Mental health services provided by medical officers in primary health centres in Kolar district in Karnataka, India: A situational assessment

Context: Mental health services are integrated into primary healthcare and delivered by medical officers (MOs). Assessment of mental health services provided by MOs and their ability to manage mental disorders in primary health centers (PHCs) would provide evidence to strengthen the quality of this integration. Aims: To conduct a situational assessment of mental health services provided by medical officers in PHCs in Kolara district in terms of availability and nature of services. To assess the ability of MOs to diagnose and treat mental disorders in PHCs. Materials and Methods: We interviewed all eligible and available PHC medical officers (45). The nature of mental health services provided (diagnosis, treatment, counseling and referral) was enquired. A case-vignette based assessment of the ability of MOs to diagnose and treat mental disorders was conducted. Results: Nearly 87% of MOs delivered psychiatric out-patient services on all working days. MOs were significantly better in diagnosing compared to providing treatment (P = 0.04). In spite of being trained in mental health, concerns exist in translating training into quality service delivery. MH drugs were available in regular supply and utilised to great extent. Conclusion: MOs are providing psychiatric out-patient services in PHCs regularly but their ability is limited. The study recommends the reorientation of existing training from a service delivery perspective.