Programme for Improving Mental Health Care (PRIME)

More than 13% of the global burden of disease is due to mental illness, of which 80% is experienced in low and middle-income countries. In these countries there’s a lack of resources for effective treatment. This contributes to a large ‘treatment gap’ of priority mental disorders such as alcohol abuse, depression (including maternal depression), psychosis (notably schizophrenia) and epilepsy. Suicide rates in Nepal are among the highest in the world, for women in the reproductive age, suicide is even the leading cause of death.

Consortium of specialists
PRIME is a six-year research consortium of mental health experts and policy makers from around the world that aims to improve the coverage of treatment for the priority mental disorders by implementing and evaluating the WHO's mental health Gap Action Programme (mhGAP). The mhGAP provides a practical tool to empower health practitioners to deliver mental health services at the primary care level. The ultimate purpose is to generate benefits for mental and physical health and socio-economic outcomes. It will achieve these broad goals by addressing three major objectives in three phases across the programme.

Key elements of the project:

a)    Developing care packages for mental disorders within both primary and maternal health care (Inception phase);
b)    Evaluating the feasibility, acceptability and impact of the care packages (Implementation phase);
c)    Scaling up and evaluating the integrated comprehensive mental health care plan at the level of administrative health units (Scaling Up phase).

Activities and results include:

  • Key barriers and possible solutions around integrating mental health in primary care were identified;
  • Recommendations for service delivery have been developed;
  • A detailed mental health care package (MHCP) was developed during 2012. The content of the package was stipulated on district-level;
  • A tool was developed to promote case finding in communities. This tool will be used to assist in the identification of people who are in need of mental health care;
  • Preparations are made for the next phase of the programme: the implementation of the package and the development of an evaluation framework.

Also see the website of the PRIME programme and the link to the policy briefs about Nepal (number one and number two).