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Page type: 
Research summaries and systematic reviews
Publication date: 
2019

Full title: Systematic evaluation of the QualityRights programme in public mental health facilities in Gujarat, India

Authors: Soumitra Pathare, Michelle Funk, Natalie Drew Bold, Ajay Chauhan, Jasmine Kalha, Sadhvi Krishnamoorthy, Jaime C. Sapag, Sireesha J. Bobbili, Rama Kawade, Sandeep Shah, Ritambhara Mehta, Animesh Patel, Upendra Gandhi, Mahesh Tilwani, Rakesh Shah, Hitesh Sheth, Ganpat Vankar, Minakshi Parikh, Indravadan Parikh, Thara Rangaswamy, Amritkumar Bakshy and Akwatu Khenti

Summary: This systematic review is the first systematic large scale evaluation of the World Health Organization's QualityRights program.


Background

Recognising the significant extent of poor-quality care and human rights issues in mental health, the World Health Organization launched the QualityRights initiative in 2013 as a practical tool for implementing human rights standards including the United Nations Convention on Rights of Persons with Disabilities (CRPD) at the ground level.

Aims

To describe the first large-scale implementation and evaluation of QualityRights as a scalable human rights-based approach in public mental health services in Gujarat, India.

Method

This is a pragmatic trial involving implementation of QualityRights at six public mental health services chosen by the Government of Gujarat. For comparison, we identified three other public mental health services in Gujarat that did not receive the QualityRights intervention.

Results

Over a 12-month period, the quality of services provided by those services receiving the QualityRights intervention improved significantly. Staff in these services showed substantially improved attitudes towards service users (effect sizes 0.50–0.17), and service users reported feeling significantly more empowered (effect size 0.07) and satisfied with the services offered (effect size 0.09). Caregivers at the intervention services also reported a moderately reduced burden of care (effect size 0.15).

Conclusions

To date, some countries are hesitant to reforming mental health services in line with the CRPD, which is partially attributable to a lack of knowledge and understanding about how this can be achieved. This evaluation shows that QualityRights can be effectively implemented even in resource-constrained settings and has a significant impact on the quality of mental health services.

Approach: 
Human rights
Disorder: 
All disorders
Setting: 
Community
Primary care
Region: 
Asia
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