Integrating mental health into primary care for displaced populations: the experience of Mindanao, Philippines

Psychologists working in mobile clinics assessed patients referred by trained clinicians located at primary level. They provided psychological first aid, brief psychotherapy and referral for severe patients. Patient characteristics and outcomes in terms of Self-Reporting Questionnaire (SRQ20) and Global Assessment of Functioning score (GAF) are described.Among the 463 adult patients diagnosed with a common mental disorder with at least two visits, median SRQ20 score diminished from 7 to 3 (p < 0.001) and median GAF score increased from 60 to 70 (p < 0.001). Baseline score and score at last assessment were different for both discharged patients and defaulters (p < 0.001).Brief psychotherapy sessions provided at primary level during emergencies can potentially improve patients' symptoms of distress.During the acute phase of an emergency, mental health interventions to reduce traumatic stress are often put in place. In addition to syndromes often associated with conflict such as post-traumatic stress disorders [1], other disorders also occur, such as depressive or anxiety disorders [2]. Further, in a context of limited access to health care, patients with mental health or neurological disorders not directly linked to the conflict, such as psychosis or epilepsy, may be neglected by vertical interventions related to the conflict or natural disaster [3]. Descriptions of treatment models and research about the outcome of interventions in emergencies are rare [4]. Much of the existing research focuses on post-traumatic disorders, often to the exclusion of other disorders. Less attention may be given to the needs of those with disorders unrelated to the conflict. Vertical trauma-focused services are often juxtaposed against the importance of the integration of trauma-focused care and the treatment of pre-existing mental disorders into general mental health and primary care [5].Humanitarian organizations now recommend that psychological first aid be provided as part of medica