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The Effectiveness and Cost-Effectiveness of Integrating Mental Health Services in Primary Care in Low- and Middle-Income Countries: Systematic Review

Citation

Cubillos, Leonardo; Bartels, Sophia M.; Torrey, William C.; Naslund, John A.; Uribe-Restrepo, José Miguel; Gaviola, Chelsea; Díaz, Sergio Castro; John, Deepak T.; Williams, Makeda J.; & Cepeda, Magda, et al. (2021). The Effectiveness and Cost-Effectiveness of Integrating Mental Health Services in Primary Care in Low- and Middle-Income Countries: Systematic Review. BJPsych Bulletin, 45(1), 40-52. PMCID: PMC8058938

Abstract

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.

URL

http://dx.doi.org/10.1192/bjb.2020.35

Reference Type

Journal Article

Article Type

Regular

Year Published

2021

Journal Title

BJPsych Bulletin

Author(s)

Cubillos, Leonardo
Bartels, Sophia M.
Torrey, William C.
Naslund, John A.
Uribe-Restrepo, José Miguel
Gaviola, Chelsea
Díaz, Sergio Castro
John, Deepak T.
Williams, Makeda J.
Cepeda, Magda
Gómez-Restrepo, Carlos
Marsch, Lisa A.

PMCID

PMC8058938

Continent/Country

LMICs