Chronic care model elements | Interventions under the Mental Health Care Package (MHCP) |
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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. |