Development and implementation of mental healthcare plans in three districts in Ghana: a mixed method process evaluation using the MRC Complex Interventions framework and Theory of Change.

Abstract

<title>Abstract</title> In Ghana, a staggering mental health treatment gap of 95–98% exists due to limited mental healthcare services. To address this gap, Ghana Somubi Dwumadie programme implemented district mental healthcare plans (DMHPs) in three demonstration districts. Collaborating with local stakeholders, the study followed the Programme for Improving Mental Healthcare model, establishing district mental health operations teams. These teams, with representatives from various sectors, utilized a Theory of Change approach to enhance mental health service accessibility. Key components included training non-specialist health workers and enrolling individuals in relevant healthcare programs. Results showed successful integration of mental health services in primary care, improved case detection and care through training sessions, and enrolment of 691 service users in mental health services. The study concludes that DMHPs, implemented with an integrated approach, can significantly reduce the care gap for individuals with mental health conditions, attributing success to committed leadership, resource availability, and stakeholder engagement.