Integrating Depression and Alcohol Use Care Into Primary Care in Low- and Middle-Income Countries: A Meta-Analysis

Area of Science:

• Global Health
• Mental Health Services Research
• Primary Health Care Integration

Background:

• Limited evidence exists on the effectiveness of integrating depression and alcohol use disorder care into primary healthcare in low- and middle-income countries (LMICs).
• This study systematically reviews and quantifies the impact of integrated mental health care models on depression and alcohol use disorder outcomes in LMICs.

Approach:

• A systematic review and meta-analysis were conducted, including studies from a previous review and new research from 2017-2020.
• Studies were evaluated based on integration models, and a random-effects model was used to assess intervention effectiveness.
• Meta-regression analyses explored the influence of study characteristics on treatment outcomes.

Key Points:

• A total of 74 articles met inclusion criteria for the meta-analysis.
• Integrated interventions showed positive effect sizes for depression (0.28) and alcohol use disorder (0.17) in LMICs.
• While country income level did not significantly impact outcomes, different integration models yielded statistically significant differences in effect sizes.

Conclusions:

• Integrating mental health care into primary healthcare settings in LMICs effectively improves outcomes for depression and alcohol use disorder.
• Findings support the consideration of integrated care models in designing interventions for mental health screening and treatment in LMICs.