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

From: Implementation process and outcomes of a mental health programme integrated in primary care clinics in rural Mexico: a mixed-methods study

Mental health serviceProgramme guidelines for the treatment of mood or anxiety disordersIndicator and descriptionData source for indicator
DiagnosisPerformed 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 guidelinesCoded from content in clinical notes
Treatment allocationPharmacological 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 casesFidelity to treatment allocation guidelines: proportion of service users diagnosed according to guidelinesCoded from content in clinical notes
Follow-upFollow-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 consultationsDates recorded on clinical notes
Clinical assessment at follow-upClinical 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 explorationFidelity to clinical assessment guidelines at follow-up: proportion of service users who receive a clinical assessment according to guidelinesCoded from content in clinical notes
Treatment allocation at follow-upProportion of service users who receive counsel or advice, or a talk-based intervention at follow-upFidelity to treatment allocation guidelines at follow-up: Proportion of service users who receive counsel or advice, or a talk-based intervention at follow-upCoded from content in clinical notes