increase in % mental health case-load as a proportion of total primary healthcare headcount	Facility detection survey Case study: facility profile
j. Services accessible, affordable and acceptable	Patients' perception of accessibility and acceptability of services	Qualitative cohort Cohort
k. People with priority disorders receive     treatment as intended for the required duration     and adequately referred if necessary	Increased number of people correctly receiving evidence-based treatment Number of patients who received psychosocial interventions at community level and facility level for the required duration	Facility detection survey Cohort
l. Improved outcomes for people with mental     disorders treated by the programme and     their families/carers	Improved health, social and economic outcomes of people living with priority mental disorders	Cohort
m. Increased effective coverage of evidence-     based mental health services	Increased coverage of evidence-based mental health services	Community survey Cohort
n. People with mental disorders are identified     in the community	Increased number of cases detected and managed by community health workers	Case study: community profile
o. People with mental disorders are willing to     seek treatment	Increase in help-seeking and earlier presentation at clinic	Facility detection survey
p. Community is aware of mental illness and     stigma is reduced	Improved mental health literacy and decrease in stigma Community members are aware of local availability of treatment Decreased reported stigma by people with priority disorders	Community survey Cohort
q. Environmental, policy, social and political     context of the district is monitored for     modification of implementation	Changes in environmental, policy, social and political contexts are monitored throughout implementation	Case study: district profile