Rachel Levy, Muthoni Mathai, Purba Chatterjee, Linnet Ongeri, Simon Njuguna, Dickens Onyango, Dickens Akena, Grace Rota, Ammon Otieno, Thomas C Neylan, Hafsa Lukwata, James G Kahn, Craig R Cohen, David Bukusi, Gregory A Aarons, Rachel Burger, Kelly Blum, Inbal Nahum-Shani, Charles E McCulloch, Susan M Meffert
BACKGROUND: Mental disorders are a leading cause of global disability, driven primarily by depression and anxiety. Most of the disease burden is in Low and Middle Income Countries (LMICs), where 75% of adults with mental disorders have no service access. Our research team has worked in western Kenya for nearly ten years. Primary care populations in Kenya have high prevalence of Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD). To address these treatment needs with a sustainable, scalable mental health care strategy, we are partnering with local and national mental health stakeholders in Kenya and Uganda to identify 1) evidence-based strategies for first-line and second-line treatment delivered by non-specialists integrated with primary care, 2) investigate presumed mediators of treatment outcome and 3) determine patient-level moderators of treatment effect to inform personalized, resource-efficient, non-specialist treatments and sequencing, with costing analyses...
December 28, 2019: BMC Psychiatry