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1 results

  • The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review

  • Leonardo Cubillos, Sophia M. Bartels, William C. Torrey, John Naslund, José Miguel Uribe-Restrepo, Chelsea Gaviola, Sergio Castro Díaz, Deepak T. John, Makeda J. Williams, Magda Cepeda, Carlos Gómez-Restrepo, Lisa A. Marsch
  • Journal:
    BJPsych Bulletin / Volume 45 / Issue 1 / February 2021
    Published online by Cambridge University Press:
    23 April 2020, pp. 40-52
    Print publication:
    February 2021
    • Article
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  • Aims and method

    This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.

    Results

    Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.

    Clinical implications

    Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.