mhGAP Intervention Guide: A systematic review of evidence from LMICs

mhGAP Intervention Guide: A systematic review of evidence from LMICs

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries

Authors: Roxanne C Keynejad, Tarun Dua, Corrado Barbui and Graham Thornicroft

Question

Despite mental, neurological and substance use (MNS) disorders being highly prevalent, there is a worldwide gap between service need and provision. WHO launched its Mental Health Gap Action Programme (mhGAP) in 2008, and the Intervention Guide (mhGAP-IG) in 2010. mhGAP-IG provides evidence-based guidance and tools for assessment and integrated management of priority MNS disorders in low and middle-income countries (LMICs), using clinical decision-making protocols. It targets a non-specialised primary healthcare audience, but has also been used by ministries, non-governmental organisations and academics, for mental health service scale-up in 90 countries. This review aimed to identify evidence to date for mhGAP-IG implementation in LMICs.

Findings 

We conducted a systematic review of evidence to date, of mhGAP-IG implementation and evaluation in LMICs. 33 included studies reported:

  • 15 training courses
  • 9 clinical implementations
  • 3 country contextualisations
  • 3 economic models
  • 2 uses as control interventions
  • 1 use to develop a rating scale.

Our review identified the importance of detailed reports of contextual challenges in the field, alongside detailed protocols, qualitative studies and randomised controlled trials. 

Conclusions

The mhGAP-IG literature is substantial, relative to other published evaluations of clinical practice guidelines: an important contribution to a neglected field.

Details

Type
Research summaries and systematic reviews
Approach(es)
Detection and diagnosis
Task sharing
Training, education and capacity building
Treatment, care and rehabilitation
Disorder(s)
All mental health conditions
Region(s)
Africa
Asia
Middle East
South America
Setting(s)
Community
Primary care