The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Improving access to psychological treatments: Lessons from developing countries
Open accessAbstract
Even though psychological treatments have been advocated as treatments for a range of mental disorders by the WHO for scaling up through primary care globally, the vast majority of potential beneficiaries are unable to access these treatments. Two major barriers impede the path between evidence based treatments and improved access: the lack of skilled human resources and the acceptability of treatments across cultures. This essay synthesizes the experiences of programs which developed and evaluated psychological treatments for depression in three resource poor developing countries. These programs addressed the human resource barrier by training lay or community health workers to deliver the treatments and addressed the acceptability barrier by systematically adapting the treatment to contextual factors. All programs demonstrated significant benefits in recovery rates when compared with usual care demonstrating the effectiveness of the approach. The implications for these experiences to improving access to psychological treatments in the global context are discussed.
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“Innovative strategies for disorders such as anxiety and depression involve training community health workers (Patel, Chowdhary, Rahman, & Verdeli, 2011), and this remains to be done following trauma.”
From Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application (2019) · cites this paper as Patel, Chowdhary, Rahman, & Verdeli, 2011
In the citing paper
“The DSM/ICD approach, considering melancholic and psychotic features as 'specifiers' or 'qualifiers' to the diagnosis of depression, rather than assuming that melancholia and psychotic depression are distinct diagnostic entities, is also supported by the evidence that, in many people with recurrent depression, some episodes are either psychotic or melancholic and some others are not. 58,86”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [86]
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Citations
Cites
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995
Resources for mental health: scarcity, inequity, and inefficiency
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61239-2 · Cited by 1,789
Treatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,483
The treatment gap in mental health care.
(2004) · Europe PMC (PubMed Central) · Cited by 1,419
Barriers to improvement of mental health services in low-income and middle-income countries
Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., Sridhar, D., & Underhill, C. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61263-x · Cited by 1,088 · cited 1×
“The challenges to implementing evidence-based PTs are enormous: several barriers have been identified ranging from inadequate investments in mental health care to stigma associated with mental illness (Saraceno et al., 2007).”
BackgroundRahman, A., Malik, A., Sikander, S., Roberts, C., & Creed, F. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61400-2 · Cited by 993 · cited 9×
“We have based our observations on the experiences of three randomized controlled trials from three LMIC in Africa and Asia which sought to improve access to the WHO approved PTs for depression, viz., cognitive behaviour therapy-based (CBT-based) or interpersonal psychotherapy (IPT) (World Health Organisation, 2010).”
BackgroundInfluentialSelf-citationTreatment and prevention of mental disorders in low-income and middle-income countries
Patel, V., Araya, R., Chatterjee, S., Chisholm, D., Cohen, A., De Silva, M., Hosman, C., McGuire, H., Rojas, G., & van Ommeren, M. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61240-9 · Cited by 930 · cited 1×
“A rapidly growing evidence testifies to the large burden and adverse impact of mental illness in the global context and the efficacy and cost-effectiveness of specific treatments and delivery systems in low resource settings (Patel et al., 2007; Patel & Thornicroft, 2009).”
BackgroundSelf-citationPatel, V., Weiss, H. A., Chowdhary, N., Naik, S., Pednekar, S., Chatterjee, S., De Silva, M. J., Bhat, B., Araya, R., King, M., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61508-5 · Cited by 752 · cited 11×
“…deliver PTs will only address a tiny fraction of the treatment gap and task-shifting these interventions to more available and affordable members of the health workforce or community is widely acknowledged to be the only sustainable way of addressing this barrier (Patel, 2009; Patel et al., 2010a).”
BackgroundInfluentialSelf-citationGroup Interpersonal Psychotherapy for Depression in Rural Uganda: A Randomized Controlled Trial
Bolton, P., Bass, J., Neugebauer, R., Verdeli, H., Clougherty, K. F., Wickramaratne, P., Speelman, L., Ndogoni, L., & Weissman, M. (2003) · JAMA · doi:10.1001/jama.289.23.3117 · Cited by 655 · cited 2×
“All three trials have published their primary results (Bolton et al., 2003; Patel et al., 2010b; Rahman, Malik, Sikander, Roberts, & Creed, 2008) as well as the methods to adapt the PT for the local context (Chatterjee et al.”
BackgroundSelf-citationState of the Science on Psychosocial Interventions for Ethnic Minorities
Miranda, J. M., Bernal, G., Lau, A. S., Kohn, L. P., Hwang, W., & LaFromboise, T. D. (2005) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.1.102803.143822 · Cited by 540 · cited 1×
“There is a growing evidence base in HIC on improving access to PTs for ethnic minority groups who have traditionally been under-represented in PT services (Miranda et al., 2005).”
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Poverty, depression, and anxiety: Causal evidence and mechanisms
Ridley, M., Rao, G., Schilbach, F., & Patel, V. (2020) · Science · doi:10.1126/science.aay0214 · Cited by 1,220
Self-citationTime for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104
Self-citationThe Lancet Psychiatry Commission on psychological treatments research in tomorrow's science
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O'Connor, R. C., Shafran, R., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30513-8 · Cited by 624
Chibanda, D., Weiss, H. A., Verhey, R., Simms, V., Munjoma, R., Rusakaniko, S., Chingono, A., Munetsi, E., Bere, T., Manda, E., et al. (2016) · JAMA · doi:10.1001/jama.2016.19102 · Cited by 502
Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness
Kazdin, A. E., & Rabbitt, S. M. (2013) · Clinical Psychological Science · doi:10.1177/2167702612463566 · Cited by 465
“The models we reviewed address many of the delivery challenges surrounding physical health care and have begun to be extended to mental health care (e.g., Belkin et al., 2011; Patel et al., 2010; Patel et al., 2011).”
Method
Metadata
- Authors
- Patel, V., Chowdhary, N., Rahman, A., & Verdeli, H.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Columbia University (US)
- Corresponding author
- Patel, Vikram
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 49
- Issue
- 9
- Pages
- 523-528
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC3242164
- OpenAlex
- W2167993523
- Cited by
- 394
- References
- 18
- Citations by year
- 2026: 29 · 2025: 27 · 2024: 27 · 2023: 27 · 2022: 45 · 2021: 29 · 2020: 29 · 2019: 22 · 2018: 26 · 2017: 25 · 2016: 25 · 2015: 32 · 2014: 26 · 2013: 19 · 2012: 5
- FWCI
- 22.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Greater South Information System
- Funders
- Wellcome Trust (MH071530)
- NIMH K23 Award
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- access to psychological treatment, depression, community health workers, lay health workers, treatment acceptability, cultural adaptation, mental health professionals, primary care, resource-limited settings, developing countries, recovery rate
- MeSH terms
- Workforce, Mental Disorders, Community Health Workers, Cross-Cultural Comparison, Health Resources, Health Services Accessibility, Humans, Mental Health Services, Poverty, Rural Population, Developed Countries
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