Since the end of conflict in 2009, Northern Sri Lanka is seeing a rapid rehabilitation and rebuilding process in health and other infrastructure. However, the need for human resources is the least being met, as the rate of capacity building and training new cadres are significantly below that of the growing need in the region. However, the relative political, social and economic stability that the region is enjoying after three decades of bitter conflict are highly conducive to training new cadre of healthcare workers and increasing the capacity of existing health work force. The proposed project, already having being implemented in pilot form in the Northern province, aims to improve the skills of existing primary care health work force in integrating mental health into primary care services across all districts of the Northern province. A comprehensive cross-sectional study is proposed to identify the mental disorder burden in the region, as the prevalence information is patchy and not current. Understanding this burden is critical in order to shed light on the mental health care needs in the region and to inform the intervention development and delivery to address the treatment gap. The setting will be in all 5 districts in Northern Sri Lanka and will specifically focus on participants who are conflict-affected, forced internal migrants. This project has two specific aims.
The first aim i s to conduct a comprehensive cross- sectional study using cluster sampling to identify the prevalence of common mental disorders within the Northern province of Sri Lanka.
The second aim i s to use an adapted version of the World Health Organization mental health gap programme (WHO mhGAP) to train primary care practitioners and public health personnel to deliver mental health treatment within the primary care health system in Northern Sri Lanka. This scaled-up study is informed by previous pilot work on its feasibility, which involved stakeholders at every step ensuring the proposed project is relevant to the local population. This project will also include an economic evaluation component to explore cost-effectiveness of integrating mental health into primary health care. Additionally, programme monitoring and evaluation will be conducted to evaluate success of the implementation of the training programme and impact on patient outcomes. This project hopes to provide a comprehensive account of the prevalence of common mental disorders within post-conflict Northern Sri Lanka, narrow the treatment gap and improve patient outcomes by integrating mental health into the primary health care system.
This project focuses on reducing the mental health treatment gap for conflict-affected, internally displaced populations in Northern Sri Lanka. The project will use the WHO mhGAP intervention guideline-based training programme for primary care practitioners and public health professionals working with displaced populations. This project will facilitate the integration of mental health into primary care settings and strengthen the public health system in post-conflict regions of Sri Lanka.