» Articles » PMID: 39962457

Providers' Insight into Quality Mental Health Services - Context-Mechanism-Outcome (CMO) Approach

Overview
Publisher Biomed Central
Specialty Health Services
Date 2025 Feb 18
PMID 39962457
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Evaluation frameworks are relevant to understanding health service providers' views regarding existing services and possible improvements, but their application to mental health services is limited, particularly in Low Middle-Income Countries.

Aim/question: To identify a program theory that explains the contextual factors and mechanisms that could enhance mental health service outcomes in Ghana.

Method: A three-phase approach was followed: initial theory and assumption, analysis, and CMO configuration. Systematic reviews were used to develop a middle-range theory and assumptions in phase 1. A purposive sample of 30 mental health professionals was recruited to participate in in-depth interviews in phase 2. Thematic analysis was used to analyze the qualitative data and further configure the CMO in phase 3.

Results: The analysis identified five CMO configurations: ripple effects and financing source sustainability; unavailability of modern equipment and logistics to support holistic services; promoting inclusivity and geographical proximity of services; information, sensitization, and awareness encourage mental health quality; and monitoring and evaluation improve mental health service quality.

Conclusion: This study concludes that government stakeholders should integrate mental health services into the ongoing insurance policy and provide adequate modern equipment and logistics. Moreover, mechanisms and priorities given to vulnerable consumers should be integrated into policies.

References
1.
Jagosh J, Bush P, Salsberg J, Macaulay A, Greenhalgh T, Wong G . A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health. 2015; 15:725. PMC: 4520009. DOI: 10.1186/s12889-015-1949-1. View

2.
Stokes T, Atmore C, Penno E, Richard L, Wyeth E, Richards R . Protocol for a mixed methods realist evaluation of regional District Health Board groupings in New Zealand. BMJ Open. 2019; 9(3):e030076. PMC: 6477391. DOI: 10.1136/bmjopen-2019-030076. View

3.
Al-Habeeb A, Qureshi N . Mental and Social Health Atlas I in Saudi Arabia: 2007-08. East Mediterr Health J. 2010; 16(5):570-7. View

4.
Kilbourne A, Beck K, Spaeth-Rublee B, Ramanuj P, OBrien R, Tomoyasu N . Measuring and improving the quality of mental health care: a global perspective. World Psychiatry. 2018; 17(1):30-38. PMC: 5775149. DOI: 10.1002/wps.20482. View

5.
Bhana A, Petersen I, Baillie K, Flisher A . Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry. 2011; 22(6):599-610. DOI: 10.3109/09540261.2010.536152. View