Integration of mental health and psychosocial support services in primary health care facilities and community settings in the post-earthquake context of two affected districts in Nepal

TPO Nepal collaboratively with International Medical Corps implemented the ‘Integration of mental health and psychosocial support services in primary health care facilities and community settings in the post-earthquake context of two affected districts in Nepal’. This one year project from June 2015 to February 2017 included primary prevention of psychosocial problems through coordination with agencies facilitating safe spaces and broad-based recreational and community support activities, and orientation and psycho-education for family and community members and front-line aid workers which would aid in early identification and referral of those with MHPSS needs. A second level of support included psychological first aid and basic emotional support, facilitation of self-help and support groups, and screening of those in need of counseling and/or therapeutic group work via female community health volunteers and home-based care workers. A third level included trained psychosocial counselors attached to health facilities providing individual and group counseling, and people in need of medication referred to primary health care workers trained in mental health as per the mental health Gap Action Program (mhGAP) Humanitarian Intervention Guide and supervised by psychiatrists for psycho-pharmacological interventions.

The project covered two districts at health facilities and in community settings. The first target district was Gorkha, which included 10 health posts, 3 primary health care centers and 2 hospitals. Similarly, the second target district was Sindhuli, which similarly included 10 health posts, 4 primary health care centers, and a district hospital. The project included community activities (awareness-raising and sensitization on MHPSS conditions, identification and referral of those with MHPSS needs, community counseling, patients support groups), and pharmacological treatment by primary health care workers based on mental health Gap Action Program (mhGAP) Humanitarian Intervention Guide, which was adapted to Nepal during the project period by TPO Nepal. Six priority disorders were worked on: depression, epilepsy, PTSD, psychosis, harmful use of alcohol and drugs, and suicide.