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Table 5 Suggestions to improve mental health service delivery 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
Change/improve facilities
Designated space for servicesA private place should be allocated for mental health sections (S)
A special (private) place be allocated for the CMHW (C)
161333971
Larger centerA larger mental health hospital should be available (P)
We need a large hospital to be built for us (D)
653215
Beautify facilitiesThe place [should] be in a garden surrounded by green areas (C)
A library to be available in the center (C)
516
Staffing changes
Increased specialist/trained staffMore expert psychotherapist and staff should be employed (S)
Provision of smart and trained psychotherapist (D)
91625353
Increase staff numbersMore staff should be employed in this centre (S)
Provide better number of doctors and staff (D)
3421836
Providers of matched genderBoth gender staff should be available in mental health section (S)
More CMHW be available of both genders (C)
6811429
Protected time for providing servicesNo other jobs imposed on psychotherapists but the service only (P)
Staff should carry out only this task in the hospital, not do any other tasks (S)
638
Raise awareness
Mental health literacyMedia methods like TV, radio and newspapers should play their role on circulating awareness on mental health and this programme as well (P)
To publicize more information about mental illnesses (D)
19291057
Educate about programThis treatment become known through media (C)
This service should be introduced through media methods, symposiums and seminars (S)
9148234
Increase support for program
Increase government supportGovernment and concerned authorities should take mental health more seriously (P)
The government have to have a special plan for paying more attention to this program (C)
32329662
Financial/material supportGovernment and ministry to provide financial and moral support (P)
If the government provide transportation means it will make the programme continue (S)
1324542
Formal recognition/integrationGovernment should recognize it formally (P)
This programme to be included within ministry structure (D)
1317535
Expand services
To all regions/centersNow it is only available in one area I wish it was available in districts and sub-districts (C)
More centres should be established for those who live far away (S)
19617143
Mobile teamsA mobile team to be available to visit remote areas (P)
Mobile psychotherapist teams should visit patients in their homes (S)
2313321
Embed in schools/officesPsychotherapist to be employed in schools (P)
If they put CMHW in the schools it would make it easy (C)
11316
Program changes
Involve familyFamily of patient should be talked with to support and cooperate the patient (S)
If possible, patients’ families to participate in this treatment (P)
5510
Adapt for illiterate clientsIt is better to make a CD version for illiterate people (C)
I prefer that the program use colors for illiterate people; for example, for something bad use a black color (C)
98
Treat patients carefully/with respectPatients should be treated with respect (S)818
Decrease sessions/timeLessening the sessions (P)
The sessions be reduced because it is difficult that the patient comes every week (C)
5218
Encourage client adherenceIt should be clear for the patient that the programme takes long time (S)
In the beginning the programme should be explained for the patient (S)
66
Financial supports
Allocate budget/resources for programBudgets should be allocated for the programme (S)
Money, staff, place, required equipment and transportation methods make continuity (D)
1920746
Accommodations for staffTransportation and communication methods should provide for psychotherapists (S)98
Financial supportAttempt to provide financial facilitation for patients (P)
Financial support should be provided for patients (S)
465420
Transportation supportProvide transportation fees for patients (P)
It is necessary that means of transport be arranged for patients (C)
558120
Training
Provide trainings on the interventionCETA to be inserted into college studies (P)
More training courses should be arranged for the staff (S)
31413232
  1. “–”indicates response was not provided at that stakeholder level