International Journal of Mental Health Systems

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Three models of community mental health services In low-income countries

Alex Cohen1*, Julian Eaton2, Birgit Radtke3, Christina George4, Bro V Manuel5, Mary De Silva1 and Vikram Patel1

Author Affiliations

1 Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK

2 CBM National Co-ordination Office,13 Okemesi Crescent, Garki 2, Abuja, Nigeria

3 Community Mental Health, CBM, Nibelungenstr. 124, 64625 Bensheim, Germany

4 Department of Psychiatry, Dr Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India

5 Holy Face Rehabilitation Centre for Mental Health, Tabaco City, Albay Province, the Philippines

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International Journal of Mental Health Systems 2011, 5:3 doi:10.1186/1752-4458-5-3

Published: 25 January 2011

Abstract

Objective

To compare and contrast three models of community mental health services in low-income settings.

Data Sources/Study Setting

Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India.

Study Design

Qualitative case study methodology.

Data Collection

Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence.

Principal Findings

A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services.

Conclusions

Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models.