Mental health training for primary health care workers and implication for success of integration of mental health into primary care: evaluation of effect on knowledge, attitude and practices (KAP)
Open accessAbstract
Mental disorders are always remained a neglected public health problems in low and middle-income countries (LMICs), most people with mental disorders never receive effective care and there is a large treatment gap. In order to solve the problem integration of mental health into primary health care is recommended and in Ethiopia implementation of the scale of mental health services at primary health care level was started in 2014. For the success of the integration of mental health into primary health care, primary care health professionals are the key personnel who are responsible for the management of mental, neurologic and substance use disorders. However, proper training and education of primary care health professionals is mandatory for an optimal performance and success of integration. This interventional study was conducted to assess the effectiveness of mental health training course for scale up of mental health services at primary health care level in Ethiopia. This quasi-experimental pre- and post-study design was conducted in Ethiopia from October to December 2016 using quantitative data collection methods. A total of 94 primary health care professionals were included in the study. The intervention was conducted by psychiatry professionals using standardized World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) guide prepared for scaling up of mental health care through integration into primary health care (PHC) and general medical services. Pre- and post intervention assessment was done for knowledge, attitude and practice (KAP); and statistically analyzed. A paired sample t test with p values was performed to test the differences between the pre- and post-test. In additions mean and standard deviation of the responses were calculated. Overall the response rate was 100% at the end of the intervention. The study resulted in a significant improvement in knowledge, attitude and practice (KAP) of PHC workers about all the four mental, neurologic and substance use disorders during the post intervention survey (p < 0.05). Post intervention the knowledge of health professionals increased by 53.19% for psychosis, 42.56% for depression, 19.25% for epilepsy and 54.22% for alcohol use disorders. Similarly, post intervention attitude increased by 55.32% for psychosis, 40.42% for depression, 36.17% for epilepsy and 43.6% for alcohol use disorders. In addition, post intervention case identification rate increased by 62.78% for psychosis, 55.46% for depression, 21.35% for epilepsy and 41.49% for alcohol use disorders with significant p value (p < 0.05). The study results suggest that mental health training could be an effective intervention for improving knowledge, attitudes, and practices among primary health care professionals regarding mental, neurologic and substance use disorders. Training is a prerequisite and vital to enhance the knowledge, attitude, and practice of primary care professionals which plays a significant role for the easy success of integrated care and treatment of mental, neurologic and substance use disorders into the existing general health care services.
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Ayano et al. (2017) noted a 99% attitude improvement in Ethiopia.
“Ayano et al. (2017) noted a 99% attitude improvement in Ethiopia”
From Scaling mental health care in Nigeria: Impact of WHO mhGAP training under the MeHPriC program on knowledge, attitudes, and practices of primary health care workers in Lagos State – A pre-post mixed-methods study (2025) · cites this paper as Ayano et al. (2017)
The paper reports improved attitudes among primary health care workers in Ethiopia, but not a 99% improvement. The Abstract’s Results give attitude increases of 36.17%–55.32% across the four disorders; the Discussion reports post-training favorable-attitude rates of 89.36%–95.74%, which are not improvement percentages. (LLM, conf=0.90)
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Experimental — accuracy not yet measuredAyano et al. (2017) reported a 101% knowledge increase in Ethiopia.
“Ayano et al. (2017) reported a 101% knowledge increase in Ethiopia”
From Scaling mental health care in Nigeria: Impact of WHO mhGAP training under the MeHPriC program on knowledge, attitudes, and practices of primary health care workers in Lagos State – A pre-post mixed-methods study (2025) · cites this paper as Ayano et al. (2017)
The Results (Knowledge about mental, neurologic and substance use disorders; Table 2, page unavailable) show improved knowledge among primary health care workers in Ethiopia after training. The paper does not report a 101% knowledge increase; Table 2 instead gives separate pre- and post-training figures for four disorders. (LLM, conf=0.89)
Experimental — accuracy not yet measured
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Faregh, N., Lencucha, R., Ventevogel, P., Dubale, B. W., & Kirmayer, L. J. (2019) · International Journal of Mental Health Systems · doi:10.1186/s13033-019-0312-9 · Cited by 120 · see citing works
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“High post-training knowledge predicted practice change, consistent with Ayano et al. (2017), where knowledge gains improved psychosis diagnosis.”
- Authors
- Ayano, G., Assefa, D., Haile, K., Chaka, A., Haile, K., Solomon, M., Yohannis, K., Adane, A. A., & Jemal, K.
- Affiliations
- Amanuel Mental Specialized Hospital (ET)
- The University of Queensland (AU)
- Salale University (ET)
- Corresponding author
- Ayano, Getinet
- Venue
- International Journal of Mental Health Systems
- Published
- 2017-10-12
- Volume
- 11
- Issue
- 1
- Pages
- 63-63
- ISSN
- 1752-4458 (ISSN-L)
- PMC
- PMC5639774
- OpenAlex
- W2761897131
- Cited by
- 67
- References
- 1
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 8 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 10 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 7.05
- Type
- journal article
- Language
- en
- Update notices
- correction (2017-11-10)
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Mental Health Systems (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Funders
- Amanuel Mental Specialized Hospital,ethiopia
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- mental health training, integration of mental health into primary care, primary health care workers, WHO Mental Health Gap Action Programme, knowledge, attitudes and practices, psychosis, depression, epilepsy, alcoholism, case finding, Ethiopia, low- and middle-income countries, substance use disorders, neurological disorders
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