Exploring implementation factors for non-specialist mental health interventions in Sri Lanka.

Kalpani Wijekoon WIJEKOON MUDIYANSELAGE1,2, Frederike JÖRG3,4, M. Sajani Dilhara MENDIS5,6, Heide BUSSE1,7, Daniela FUHR1,2

1Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
2University of Bremen, Bremen, Germany
3University of Groningen, University Medical Center Groningen, Groningen, Netherlands
4Friesland Mental Health Care Services, Leeurwarden, Netherlands
5International College of Business and Technology, Colombo, Sri Lanka
6Cardiff Metropolitan University , Cardiff, United Kingdom
7Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany

Introduction: Addressing the mental healthcare gap in low- and middle-income countries like Sri Lanka requires innovative solutions. This study investigates the perspectives of local mental healthcare workers and other community members on non-specialist mental health interventions. The primary goal is to identify anticipated barriers and facilitators to their implementation, with a secondary focus on exploring alternative strategies to reduce the mental healthcare gap in Sri Lanka.

 

Methods: Qualitative interviews were conducted with mental healthcare workers (n=9) and community members (n=11) from Colombo and Badulla in Sri Lanka, using convenience sampling until data saturation. Thematic analysis using an inductive approach was used to derive codes and themes from anonymized data.

 

Results: Anticipated barriers manifested as concerns (theme 1) regarding the effectiveness, acceptance, and feasibility of the general concept of non-specialist mental health interventions and specific intervention types. Anticipated facilitators were depicted through perceived values (theme 2) in these interventions, highlighting participants' trust in addressing the mental healthcare gap, increasing awareness, and reducing the overall mental illness burden. Other facilitators included suitable non-specialist characteristics (theme 3), such as social acceptance, specific occupational background, higher education, and personal attributes. Practical suggestions to facilitate implementation (theme 4) include community recruitment, engaging family members, collaborating with important societal groups, ensuring privacy protection, providing transportation and payment regulations, emphasizing positive psychology in school-based interventions, and considering cultural norms and resource availability differences. Ideas for reducing the mental healthcare gap centered on expanding mental health literacy and awareness programs.

 

Conclusion: This study offers valuable insights into essential contextual factors that may impact the implementation of non-specialist mental health interventions in Sri Lanka, providing crucial recommendations for researchers and policymakers. Acknowledging potential barriers in Sri Lanka, the study suggests counteracting these challenges through careful selection of non-specialists and adapting interventions to country-specific demands, norms, and availability of resources.