Listening to the Shenzhen Primary Healthcare Context to Adapt the mhGAP-IG.v2 for the Assessment of Depression: Qualitative Workshops with Primary Healthcare Leaders

Kendall Searle, Grant Blashki, Ritsuko Kakuma, Hui Yang and Harry Minas
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Kendall Searle: Global and Cultural Mental Health Unit, Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
Grant Blashki: Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
Ritsuko Kakuma: Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London WC1E 7HTE, UK
Hui Yang: Monash Institute for Health & Clinical Education, School of Primary Health Care, Monash University, Melbourne, VIC 3168, Australia
Harry Minas: Global and Cultural Mental Health Unit, Centre for Mental Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia

IJERPH, 2022, vol. 19, issue 5, 1-17

Abstract: In Shenzhen, despite recent primary and mental healthcare reform, Primary healthcare doctors (PHC) have limited access to diagnostic tools and a significant mental health treatment gap presides. The World Health Organization’s (WHO) mental health gap intervention guide (mhGAP-IG.v2) offers a non-specialist and evidence-based guide for the assessment of depression however requires adaptation to the context of use. Bilingual (Mandarin and English) qualitative research was undertaken with 30 PHC leaders from Shenzhen to compare their assessment approach for depression against the mhGAP-IG.v2 in order to identify context-specific modifications for a local guide. Local assessment differentiators included: a need for culturally sensitive translation of depression symptoms; a preference for a broad, non-hierarchical symptom presentation (including somatic, behavioural and anxiety items); national prioritisation of suicide patients; the integration of family into the cycle of care; limited primary care awareness of a depressive episode in Bipolar Disorder; and China’s specialist-led diagnostic approach. Contextual modification of mhGAP-IG.v2 is recommended to take account of China’s unique cultural and primary health system response to depression. Ongoing mental health training is required to develop professional confidence in the recognition of mental disorders.

Keywords: depression; mhGAP-IG.v2; primary healthcare; China; Shenzhen; conceptualisation; cultural adaption; contextualisation; depression presentation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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