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Global Health. 2017 Jan 13;13(1):2. doi: 10.1186/s12992-016-0226-0.

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal.

Acharya B1,2,3, Maru D4,5,6,7, Schwarz R4,5,7,8, Citrin D4,9,10,11, Tenpa J4, Hirachan S12,13, Basnet M12,14, Thapa P4, Swar S4,15, Halliday S4,11, Kohrt B16,17,18,19, Luitel NP16, Hung E20, Gauchan B4, Pokharel R21, Ekstrand M22.

Author information

1
Bayalpata Hospital, Possible, Sanfebagar-10, Achham, Nepal. Bibhav.Acharya@ucsf.edu.
2
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Langley Porter, San Francisco, CA, 94143, USA. Bibhav.Acharya@ucsf.edu.
3
Shared Minds, Boston, MA, USA. Bibhav.Acharya@ucsf.edu.
4
Bayalpata Hospital, Possible, Sanfebagar-10, Achham, Nepal.
5
Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
6
Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.
7
Department of Medicine, Harvard Medical School, Boston, MA, USA.
8
Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
9
Department of Anthropology, University of Washington, Seattle, WA, USA.
10
Department of Global Health, University of Washington, Seattle, WA, USA.
11
Henry M. Jackson School of International Studies, University of Washington, Seattle, WA, USA.
12
Shared Minds, Boston, MA, USA.
13
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
14
Faculty of Medicine, Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal.
15
Psychiatric Department, Kathmandu Medical College, Kathmandu, Nepal.
16
Research Department, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal.
17
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
18
Global Health Institute, Duke University, Durham, NC, USA.
19
Department of Cultural Anthropology, Duke University, Durham, NC, USA.
20
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, Langley Porter, San Francisco, CA, 94143, USA.
21
Policy Planning & International Cooperation Division, Ministry of Health, Kathmandu, Nepal.
22
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.

Abstract

BACKGROUND:

Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation.

PARTNERSHIPS NETWORK:

We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community.

CONCLUSIONS:

We propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal.

KEYWORDS:

Global health; Low— and middle-income countries; Mental health; Nepal; Partnerships

PMID:
28086925
PMCID:
PMC5237195
DOI:
10.1186/s12992-016-0226-0
[Indexed for MEDLINE]
Free PMC Article

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