Situational analysis to inform development of primary care and community-based mental health services for severe mental disorders in Nepal

Angdembe, Mangesh; Kohrt, Brandon A.; Jordans, Mark; Rimal, Damodar; Luitel, Nagendra P.

doi:10.1186/s13033-017-0176-9

Cited by 39Mental Health Treatment and AccessPsychiatric care and mental health servicesHealth Policy Implementation Science

Situational analysis to inform development of primary care and community-based mental health services for severe mental disorders in Nepal

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Angdembe, Mangesh, Kohrt, Brandon A., Jordans, Mark, Rimal, Damodar, Luitel, Nagendra P.·2017·International Journal of Mental Health Systems

DOI 10.1186/s13033-017-0176-9PMC PMC5688643

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Abstract

BACKGROUND: Nepal is representative of Low and Middle Income Countries (LMIC) with limited availability of mental health services in rural areas, in which the majority of the population resides. METHODS: This formative qualitative study explores resources, challenges, and potential barriers to the development and implementation of evidence-based Comprehensive Community-based Mental Health Services (CCMHS) in accordance with the mental health Gap Action Programme (mhGAP) for persons with severe mental health disorders and epilepsy. Focus Group Discussions (FGDs, n = 9) and Key-Informant Interviews (KIIs, n = 26) were conducted in a rural district in western Nepal. Qualitative data were coded using the Framework Analysis Method employing QSR NVIVO software. RESULTS: Health workers, general community members, and persons living with mental illness typically attributed mental illness to witchcraft, curses, and punishment for sinful acts. Persons with mental illness are often physically bound or locked in structures near their homes. Mental health services in medical settings are not available. Traditional healers are often the first treatment of choice. Primary care workers are limited both by lack of knowledge about mental illness and the inability to prescribe psychotropic medication. Health workers supported upgrading their existing knowledge and skills through mhGAP resources. Health workers lacked familiarity with basic computing and mobile technology, but they supported the introduction of mobile technology for delivering effective mental health services. Persons with mental illness and their family members supported the development of patient support groups for collective organization and advocacy. Stakeholders also supported development of focal community resource persons to aid in mental health service delivery and education. CONCLUSION: Health workers, persons living with mental illness and their families, and other stakeholders identified current gaps and barriers related to mental health services. However, respondents were generally supportive in developing community-based care in rural Nepal.

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A qualitative study in rural Nepal found that although providers tended to have low digital literacy, they supported including mobile health technology to facilitate services.
“A qualitative study in rural Nepal also found that although providers tended to have low digital literacy, they supported inclusion of mobile health technology to facilitate services (Angdembe et al., 2017).”
From Mobile technology and task shifting to improve access to alcohol treatment services in Mozambique (2022) · cites this paper as Angdembe et al., 2017

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Authors: Angdembe, M., Kohrt, B. A., Jordans, M., Rimal, D., & Luitel, N. P.
Affiliations: George Washington University (US)
King's College London (GB)
Corresponding author: Angdembe, Mangesh
ORCID: Angdembe, Mangesh
Kohrt, Brandon A.
Jordans, Mark
Luitel, Nagendra P.
Venue: International Journal of Mental Health Systems
Publisher: Springer Science and Business Media LLC
Published: 2017-11-15
Volume: 11
Issue: 1
Pages: 69-69
ISSN: 1752-4458 (ISSN-L)
DOI: 10.1186/s13033-017-0176-9
PMC: PMC5688643
OpenAlex: W2768217634
Cited by: 39
References: 59
Citations by year: 2026: 4 · 2025: 6 · 2024: 6 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 5 · 2017: 2
FWCI: 3.53
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: International Journal of Mental Health Systems (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Research Portal (King's College London) (publishedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Grand Challenges Canada (GMH_0091-04)
Topics: Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords: severe mental illness, community mental health services, primary care, Mental Health Gap Action Programme, rural mental health, mental health stigma, traditional healers, psychotropic prescribing, patient support groups, epilepsy, Nepal

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Situational analysis to inform development of primary care and community-based mental health services for severe mental disorders in Nepal

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