What did we learn from a pilot trial to inform the scale-up of training based on the Mental Health Gap Action Programme in Tunisia?

Abstract

The Mental Health Gap Action Programme (mhGAP) Intervention Guide was developed to support evidence-based training offered to nonspecialists to further encourage the integration of mental health into primary care and community-based settings. This training programme was implemented in many countries of the Eastern Mediterranean Region (EMR). Tunisian primary care physicians were offered an mhGAP-based training programme as a pilot in 2016 and it was evaluated using an 18-month exploratory trial and implementation analysis. Pilot findings informed the scale-up of a mental health training programme that began in January 2020 by recommending amendments to mental health policy, informing training content, further operationalizing the National Strategy for Mental Health Promotion, and encouraging the sustainability of the training’s effects through a cascade model. Our lessons learned may be useful to other countries of the EMR, invested in furthering the training of primary care physicians/other nonspecialists, as well as the integration of mental health into primary care settings.