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Table 1 Interventions under the mental health care package categorized as per the elements of chronic care model

From: Evaluating the integration of chronic care elements in primary health care for people with mental illness: a longitudinal study in Nepal conducted among primary health care workers

Chronic care model elements Interventions under the Mental Health Care Package (MHCP)
Organization of the Healthcare Delivery System 1) Involvement of clinicians, civil society organization and policy makers in the development of treatment protocol for delivery of mental health services; 2) Participatory process of development of mental health training guidelines and accreditation from National Health Training Center; 3) Policy engagement workshops at the national and district levels; and 4) Managerial supervision by District Public Health Office (DPHO).
Community linkages 1) Anti-stigma program, mass sensitization and awareness through radio program; 2) Home based care by FCHVs; 3) Psychosocial counseling by community based counselors; and 4) Use of Community Informant Detection Tool (CIDT) by community members to identify and refer people with mental health and psychosocial problems.
Self-care management support for patients 1) Psycho-education on self-care management strategies, stress and anger management techniques, common side effects of psychotropic drugs and consequences of inappropriate use of drugs; 2) Individual patient goal setting through counseling; 3) Relaxation exercises; and 4) Peer-support.
Decision support for service providers 1) Diagnosis and treatment plan flow chart; 2) Checklist for screening suicidal ideation, depression, epilepsy, psychosis and alcohol use; 3) Monthly clinical supervision to discuss on difficult cases; and 4) Provision of phone contacts to psychiatrist and clinical psychologist for consultation of difficult cases.
Delivery system redesign 1) Appointment system for follow up; 2) Defaulters tracking system; 3) Psychotropic drug supply chain system; and 4) System for supervision/onsite coaching and referral pathways.
Clinical information system 1) Out Patient Department (OPD) card and patient register; 2) Monthly data compilation using data from patient registers; 3) Drug quantification, storage, recording and drug demand and supply tracking system; and 4) Integration of mental health indicators into existing health management information system.