TY - JOUR
KW - Delivery of Health Care, Integrated/methods
KW - Health Knowledge, Attitudes, Practice
KW - Health Personnel/psychology
KW - Humans
KW - Mental Health Services/organization & administration
KW - Primary Health Care/organization & administration
KW - Barriers and facilitators
KW - integration
KW - Mental Health Services
KW - Primary Health Care
KW - Systematic Review
AU - E. K. Wakida
AU - Z. M. Talib
AU - D. Akena
AU - E. S. Okello
AU - A. Kinengyere
AU - A. Mindra
AU - C. Obua
A1 - 
AB - BACKGROUND: The objective of the review was to synthesize evidence of barriers and facilitators to the integration of mental health services into PHC from existing literature. The structure of the review was guided by the SPIDER framework which involves the following: Sample or population of interest-primary care providers (PCPs); Phenomenon of Interest-integration of mental health services into primary health care (PHC); Design-influenced robustness and analysis of the study; Evaluation-outcomes included subjective outcomes (views and attitudes); and Research type-qualitative, quantitative, and mixed methods studies. METHODS: Studies that described mental health integration in PHC settings, involved primary care providers, and presented barriers/facilitators of mental health integration into PHC were included in the review. The sources of information included PubMed, PsycINFO, Cochrane Central Register of Controlled trials, the WHO website, and OpenGrey. Assessment of bias and quality was done using two separate tools: the Critical Appraisal Skills Program (CASP) qualitative checklist and the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS: Twenty studies met the inclusion criteria out of the 3353 search results. The most frequently reported barriers to integration of mental health services into PHC were (i) attitudes regarding program acceptability, appropriateness, and credibility; (ii) knowledge and skills; (iii) motivation to change; (iv) management and/or leadership; and (v) financial resources. In order to come up with an actionable approach to addressing the barriers, these factors were further analyzed along a behavior change theory. DISCUSSION: We have shown that the integration of mental health services into PHC has been carried out by various countries. The analysis from this review provides evidence to inform policy on the existing barriers and facilitators to the implementation of the mental health integration policy option. Not all databases may have been exhausted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2016 (Registration Number: CRD42016052000 ) and published in BMC Systematic Reviews August 2017.
AD - Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda. ediwakida@must.ac.ug.; Department of Medical Education, California University of Science and Medicine, California, USA.; Mbarara University of Science and Technology, Mbarara, Uganda.; Africa Center for Systematic Reviews and Knowledge Translation, College of Health Sciences Makerere University, Kampala, Uganda.; Department of Psychiatry, Makerere University, Kampala, Uganda.; Department of Psychiatry, Makerere University, Kampala, Uganda.; Department of Psychiatry, Makerere University, Kampala, Uganda.; Library, Africa Center for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.; Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda.; Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda.
BT - Systematic reviews
C5 - Healthcare Policy
CP - 1
CY - England
DO - 10.1186/s13643-018-0882-7
IS - 1
JF - Systematic reviews
M1 - Journal Article
N2 - BACKGROUND: The objective of the review was to synthesize evidence of barriers and facilitators to the integration of mental health services into PHC from existing literature. The structure of the review was guided by the SPIDER framework which involves the following: Sample or population of interest-primary care providers (PCPs); Phenomenon of Interest-integration of mental health services into primary health care (PHC); Design-influenced robustness and analysis of the study; Evaluation-outcomes included subjective outcomes (views and attitudes); and Research type-qualitative, quantitative, and mixed methods studies. METHODS: Studies that described mental health integration in PHC settings, involved primary care providers, and presented barriers/facilitators of mental health integration into PHC were included in the review. The sources of information included PubMed, PsycINFO, Cochrane Central Register of Controlled trials, the WHO website, and OpenGrey. Assessment of bias and quality was done using two separate tools: the Critical Appraisal Skills Program (CASP) qualitative checklist and the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS: Twenty studies met the inclusion criteria out of the 3353 search results. The most frequently reported barriers to integration of mental health services into PHC were (i) attitudes regarding program acceptability, appropriateness, and credibility; (ii) knowledge and skills; (iii) motivation to change; (iv) management and/or leadership; and (v) financial resources. In order to come up with an actionable approach to addressing the barriers, these factors were further analyzed along a behavior change theory. DISCUSSION: We have shown that the integration of mental health services into PHC has been carried out by various countries. The analysis from this review provides evidence to inform policy on the existing barriers and facilitators to the implementation of the mental health integration policy option. Not all databases may have been exhausted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2016 (Registration Number: CRD42016052000 ) and published in BMC Systematic Reviews August 2017.
PP - England
PY - 2018
SN - 2046-4053; 2046-4053
SP - 018
EP - 7
EP - 211+
T1 - Barriers and facilitators to the integration of mental health services into primary health care: a systematic review
T2 - Systematic reviews
TI - Barriers and facilitators to the integration of mental health services into primary health care: a systematic review
U1 - Healthcare Policy
U2 - 30486900
U3 - 10.1186/s13643-018-0882-7
VL - 7
VO - 2046-4053; 2046-4053
Y1 - 2018
Y2 - Nov 28
ER -