Evidence map›Paper›PMID 25012090›Full record

ArticleHealth policy and planning2015

Collaboratively reframing mental health for integration of HIV care in Ethiopia.

Lawrence S Wissow, Teketel Tegegn, Kassahun Asheber, Marion McNabb, Teklu Weldegebreal, Degu Jerene, Andrea Ruff

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health policy and planning, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. A Study Protocol for the "Practitioner Training in Child and Adolescent Psychiatry" Cluster-randomized Pilot Study.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2018
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Integrating Children's Mental Health into Primary Care.Pediatric clinics of North America · 2016
    Review
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Lawrence S WissowDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia Lwissow@jhsph.edu.
Teketel TegegnDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Kassahun AsheberDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Marion McNabbDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Teklu WeldegebrealDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Degu JereneDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Andrea RuffDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia, Johns Hopkins University, Technical Support for Ethiopia HIV/AIDS ART Initiative (JHU-TSEHAI), Addis Ababa, Ethiopia, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.
Johns Hopkins University · USAddis Ababa University · ET

Funding

TECHNICAL SUPPORT IN HIV TREATMENT, CARE AND PREVENTION IN ETHIOPIAU2GPS000858 · PS · JOHNS HOPKINS UNIVERSITY · PI RUFF, ANDREA JENAY · 2007 to 2013
$76.5M
Using Evidence-Base Care: Age Variation in Common Factors in PPCP20MH086048 · NIMH · JOHNS HOPKINS UNIVERSITY · PI WISSOW, LAWRENCE S · 2010 to 2014
$4.2M
Intramural NIH HHSNCHHSTP CDC HHS U2G PS000858NIMH NIH HHS P20 MH86048PHS HHS 5U2GPS000858
6 · The paper itself

Abstract

backgroundIntegrating mental health with general medical care can increase access to mental health services, but requires helping generalists acquire a range of unfamiliar knowledge and master potentially complex diagnostic and treatment processes.

methodWe describe a model for integrating complex specialty care with generalist/primary care, using as an illustration the integration of mental health into hospital-based HIV treatment services in Ethiopia. Generalists and specialists collaboratively developed mental health treatments to fit the knowledge, skills and resources of the generalists. The model recognizes commonalities between mental health and general medical care, focusing on practical interventions acceptable to patients. It was developed through a process of literature review, interviews, observing clinical practice, pilot trainings and expert consultation. Preliminary evaluation results were obtained by debriefing generalist trainees after their return to their clinical sites.

resultsIn planning interviews, generalists reported discomfort making mental health diagnoses but recognition of symptom groups including low mood, anxiety, thought problems, poor child behaviour, seizures and substance use. Diagnostic and treatment algorithms were developed for these groups and tailored to the setting by including possible medical causes and burdens of living with HIV. First-line treatment included modalities familiar to generalists: empathetic patient-provider interactions, psychoeducation, cognitive reframing, referral to community supports and elements of symptom-specific evidence-informed counselling. Training introduced basic skills, with evolving expertise supported by job aides and ongoing support from mental health nurses cross-trained in HIV testing. Feedback from trainees suggested the programme fit well with generalists' settings and clinical goals.

conclusionsAn integration model based on collaboratively developing processes that fit the generalist setting shows promise as a method for incorporating complex, multi-faceted interventions into general medical settings. Formal evaluations will be needed to compare the quality of care provided with more traditional approaches and to determine the resources required to sustain quality over time.

Indexed as

Cooperative BehaviorMental Health ServicesDelivery of Health Care, IntegratedEthiopiaHealth PersonnelHIV SeropositivityHumansPrimary Health CareAfricaHIVintegrated caremental health

Identifiers

PMID25012090
PMCPMC4451168
OpenAlexW2149021669

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.