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Programme for Improving Mental Health Care (PRIME) (01 May 2011 to 31 march 2019)

PRIME is a Eight-year multi-national research project funded by  DFID (Department for International Development) UK to consortium partners in five countries (South Africa, Uganda, Ethiopia, India and Nepal). The study is being led by the University of Cape Town, South Africa with partners in the UK and the World Health Organization (WHO). The overall aim of PRIME is to generate world-class research evidence on the implementation and scaling up of treatment programs for priority mental disorders in primary and maternal health care contexts in low resource settings which can be widely adopted by policy makers and practitioners.

In Nepal, the project is being implemented in Chitwan district in close collaboration with Ministry of Health and Population, and Netherland based organization, Healthnet TPO. The project primarily focuses on priority mental disorders – depression, alcohol use disorder (AUD), psychosis and epilepsy. The health workers of 12 primary health facilities are trained and equipped in mental health service delivery for the priority disorders based on WHO’s mental health Gap Action Programme (mhGAP). To increase detection and referral in the community level, we have developed a tool called Community Informant Detection Tool (CIDT) for each disorder. The female community health volunteer (FCHVs) are mobilized to undertake the task of detection and referral from the community level to the health facility level using this tool. The CIDT referred cases receive basic mental health services from the health facilities. At the health facility, pharmacological treatment is provided by the prescribers (e.g. HAs, CMAs) while the basic psychosocial support is provided by the trained non-prescribers (ANMs, MCHWs). In addition to this, considering the busy schedule of the health workers, psychosocial counselors have also been mobilized to provide (focused) counseling services. To ensure the quality service, regular supervision of the trained health workers and psychosocial counselors is being conducted on a monthly basis by the psychiatrist and psychologist through monthly case conference. Patients in need of  specialized care are referred to psychiatrists at the district hospital. Community based mental health sensitization programs are also being organized simultaneously to sensitize the community members on mental health issues and  stigma associated with mental health care.

The project is now running on its final phase of scaling up. From the next year i.e. 2016, the program will be scaled up to all the remaining VDCs covering the whole Chitwan district.

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