ArticleEpidemiology and psychiatric sciences2019
Impact of integrated district level mental health care on clinical and social outcomes of people with severe mental illness in rural Ethiopia: an intervention cohort study.
Article in Epidemiology and psychiatric sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of Social Inclusion Interventions for Anxiety and Depression among Adolescents: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Effectiveness of the Systems Analysis and Improvement Approach to optimise outpatient mental, neurological, and substance-use disorder treatment cascades in Mozambique: a cluster-randomised trial.The lancet. Psychiatry · 2026Trial
- Effects of community-based rehabilitation on caregivers of people with schizophrenia in Ethiopia in the RISE trial.BMC psychiatry · 2025Trial
- Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (RISE): results of a 12-month cluster-randomised controlled trial.The Lancet. Global health · 2022Trial
- Efficacy and cost-effectiveness of task-shared care for people with severe mental disorders in Ethiopia (TaSCS): a single-blind, randomised, controlled, phase 3 non-inferiority trial.The lancet. Psychiatry · 2022Trial
- Association of depression and epilepsy in rural northern Rwanda: a prospective longitudinal study with a patient-centered approach.Epilepsy & behavior reports · 2026Article
- Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Article
- A latent profile analysis of health behaviors among rural patients with ischemic stroke in China.Frontiers in public health · 2026Article
- Intervention effectiveness reducing disability stigma in sub-Saharan Africa: Systematic review.African journal of disability · 2026Article
- Adaptation of a PTSD intervention for use in primary care in a low-income country: The Brief Relaxation, Education And Trauma HEaling intervention for Ethiopia (BREATHE Ethiopia).SSM. Mental health · 2025Article
- Clinical outcomes of a primary care mental health implementation program scale-up in the Eastern Province of Rwanda: a prospective cohort study.BMC psychiatry · 2025Article
- Picturing a mental health journey: experience of a participatory photovoice approach to presenting recovery narratives of people with lived experiences and caregivers in Ethiopia.International journal of mental health systems · 2025Article
- Affiliate stigma among primary caregivers of adult patients with severe mental illness: a facility-based cross-sectional study in Addis Ababa, Ethiopia.BMC psychiatry · 2025Article
- Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme.Epidemiology and psychiatric sciences · 2025Article
- The effect of expanded access to mental health care on economic status of households with a person with a mental disorder in rural Ethiopia: a controlled before-after study.International journal of mental health systems · 2025Article
- Utilization of mental health services and associated factors among residents of southern Ethiopia; a community based cross-sectional study.BMC health services research · 2025Article
- Healthcare providers' experiences of community-based collaborative care for serious mental illness: a qualitative study in two integrated clinics in South Africa.Global mental health (Cambridge, England) · 2025Article
- Early intervention in psychosis programs in Africa, Asia and Latin America; challenges and recommendations.Global mental health (Cambridge, England) · 2025Review
- Applying the Health Stigma and Discrimination Framework to psychosis stigma in Malawi.PLOS mental health · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
aimThere is limited evidence of the safety and impact of task-shared care for people with severe mental illnesses (SMI; psychotic disorders and bipolar disorder) in low-income countries. The aim of this study was to evaluate the safety and impact of a district-level plan for task-shared mental health care on 6 and 12-month clinical and social outcomes of people with SMI in rural southern Ethiopia.
methodsIn the Programme for Improving Mental health carE, we conducted an intervention cohort study. Trained primary healthcare (PHC) workers assessed community referrals, diagnosed SMI and initiated treatment, with independent research diagnostic assessments by psychiatric nurses. Primary outcomes were symptom severity and disability. Secondary outcomes included discrimination and restraint.
resultsAlmost all (94.5%) PHC worker diagnoses of SMI were verified by psychiatric nurses. All prescribing was within recommended dose limits. A total of 245 (81.7%) people with SMI were re-assessed at 12 months. Minimally adequate treatment was received by 29.8%. All clinical and social outcomes improved significantly. The impact on disability (standardised mean difference 0.50; 95% confidence interval (CI) 0.35-0.65) was greater than impact on symptom severity (standardised mean difference 0.28; 95% CI 0.13-0.44). Being restrained in the previous 12 months reduced from 25.3 to 10.6%, and discrimination scores reduced significantly.
conclusionsAn integrated district level mental health care plan employing task-sharing safely addressed the large treatment gap for people with SMI in a rural, low-income country setting. Randomised controlled trials of differing models of task-shared care for people with SMI are warranted.
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