Table 1 CES programme guidelines for mental health service delivery and process indicators

Diagnosis

Performed using (1) the score of the 9-item Patient Health Questionnaire (PHQ-9) [17] for mood disorders or the 7-item Generalized Anxiety Disorder scale (GAD-7) [18] for anxiety disorders and (2) a clinical assessment (i.e. exploration of key symptoms, medical history, and relevant life events)

Fidelity to diagnosis guidelines: proportion of service users diagnosed according to guidelines

Coded from content in clinical notes

Treatment allocation

Pharmacological treatment is allocated when PHQ-9 [17] or GAD-7 [18] score is 15 or above unless user rejects medication or clinician decides to reassess need in a second appointment; if 14 or less, medication is not prescribed until reassessment at second appointment; psychoeducation or other talk-based intervention is provided in all cases

Fidelity to treatment allocation guidelines: proportion of service users diagnosed according to guidelines

Coded from content in clinical notes

Follow-up

Follow-up provided until remission (at least 6 months with no symptoms)

Dose of mental health follow-up consultations: proportion of service users who attended more than 50% of programmed monthly consultations

Dates recorded on clinical notes

Clinical assessment at follow-up

Clinical assessment at follow-up done through: (1) the use of PHQ-9 [17] or GAD-7 [18], (2) key symptom exploration, and (3) life event exploration

Fidelity to clinical assessment guidelines at follow-up: proportion of service users who receive a clinical assessment according to guidelines

Coded from content in clinical notes

Treatment allocation at follow-up

Proportion of service users who receive counsel or advice, or a talk-based intervention at follow-up

Fidelity to treatment allocation guidelines at follow-up: Proportion of service users who receive counsel or advice, or a talk-based intervention at follow-up

Coded from content in clinical notes