Work

Factors influencing the external validity of the evidence of HIV counseling and testing data in global health settings

Year: 2014

Type: article

Abstract: Background: The 2010 global burden of disease study indicated that mental and behavioral disorders account for approximately 9.5% of all disability-adjusted life years and 23.6% of all years lived with disability in China.With rapid socioeconomic transformation, the Chinese mental health system is in great need of service expansion with delivery models capable of operationalizing treatment packages into local practices.For Chinese cities facing many unique challenges today, it is critical to understand in detail both the local practices of mental health delivery, and the local ideas about mental illness and major services barriers such as stigma.Structure/Method/Design: Methods of analysis included literature review, policy and service structure analysis, participant observation, and individual as well as focus group interviews with stakeholders from various arenas of the mental health delivery system in Shanghai, China.The methods were formulated within a transdisciplinary framework involving the fields of psychiatry, public health, clinical social work, and medical anthropology in order to gain a comprehensive insight into the Chinese mental health system. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract):A solution narrative of transdisciplinary strategies was generated based on available local resources and strategies acquired from previous field practices.We delineated in detail the service structure, care pathway, and essential skill packages of the mental health delivery system in Shanghai, and the scale of challenges it is facing.The findings generally supported the current Chinese strategy for community mental health service expansion and highlighted multiple barriers to expansion, such as restricted diagnostic privileges, lack of mental health social workers, and stigma experienced in the Chinese culture.Summary/Conclusion: We concluded that in spite of differences in local context, the experience of Partners in Health in implementing mental health services in low-and middle-income countries would contribute significantly to China's service scale-up efforts.Some initial recommendations include equip community health service centers for the initial diagnosis of common mental disorders; improve tasksharing training for mental health social workers; identify and implement intervention strategies to destigmatize mental illness; and improve community prevention and education programs focused on generating behavioral change.The newly implemented Chinese mental health legislation provides an excellent opportunity for mental health service expansion; however, some aspects of the law should be considered for revision in order to maximize service capacity.Further needs assessment and policy analysis are needed to assess the impact of large-scale internal migration and rapid population aging.

Source: Annals of Global Health

DOI: 10.1016/j.aogh.2014.08.099

Authors: E. Marseilli, A. Mirzazadeh, M. Malekinejad, J. Kahn, A.J. Goodell

Institutions: University of California System, University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies

Language: English

Topic: Mental Health Treatment and Access

Subfield: Social Psychology

Field: Psychology

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,200