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Table 2 Summary of level of intervention, key tasks, intervention and preconditions

From: Developing a Theory of Change model of service user and caregiver involvement in mental health system strengthening in primary health care in rural Ethiopia

Levels of intervention Key tasks Intervention Preconditions
Local community level Mobilize resources
Raise awareness about mental illness, roles or service user and caregivers
Establish and empower service user and caregiver groups
Support rehabilitation/livelihood support and social inclusion of service user and caregivers
Promote human rights protection
Support mobilization and organization of service user/caregiver organizations
Working with the Community Advisory Board (CAB), leaders of social associations, faith based and religious organizations, Health Development Army, Development agents and health extension workers
Building capacities (e.g., training) local statutory and non-statutory leaders in service user involvement and empowerment
Conducting CAB consultative meetings
Awareness raising to the local community about service user and caregiver involvement
Strengthening collaboration and involvement of community stakeholders
Improved community awareness about mental health/illness, and service user and caregiver involvement
Non-stigmatizing support
Improved collaboration of community stakeholders
Improved support, inclusion, human rights protections, and rehabilitation/livelihood support of service user and caregivers
Health organization (service provider/managers) Provide mental health services within primary healthcare
Avail adequate and reliable treatment (medication and basic psychosocial care)
Ensure competent, compassionate and respectful care services
Provide relevant and evidence-based information and treatment choices
Ensure services are accountable and responsive
Mobilize and organize service user and caregiver groups
Encourage social inclusion
Capacity building training about how best to involve and work with service user and caregivers
Facilitate involvement to develop and evaluate a plan for service user and caregiver involvement, focused to ensure availability and quality of mental health care
District health office continues to support availability of integrated mental health care in the study site
Improved information and treatment choices for accountable and responsive mental health care
Improved knowledge of participatory care provision involving service user and caregiver
Non-stigmatizing (inclusive) care
Availability of competent, compassionate, respectful and caring service providers
Service users Establish service user groups
Advocate for prioritization of mental health service delivery, sustainable medication supplies, and human rights protection for service users
Provide peer support, awareness raising about mental illness for the local community
Establish collaborations with various stakeholders to empower service users and address unmet social needs
Capacity building training about basics of mental health and illness, understanding service user involvement, mental health related stigma and discrimination, human rights issues and mental health advocacy
Facilitation of service user organization and empowerment
Facilitation of involvement to develop and evaluatea plan for service user involvement
Improved service user awareness about mental health and mental health services
Improved communication between service users, caregivers and service providers
Non-stigmatizing attitudes
Improved treatment adherence of service users
Improved care(pharmacological and basic psychosocial) for service users
Improved influence of service user voices and perspectives
Caregiver Collaborate with service user groups
Enhance advocacy for mental health service and protection of service user`s rights
Provision of peer support
Provision of awareness raising about mental health for the local community
Encourage social inclusion
Establish collaborations with various stakeholders
Capacity building training about basics of mental health and illness, understanding caregiver involvement, mental health related stigma and discrimination, human rights issues and mental health advocacy
Facilitation of caregiver organization and empowerment
Facilitation involvement to develop and evaluate the plan for caregiver involvement
Improved caregivers awareness about mental health and mental health services
Non-stigmatizing attitudes
Improved communication between service user and caregiver
Reduced caregiver burden of care, costs
Increased economic productivity
Improved influence of caregiver voices and perspectives