Implementation of a mental health programme in primary health care clinics in Chiapas, Mexico

The World Health Organization (WHO) advocates for the integration of mental health services into primary care in order to increase access to good quality services by larger proportions of the population in need and address the so-called “treatment gap”. Nonetheless, implementing best practices identified through RCTs or small pilots into routine health service delivery has not been possible at a large scale. This challenge has been approached by the science of implementation which has become essential to answer questions such as: how to train health providers; keep them motivated and engaged to continue delivering services for a long-term; how to facilitate necessary communication between different levels of care; and what resources or engagement need to be in place for a system to adopt a new intervention or package of care. This project aims to assess the relationship between factors that drive or hinder the implementation (i.e. implementation determinants) of a mental health programme delivered at primary health care clinics in rural Mexico and its process and clinical outcomes using a mixed-methods case study methodology. Increasing understanding about the factors that have an impact on the implementation of programmes can help in the design of quality improvement mechanisms and aid the scale up of mental health services.