The integration of mental health into primary health care in Lebanon

In Lebanon, the International Medical Corps is working to address the multiple needs of Iraqi refugees, as well as the long term needs of the vulnerable host population, by integrating mental health services into primary health care (PHC). Over the past two years, 152 PHC providers (doctors, nurses and social workers) were trained in the identification, management and referral of people with mental health problems. The Ministry of Health has certified the completion of a training that includes: 12 theoretical training days, and a minimum of three on-the-job, supervised clinical sessions. Two formative evaluations were conducted to guide training implementation. Trainees completed pre/post tests, and clinical skills were evaluated during the on the-job supervision sessions. Trainees showed an average of 12-25% improvement in knowledge, and 85% doctors and 91% nurses met minimum competency standards. Results from the evaluation were used to address challenges, including: strengthening referral mechanisms; promoting organisational change through clinic management; tailoring training for different groups of professionals; utilising a team approach to care, providing refresher training on topics such as medication management and planning longer term follow-up. The project provides important input towards integrating mental health into primary health, on the national policy level.