Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

BMC Health Services Research

Volumn 16, Issue 1, 2016, Pages 1-15

  Athié, Karen ^a   Menezes, Alice Lopes do Amaral ^a   Da Silva, Angela Machado ^a   Campos, Monica ^b   Delgado, Pedro Gabriel ^c   Fortes, Sandra ^a   Dowrick, Christopher ^d  

^a UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO   (Brazil)

^b INSTITUTO OSWALDO CRUZ   (Brazil)

^c FEDERAL UNIVERSITY OF RIO DE JANEIRO   (Brazil)

^d UNIVERSITY OF LIVERPOOL   (United Kingdom)

Author keywords

Collaborative care; Implementation science; Integration; LAMIC; Mental health; Mental health matrix support; MHGAP; Mixed methods; Primary care; Public health

Indexed keywords

ADMINISTRATIVE PERSONNEL; BRAZIL; COOPERATION; CROSS-SECTIONAL STUDY; FEMALE; HEALTH CARE PERSONNEL; HEALTH PERSONNEL ATTITUDE; HUMAN; INTEGRATED HEALTH CARE SYSTEM; MALE; MANAGEMENT; MENTAL DISORDERS; MENTAL HEALTH; MENTAL HEALTH SERVICE; ORGANIZATION AND MANAGEMENT; PATIENT CARE; PERCEPTION; PILOT STUDY; PRIMARY HEALTH CARE; PSYCHOLOGY; PUBLIC RELATIONS;

ADMINISTRATIVE PERSONNEL; ATTITUDE OF HEALTH PERSONNEL; BRAZIL; COMMUNITY MENTAL HEALTH SERVICES; COOPERATIVE BEHAVIOR; CROSS-SECTIONAL STUDIES; DELIVERY OF HEALTH CARE, INTEGRATED; FEMALE; HEALTH PERSONNEL; HUMANS; INTERPROFESSIONAL RELATIONS; MALE; MENTAL DISORDERS; MENTAL HEALTH; PATIENT CARE TEAM; PERCEPTION; PILOT PROJECTS; PRACTICE MANAGEMENT, MEDICAL; PRIMARY HEALTH CARE;

EID: 84995527825     PISSN: None     EISSN: 14726963     Source Type: Journal    
DOI: 10.1186/s12913-016-1740-8     Document Type: Article

References (69)

