02233nas a2200277   4500000000100000008004100001653002300042653001900065653002100084653001900105100001600124700001500140700001500155700001600170700001400186700001500200700001200215700001100227700001500238245017200253856007200425300000700497490000700504520143000511022001401941       2019                            d10aMental health care10adistrict level10acontact coverage10aCase detection1 aNakku J E M1 aRathod S D1 aGarman E C1 aSsebunnya J1 aKangere S1 aDe Silva M1 aPatel V1 aLund C1 aKigozi F N00aEvaluation of the impacts of a district-level mental health care plan on contact coverage, detection and individual outcomes in rural Uganda: a mixed methods approach.  uhttps://ijmhs.biomedcentral.com/track/pdf/10.1186/s13033-019-0319-2  a630 v133 a<p><strong>Background: </strong>The burden of mental disorders in low- and middle-income countries is large. Yet there is a major treatment gap for these disorders which can be reduced by integrating the care of mental disorders in primary care.</p>

<p><strong>Aim: </strong>We aimed to evaluate the impact of a district&nbsp;mental health care plan&nbsp;(MHCP) on contact coverage for and detection of mental disorders, as well as impact on mental health symptom severity and individual functioning in rural Uganda.</p>

<p><strong>Results: </strong>For adults who attended primary care facilities, there was an immediate positive effect of the MHCP on clinical detection at 3&nbsp;months although this was not sustained at 12 months. Those who were treated in primary care experienced significant reductions in symptom severity and functional impairment over 12&nbsp;months. There was negligible change in population-level contact coverage for depression and alcohol use disorder.</p>

<p><strong>Conclusion: </strong>The study found that it is possible to integrate mental health care into primary care in rural Uganda. Treatment by trained primary care workers improves clinical and functioning outcomes for depression, psychosis and epilepsy. Challenges remain in accessing the men for care, sustaining the improvement in detection over time, and creating demand for services among those with presumed need.</p>
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