Citation

Acharya B, Ekstrand M, Rimal P, Ali MK, Swar S, Srinivasan K, Mohan V, Unützer J, Chwastiak LA. Psychiatr. Serv. 2017; 68(9): 870-872.

Affiliation

Dr. Acharya, Ms. Rimal, and Dr. Swar are with Possible, Achham, Nepal. Dr. Acharya is also with the Department of Psychiatry, University of California, San Francisco (UCSF), where Dr. Ekstrand is with the Department of Medicine. Dr. Ali is with the Department of Global Health and Epidemiology, Emory University, Atlanta. Dr. Srinivasan is with St. Johns Research Institute, Bengaluru, Karnataka, India. Dr. Mohan is with the Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India. Dr. Unützer and Dr. Chwastiak are with the Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle.

Copyright

(Copyright © 2017, American Psychiatric Association)

DOI

10.1176/appi.ps.201700232

PMID

28760096

Abstract

The collaborative care model is an evidence-based intervention for behavioral and other chronic conditions that has the potential to address the large burden of mental illness globally. Using the World Health Organization Health Systems Framework, the authors present challenges in implementing this model in low- and middle-income countries (LMICs) and discuss strategies to address these challenges based on experiences with three large-scale programs: an implementation research study in a district-level government hospital in rural Nepal, one clinical trial in 50 primary health centers in rural India, and one study in four diabetes clinics in India. Several strategies can be utilized to address implementation challenges and enhance scalability in LMICs, including mobilizing community resources, engaging in advocacy, and strengthening the overall health care delivery system.

Language: en

Keywords

collaborative care; diabetes