Skip to main content

Table 4 Facilitators to mental health service implementation reported across stakeholder levels

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

 ExamplesClients
(n = 62)
N
Providers
(n = 26)
N
Staff
(n = 40)
N
Directors
(n = 12)
N
Total
(N = 140)
N
Positive perceptions of program
Program is good/people like itI believe it is the best psychotherapy (P)
People talk good about this therapy (C)
58264011137
Program is acceptable/agrees with valuesThis therapy suits my values, otherwise I could not come (C)
It is accepted by [when] explaining the treatment (P)
5126336116
Program is suitable/appropriateIt suits my needs (C)
This treatment is suitable and blessed (D)
47262911113
Program is feasibleIt is feasible and requires no changes (P)
It is feasible with the current capacities (D)
18271055
Program is accessible/is for everyoneEveryone and [every] section of the community can have access to it (C)77
Program impacts
Is useful/effectiveI had the feeling that I was getting better session after session (C)
We were able to treat most of our patients’ problems (P)
Patients get rid of psychological stress and it is useful for the community (D)
The good thing is that patients recover to enjoy better normal health status (S)
5818245106
Increased knowledge/MH literacyI learned from it that not only I am ill (C)
People’s awareness about mental health sicknesses increased (D)
915428
No harmful impactIt does not have any bad effect for me (C)2727
Empowers clientsIt enables patients to depend upon oneself (P)
It teaches people better know their problems and have them solved by themselves (S)
I have learned a lot from this treatment that I can control my mental issues (C)
145221
Prevents suicidePreviously I had suicide idea but now it is no longer in my mind (C)
This treatment helps decrease the level of suicide and self-burning (P)
91515
Gives security, comfortI had the feeling that I become comfortable when I come here (C)
I felt secure (C)
1515
Gives hopeI have regained hope for life (C)
This mental health section gave hope to people, influenced them and people took benefit (S)
538
Program attributes
Free of drugsMy problem was solved without taking a single pill (C)
This treatment is better and more effective than drugs (S)
34918566
No costThe treatment was free of charge (C)
If treatment is free of charge, poor people will take benefit from the program (S)
291314460
Talk-based treatmentI could talk out what was in my heart (C)
I needed someone to listen to me (C)
3635
Simple/easy to followThe home exercises made it easy (C)
We feel the programme is not difficult, patients can apply there, therefore, it is feasible (P)
163422
Flexible schedulingThey set the appointment according to my time (C)1615
Protects confidentialityThere was no name recording (C)
Patients’ private data kept confidential by us (S)
1212115
Providers receive trainingWe received good trainings (P)
In the university, I did not know anything, but here I learned (P)
1313
Step-by-step/session-basedWeekly you sit with a CMHW for an hour or two; possibly you could not do so with someone else (C)
This program is step-by-step that is why it will have effect on the patient (C)
77
Provider attributes
Caring/respectfulThere is someone who listens to you and trusts your decisions (C)
We are always ready for any patient without difference (P)
In this treatment, patients are respected and listened to (S)
5461273
Providers are capable/specializedThe CHHW was there ready at the exact time (C)
There are capable psychotherapists (D)
13811335
Eager/motivated providersAs a psychotherapist, I continue and never quit (P)
Staff eagerness and loyalty for the work (D)
10313
Service environment
Good facilities (large, quiet, clean)The place was quiet (C)
Our building is new and large (D)
35717362
Center has good reputationThe say good things about the reputation of the health center (C)
The structure of the program is robust (C)
4141
Separate space/MH sectionThere is a private place where I can talk (C)
I have my own room (P)
104318
Coffee/tea providedThey bring us water, tea and sweets (C)1213
Conveniently locatedThe place was very near for me (C)
In terms of location, our hospital is suitably located (P)
81110
Positive work environment
Good cooperation among staffThey show readiness for giving their places whenever there is patients or when I ask them (P)
Staff are very cooperative to the programme (S)
Employees enjoy a good cooperation between them (D)
25371274
Supportive leadershipSupervision is at a very good level (S)
The director facilitating a lot of things for us (P)
11528448
Client attributes
Supportive friends/familyMy mother told me many times to use this treatment to get better and this made me continue (C)
My friends were happy that I came here (C)
5353
Autonomy for treatment decisionsI come to this treatment based on my decision (C)5050
Able to arrange work/scheduleI arrange my work ahead of time (C)
In my job, they give me permission [to leave] anytime I want (C)
2121
Trust for the program/CMHWThe CMHW can be trusted so you talk about your problem with them (C)
Patients tell psychotherapists their stories because they trust them (S)
104520
Motivation/recognized needI needed this treatment very much (C)
I wanted to get rid of my problem (C)
1920
Sufficient time availableI have time to come here (C)1213
Childcare availableI take my children to my neighbors (C)1111
Adequate program resources
Financial/material support for clients and programPaying the transport cost made it easy (C)
Help from ‘material’ (Financial) aspect (C)
121417
Provision of incomes for staffProvision of incomes make it suitable to continue (S)1313
Adequate staffing/staff timeI allocate much time for patients (P)
In the past, we suffered lack of doctors and social workers but now we have psychotherapist (S)
638
  1. “–” indicates response was not provided at that stakeholder level