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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