Journal Article

A Multiple Case Study of Mental Health Interventions in Middle Income Countries: Considering the Science of Delivery

Raja, Shoba, Wiljer, David, Madan, Athena, Cole, Donald C., Kidd, Sean A., Rallabandi, Susmitha, Aylward, David, McKenzie, Kwame, Muskat, Elisha

2016

Overview

In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the \"non-specific\", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy \"space\" within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Addictions / Analysis / Bangladesh / Biology and Life Sciences / Care and treatment / Case reports / Case studies / Colombia / Computer and Information Sciences / Cross cutting / Delivery of Health Care / Developing countries / Egypt / Entrepreneurs / Entrepreneurship / Ghana / Grounded theory / Health aspects / Health problems / Health promotion / Health Services Research / Income / India / Influence / Intervention / Marginalized groups / Medicine and Health Sciences / Mental disorders / Mental Disorders - therapy / Mental Health / Mental health care / Mental Health Services - organization & administration / Models, Organizational / People and Places / Physical Sciences / Program Development / Psychiatry / Qualitative research / Risk factors / Scaling / Social entrepreneurship / Social Sciences / Social Sciences - organization & administration / Systems Theory / Vietnam