This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by James, S. Articles by Mubbashar, M. Search for Related Content PubMed PubMed Citation Articles by James, S. Articles by Mubbashar, M. Social Bookmarking                         What's this?

Demand for, Access to and Use of Community Mental Health Care: Lessons from a Demonstration Project in India and Pakistan

Centre for Development Studies, University of Wales, Swansea (formerly Institute for Health Sector Development, London), UK

Daniel Chisholm

Health Services Research Department, Institute of Psychiatry, King's College Medical School, London, UK; World Health Organisation, Avenue Appia, 1211 Geneva 27, Switzerland. ChisholmD{at}WHO.int

R. Srinivasa Murthy

K. Kishore Kumar

K. Sekar

National Institute of Mental Health and Neurosciences, Bangalore, India

Khalid Saeed

Malik Mubbashar

Institute of Psychiatry, Rawalpindi, Pakistan

Background: A widely promoted model of mental health care and prevention appropriate to many low-income countries is one that is integrated into the local primary health care system.

Aims: To examine the influence of health-seeking behaviours (demand-side factors) and the access to/availability of services (supply-side factors) on local service utilisation patterns for people with common mental disorders.

Method: Two rural catchment populations outside Bangalore (India) and Rawalpindi (Pakistan), one with the standard primary health care system, the other with additional mental health care training and support, were screened for common mental disorders. Diagnosed cases were interviewed about thier use of and perceptions of local health care services (repeated three months later).

Results: Individuals' use of integrated mental health and other care was modest. Principal (self-rated) supply-side factors were the cost of care, distance from treatment centre, a perception that care would not be effective, and concerns regarding stigma. Perceptions improved over three months, accompanied by an increased preference for public over private providers, but this was not restricted to the integrated care localities.

Conclusion: The use (and therefore effectiveness) of mental health services integrated into primary care is influenced by the health-seeking behaviours and perceptions of the local population. Efforts to integrate mental health into primary care need to be accompanied by educational activities in order to increase awareness, reduce stigma and draw attention to the availability of effective treatment.

International Journal of Social Psychiatry, Vol. 48, No. 3, 163-176 (2002)
DOI: 10.1177/002076402128783217


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Furnham Psychiatric and Psychotherapeutic Literacy: Attitudes To, and Knowledge of, Psychotherapy International Journal of Social Psychiatry, November 1, 2009; 55(6): 525 - 537. [Abstract] [PDF]

				M. Knapp, M. Funk, C. Curran, M. Prince, M. Grigg, and D. McDaid Economic barriers to better mental health practice and policy Health Policy Plan., May 1, 2006; 21(3): 157 - 170. [Abstract] [Full Text] [PDF]