PRIME: Programme for Improving Mental Health Care
The Programme for Improving Mental Healthcare (PRIME) is a consortium of research institutions and ministries of health in five countries, creating high quality research evidence on how best to implement and expand the coverage of mental health treatment programmes for priority mental disorders in primary healthcare contexts in low resource settings. PRIME has developed, implemented, evaluated and scaled up integrated mental healthcare plans over eight years, ending in 2019.
PRIME focused on the four mental disorders which contribute to the greatest overall burden of disease; alcohol abuse, depression (including maternal depression), psychosis and epilepsy, and for which there was evidence of cost-effective interventions. PRIME developed an integrated a mental health care plan (MHCP) comprising packages of mental health care for delivery in primary health care and maternal health care, to suit each study country’s unique setting. It evaluated the feasibility, acceptability and impact of these packages with four separate studies, including a community survey, facility survey, a cohort study and a case study. PRIME then scaled up to 94 facilities across the five study countries. In the final phase, it partnered with other countries beyond the PRIME network, with a goal to help make a significant ongoing contribution to a broader investment in mental health and mental healthcare.
IMPACT
In Nepal, PRIME work has been used to advocate for psychotropic medications for the free drugs list; develop a national level mental health curriculum for health workers; and provide input into the revision of the national mental health policy.
In Ethiopia, the PRIME District Mental Healthcare Plan is being used to inform the current revision of the 2012 Ethiopian Mental Health Strategy and the Federal Ministry of Health plan to scale up mental health care to every district by 2020.
The PRIME South Africa district MHCP informed the Dr Kenneth Kaunda district MHCP and is being used to provide a template for district mental health care plans in two other districts, and in Uganda work continues with the Ministry of Health to scale up mental health services in various districts.
PRIME has been asked to contribute to state level planning for mental health in Madhya Pradesh, India, and been involved in the establishment of mental health care consultation rooms in 51 district hospitals in the state.
PRIME has built significant capacity over the last six years. It supports 20 PhD students, and around a third of the 100 PRIME publications have been authored by these PhD students.