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Scaling up MNS services | International Health | Volume 1, Issue 1, pp. 37-44

“The WHO’s new Mental Health Gap Action Program (mhGAP) specifically aims to develop packages of care for seven mental, neurological, and substance abuse disorders and for suicide […] The key challenge remains how these various packages can be integrated across disorder categories and demographic groups and, furthermore, how these can be integrated across within existing health care programs.”


Mental and neurological disorders (MNDs) account for a large, and growing, burden of disease in low- and middle-income countries. Most people do not have access to even basic health care for these disorders. Recent evidence shows that task-shifting to non-specialist community health workers is a feasible and effective strategy for delivery of efficacious treatments for specific MND in low-resource settings. New global initiatives, such as the WHO’s mental health Gap Action Program, are utilizing this evidence to devise packages of care for specific MNDs. This paper describes a plan that seeks to integrate the evidence on the treatment of specific MNDs, based on a task-shifting paradigm, for scaling up services for MNDs at the level of a defined population. The plan was developed by a state government in India in collaboration with technical partners, as a model District Mental Health Program for India’s National Mental Health Program.