Stakeholder perspectives on integration of mental health services into primary care: a mixed methods study in Northern Iraq

Table 2 Quantitative Items with average scores less than 50% (●) or 67% (○) of the optimal score^a indicating potential barriers

Domain/item	Client	Provider	Non-MH staff	Director
*Autonomy*
Mental health care decisions are made by others in the family	●
*Accessibility*
Service accessibility for most people in the community		○	○	○
Service accessibility for the poorest people in the community		○	●	●
Service accessibility for women who need them	○	○	●	○
Service accessibility for men who need them		○	○
There are groups in the community that are unable to access the services^b	●	●	●	●
*Acceptability*
Services are a priority for the government		●	●	○
Services are acceptable to the community		○	○	○
Your job negatively affects your family life				○
*Feasibility*
Difficulty attending weekly treatment sessions for 8–12 weeks	○
Sufficient access to computer/internet equipment		●
Sufficient access to private space to meet with clients		○	●	●
Enough counselors to implement step-by-step psychotherapy			○	○
Enough counselor time to implement step-by-step psychotherapy			○	○
Sufficient budget to implement step-by-step psychotherapy			●	●
Enough other necessary resources (e.g.: support staff, administrative time, transportation money, etc.)			●	●
Feasibility of integrating step-by-step psychotherapy into primary health centers			○	○
*Positive organizational structure* (not included in client interviews)
Feeling overworked		○	●	●
Satisfaction with salary		○
Enough learning opportunities available			○	○
Clinic promotes professional growth			○
Positive working environment				○
Regularly paid on time		○	●	●