1. Kakuma R, Minas H, van Ginneken N, Dal Poz MR, Desiraju K, Morris JE, et al. Global Mental Health 5 Human resources for mental health care: current situation and strategies for action. Lancet. 2011;378(9803):1654-63.
2. World Health Organization. mhGAP intervention guide - For mental, neurological and substance abuse disorders in non-specialized health settings [Internet]. Mental Health Gap Action Programme. Geneva; 2010.
3. Hailemariam M, Fekadu A, Selamu M, Alem A, Medhin G, Giorgis TW, et al. Developing a mental health care plan in a low resource setting: the theory of change approach. BMC Health Serv Res. 2015;15(1):429.
4. Zolnierek CD. Mental health policy and integrated care: global perspectives. J Psychiatr Ment Heal Nurs. 2008;15(7):562-8.
5. Sunkel C. Empowerment and partnership in mental health. Lancet. 2012;379(9812):201-2.
6. Chisholm D, Flisher AJ, Lund C, Patel V, Saxena S, Thornicroft G, et al. Scale up services for mental disorders: a call for action. Lancet [Internet]. 2007;370(9594):1241-52. Elsevier; [cited 2015 Nov 2].
7. World Health Organization (WHO), WHO and WONCA, Vingilis E, Paquette-Warren J, Kates N, Crustolo AM, et al. Collaborative Care: models for treatment of patients with complex medical-psychiatric conditions. UNESCO e Ministério da Saúde, editor. Ciênc saúde coletiva [Internet]. BMC Health Serv Res. 2013;4(1):473-4 [cited 2014 May 2].
8. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502.
9. Patel V. Mental health in low- and middle-income countries. Br Med Bull. 2007;81-82(1):81-96 [cited 2015 Oct 30].
10. Conill EM. [Primary care policies and health reforms: an evaluative approach based on an analysis of the Family Health Program in Florianopolis, Santa Catarina, Brazil, 1994-2000]. Cad Saude Publica. 2002;18(Suppl):191-202.
11. Nunes MA, Ferri CP, Manzolli P, Soares RM, Drehmer M, Buss C, et al. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil--ECCAGE study. BMC Psychiatry. 2010;10:66.
12. Taborda JG, Bertolote JM, Cardoso RG, Blank P. The impact of primary mental health care in a prison system in Brazil. Can J Psychiatry. 1999;44(2):180-2.
13. Paula CS, Nakamura E, Wissow L, Bordin I a, do Nascimento R, Leite AM, et al. Primary care and children's mental health in Brazil. Acad Pediatr. 2009;9(4):249-55.e1.
14. Goncalves DA, Fortes S, Campos M, Ballester D, Portugal FB, Tófoli LF, et al. Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study. Gen Hosp Psychiatry. 2013;35(3):304-8.
15. Frosi RV, Tesser CD. Mental health care practices in primary health care: an analysis based on experiences developed in Florianópolis, Brazil. Cien Saude Colet [Internet]. 2015;20(10):3151-61 ABRASCO - Associação Brasileira de Saude Coletiva; [cited 2015 Oct 30].
16. Goncalves DA, Fortes S, Tofoli LF, Campos MR, Mari Jde J. Determinants of common mental disorders detection by general practitioners in primary health care in Brazil. Int J Psychiatry Med. 2011;41(1):3-13.
17. Kathree T, Selohilwe OM, Bhana A, Petersen I. Perceptions of postnatal depression and health care needs in a South African sample: the “mental” in maternal health care. BMC Womens Health. 2014;14(1):140.
18. de Jesus Mari J, Tófoli LF, Noto C, Li LM, Diehl A, Claudino AM, et al. Pharmacological and psychosocial management of mental, neurological and substance use disorders in low- and middle-income countries: issues and current strategies. Drugs. 2013;73:1549-68. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24000001.
19. Knowles SE, Chew-Graham C, Coupe N, Adeyemi I, Keyworth C, Thampy H, et al. Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems. Implement Sci. 2013;8(1):110. Available from: http://www.implementationscience.com/content/8/1/110.
20. Lawn S, Lloyd A, King A, Sweet L, Gum L. Integration of primary health services: being put together does not mean they will work together. BMC Res Notes. 2014;7:66.
21. Bower P. Primary care mental health workers: models of working and evidence of effectiveness. Br J Gen Pract. 2002;52(484):926-33.
22. Campbell SM, Shield T, Rogers A, Gask L. How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings? Qual Saf Health Care. 2004;13(March 2008):428-34.
