Sukumar Gautham Melur, Yalgudri Bujabali D, Narayana Manjunatha, Rao Girish N
Department of Epidemiology, National Institute of Mental Health and Neuro Sciences (NIMHANS) Bengaluru, Karnataka, India.
Department of Health and Family Welfare, Government of Karnataka, Karnataka, India.
J Family Med Prim Care. 2020 Jan 28;9(1):173-179. doi: 10.4103/jfmpc.jfmpc_906_19. eCollection 2020 Jan.
Mental health services are integrated into primary healthcare and delivered by medical officers (MOs). Assessment of mental health services provided by MOs and their ability to manage mental disorders in primary health centers (PHCs) would provide evidence to strengthen the quality of this integration.
To conduct a situational assessment of mental health services provided by medical officers in PHCs in Kolara district in terms of availability and nature of services. To assess the ability of MOs to diagnose and treat mental disorders in PHCs.
We interviewed all eligible and available PHC medical officers (45). The nature of mental health services provided (diagnosis, treatment, counseling and referral) was enquired. A case-vignette based assessment of the ability of MOs to diagnose and treat mental disorders was conducted.
Nearly 87% of MOs delivered psychiatric out-patient services on all working days. MOs were significantly better in diagnosing compared to providing treatment ( = 0.04). In spite of being trained in mental health, concerns exist in translating training into quality service delivery. MH drugs were available in regular supply and utilised to great extent.
MOs are providing psychiatric out-patient services in PHCs regularly but their ability is limited. The study recommends the reorientation of existing training from a service delivery perspective.
精神卫生服务已纳入初级卫生保健，并由医务人员提供。评估医务人员提供的精神卫生服务及其在初级卫生保健中心管理精神障碍的能力，将为加强这种整合的质量提供依据。
对科拉拉区初级卫生保健中心医务人员提供的精神卫生服务的可及性和性质进行现状评估。评估初级卫生保健中心医务人员诊断和治疗精神障碍的能力。
我们采访了所有符合条件且在岗的初级卫生保健中心医务人员（45人）。询问了所提供的精神卫生服务的性质（诊断、治疗、咨询和转诊）。基于病例 vignette 对医务人员诊断和治疗精神障碍的能力进行了评估。
近87%的医务人员在所有工作日都提供精神科门诊服务。与提供治疗相比，医务人员在诊断方面明显更擅长（P = 0.04）。尽管接受过精神卫生方面的培训，但在将培训转化为高质量服务提供方面仍存在问题。精神科药物有定期供应且得到了大量使用。
医务人员在初级卫生保健中心定期提供精神科门诊服务，但其能力有限。该研究建议从服务提供的角度对现有培训进行重新定位。
