Integrating mental health and non-communicable disease care: A WONCA advocacy project report

Abstract

The integration of mental health into the management of non-communicable diseases (NCDs) is crucial, particularly in low-resource settings like Ghana. This is a report of an integrated care project in primary care for the management of patients with hypertension and type 2 diabetes mellitus. This quality improvement project involved screening, providing information and education about common warning signs for mental health problems, and available health personnel from whom patients can seek help. This practice quality improvement project was executed in a primary care hospital in Ghana under the World Organization of Family Doctors (WONCA) Integrating Care Leadership and Advocacy Programme. Adult patients with hypertension and/or type 2 diabetes mellitus were screened using the 4-item Patient Health Questionnaire (PHQ-4) tool for anxiety and depression. The project screened 205 patients, of which 39 (19%) were found to have either anxiety and/or depression and were managed appropriately. The findings underscore the importance of integrating mental health care into the management of non-communicable diseases. Additionally, integration is essential to enhancing access to appropriate interventions and decreasing fragmentation in the delivery of care. This approach improves access to comprehensive care, reduces treatment fragmentation, lowers healthcare costs, fosters better patient satisfaction through holistic treatment, and reduces the stigma associated with mental health issues. This paper gives support to the feasibility of this integration in primary care settings. Several benefits have been demonstrated, showing the necessity of such integration in primary care settings, and advocating for policy with detailed guidelines for integrating mental health into non-communicable disease care in Ghana.