23. Gask L. Overt and covert barriers to the integration of primary and specialist mental health care. Soc Sci Med. 2005;61:1785-94.
24. Macinko J, Harris MJ. Brazil's family health strategy-delivering community-based primary care in a Universal Health System. N Engl J Med. 2015;372(23):2177-81.
25. Gonçalves DA, Mari Jde J, Bower P, Gask L, Dowrick C, Tófoli LF, et al. Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors. Cad Saude Publica [Internet]. 2014;30(3):623-32 Escola Nacional de Saude Publica, Fundação Oswaldo Cruz; [cited 2015 Jul 10].
26. Portugal FB, Campos MR, Gonçalves DA, Mari JDJ, Gask L, Bower P, et al. Psychiatric morbidity and quality of life of primary care attenders in two cities in Brazil. J Bras Psiquiatr. 2014;63(1):23-32.
27. Mateus MD, Mari JJ, Delgado PGG, Almeida-Filho N, Barrett T, Gerolin J, et al. The mental health system in Brazil: Policies and future challenges. Int J Ment Health Syst. 2008;2(1):12.
28. Harzheim E, Lima KM, Hauser L. Pesquisa avaliativa sobre aspectos de implantacao, estrutura, processo e resultados das clinicas da familia na cidade do Rio de Janeiro [Internet]. Porto Alegre: Universidade Federal do Rio Grande do Sul (UFRGS); 2013.
29. Do Patrocinio SSM, et al. The Support Center for Family Health: national proposal and implementation in towns of Rio de Janeiro. Saude debate Vol 39 no spe Rio de Janeiro; 2015.
30. Xavier HN, Magalhães F. Urban Slums Reports: The case of Rio de Janeiro, Brazil [Internet]. Urban Slums Reports. Rio de Janeiro; 2003. Available from: http://www.ucl.ac.uk/dpu-projects/Global_Report/pdfs/Rio_bw.pdf. Accessed 12 Sept 2016.
31. Gaffney C. Mega-events and socio-spatial dynamics in Rio de Janeiro, 1919-2016. J Lat Am Geogr. 2010;9(1):7-29.
32. Roth-Gordon J. The language that came down the hill: Slang, crime, and citizenship in Rio de Janeiro. Am Anthropol. 2009;111(1):57-68.
33. Instituto Municipal de Urbanismo Pereira Passos (Armazem dos dados). Indice de Desenvolvimento Social (IDS) e seus indicadores constituintes, segundo favelas. Rio de Janeiro: Prefeitura do Rio de Janeiro; 2010.
34. Instituto Municipal de Urbanismo Pereira Passos (Armazem dos dados). Indicadores de Renda - Desigualdade por extratos da população. Renda domiciliar nominal per capita media do 1o, 2o, 3o, 4o e 5o quintos mais pobres e do quinto e decimo mais ricos, por Bairros ou Grupo de Bairros. Rio de Janeiro: Prefeitura do Rio de Janeiro; 2010.
35. Instituto Municipal de Urbanismo Pereira Passos (Armazem dos dados). Desenvolvimento Humano e Condiçoes de Vida na Cidade do Rio de Janeiro (jan. 2004) (Estudo No 1347) [Internet]. Rio de Janeiro; 2004. Available from: http://www.camara.rj.gov.br/planodiretor/pd2009/saudepd/Anexo3_IDH.pdf. Accessed 12 Sept 2016.
36. Prefeitura do Rio de Janeiro. Instituto Municipal de Urbanismo Pereira Passos (Armazem dos dados) [Internet]. 2000 [cited 2015 Nov 20]. Available from: http://www.armazemdedados.rio.rj.gov.br/. Accessed 12 Sept 2016.
37. Governo do Rio de Janeiro. Unidade de Policia Pacificadora website [Internet]. [cited 2015 Nov 20]. Available from: http://www.upprj.com/. Accessed 12 Sept 2016.
38. Simon GE, Katon WJ, VonKorff M, Unutzer J, Lin EH, Walker EA, et al. Cost-effectiveness of a collaborative care program for primary care patients with persistent depression. Am J Psychiatry. 2001;158(10):1638-44.
39. Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166(21):2314-21.
40. Bower P, Gilbody S, Richards D, Fletcher J, Sutton A. Collaborative care for depression in primary care. Making sense of a complex intervention: systematic review and meta-regression. Br J Psychiatry. 2006;189:484-93.
41. Chiaverini D. Guia Prático de Matriciamento em Saúde Mental. Brasília: Ministério da Saúde; 2011.
42. Prefeitura do Rio de Janeiro. Plano Municipal de Saude do Rio de Janeiro PMS [Internet]. 2014. Available from: http://www.rio.rj.gov.br/dlstatic/10112/3700816/4128745/PMS_20142017.pdf. Acessed 12 Sept 2016.
43. Friedman DJ, Starfield B. Models of Population Health: their value for US Public Health Practice, policy, and research. Am J Public Health. 2003;93(3):366-9.
44. Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. BMJ Br Med J. 2003;327(7425):1219-21.
45. Ministério da Saúde. Manual do instrumento de avaliação da Atenção Primária à Saúde. 2010. p. 80.
46. Blanco MN, Taquette SR, Monteiro DLM, Miranda FRD. Postnatal and postabortion care during adolescence in the National Health System in Rio de Janeiro, Brazil. Int J Gynecol Obstet. 2014;126(2):126-9.
47. Cronbach L. Coefficient alpha and teh internal structure of tests. Psychometrika. 1951;16(3):297-334.
48. Taft C, Karlsson J, Sullivan M. Performance of the Swedish SF-36 version 2.0. Qual Life Res. 2004;13(1):251-6.
49. George D. SPSS for Windows step by step: A simple guide and reference. 11.0 update [Internet]. Boston: Allyn y Bacon; 2003. p. 386.
50. Snape D, Spencer L. The foundation of qualitative research. In: Editoral matter, editor. Qualitative research practice: A guide for social science students and researchers. London: SAGE Publications; 2003. p. 2-10.
51. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45.
52. Jenkins R, Othieno C, Okeyo S, Aruwa J, Kingora J, Jenkins B, et al. Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers. BMC Health Serv Res. 2013;13:1.
53. Siriwardhana C, Adikari A, Jayaweera K, Abeyrathna B, Sumathipala A. Integrating mental health into primary care for post-conflict populations: a pilot study. Int J Ment Health Syst. 2016;10(1):12.
54. Thomas DR. A general inductive approach for qualitative data analysis. Popul English Ed. 2003;27(2):237-46.
55. Cathain AO, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ. 2010;341(November):1147-50.
56. O'Cathain A, Murphy E, Nicholl J. RESEARCH METHODS & REPORTING: Three techniques for integrating data in mixed methods studies. BMJ Br Med J. 2010;341:1147-50. Overseas Retired Dr Ed.
57. Chew-Graham C, et al. Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities. BMC Family Practice. 2014;15:68.
58. Warne T, McAndrew S, King M, Holland K. Learning to listen to the organisational rhetoric of primary health and social care integration. Nurse Educ Today. 2007;27(8):947-54.
59. Ford K, Middleton J, Palmer B, Farrington A. Primary healthcare workers: training needs in mental health. Br J Nurs [Internet]. 2014;6(21):1244-50. MA Healthcare London; [cited 2015 Jul 17].
60. Patel V, Araya R, De Lima M, Ludermir A, Todd C. Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med. 1999;49(11):1461-71.
61. Jenkins R, Bobyleva Z, Goldberg D, Gask L, Zacroeva AG, Potasheva A, et al. Integrating mental health into primary care in Sverdlovsk. Ment Health Fam Med. 2009;6:29-36. Radcliffe Publishing.
62. Majale M. Employment creation through participatory urban planning and slum upgrading: The case of Kitale, Kenya. Habitat Int. 2008;32:270-82.
63. O'Hanlon KP, Budosan B. Post-disaster recovery: a case study of human resource deployment in the health sector in post-conflict Kosovo. Prehosp Disaster Med. 2011;26(1):7-14.
64. Kelly JT, Betancourt TS, Mukwege D, Lipton R, VanRooyen MJ. Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study. Confl Health. 2011;5(1):25. Available from: http://www.conflictandhealth.com/content/5/1/25.
65. Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J, et al. The mental health workforce gap in low- and middle-income countries: A needs-based approach. Bull World Health Organ. 2011;89(3):184-94.
66. Coupe N, Anderson E, Gask L, Sykes P, Richards DA, Chew-Graham C. Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory. BMC Fam Pract. 2014;15(1):78.
67. Flys T, González R, Sued O, Suarez Conejero J, Kestler E, Sosa N, et al. A novel educational strategy targeting health care workers in underserved communities in Central America to Integrate HIV into primary medical care. PLoS One. 2012;7(10):e46426.
68. King M, Nazareth I, Lampe F, Bower P, Chandler M, Morou M, et al. Conceptual framework and systematic review of the effects of participants' and professionals' preferences in randomised controlled trials. Winchester: Health technology assessment; 2005.
69. Belling R, Whittock M, McLaren S, Burns T, Catty J, Jones IR, et al. Achieving continuity of care: facilitators and barriers in community mental health teams. Implement Sci. 2011;6(1):23.