The Allillanchu Project seeks that public health services show a greater interest in the emotional well-being of their users and to incorporate the assessment of their mental health as a common practice among health workers who attend to them.

Allillanchu is a greeting in Quechua that translated into Spanish means «How are you? Are you okay?». This name was chosen to emphasize the need to integrate mental health care into the routine practices of health providers.

Aim:

The Allillanchu Project aimed to develop, implement and evaluate an intervention to promote early detection, timely referral and access to treatment of patients with mental disorders who attend public primary care services in Lima, Peru.

Study design:

The Allillanchu Project combined three strategies: 1) Training of Primary Health Care Providers (PHCP), 2) Task-shifting for the detection and referral of people with mental disorders, and 3) A mobile health (mHealth) component that included a) an app for the detection of mental disorders and b) a set of SMSs to remind and encourage the search for specialized care. The intervention was implemented by 22 PHCPs from five health centers, working in antenatal care, tuberculosis, chronic diseases, and HIV/AIDS services.

The intervention was also based on two other essential components: 1) The commitment of key stakeholders, such as authorities at EsSalud and the Ministry of Health, as well as the heads and staff of the participating health centers, and 2) A formative study to adapt the intervention to the context in which it was implemented.

Result:

Over a 9-week period (September-November 2015), the 22 PHCPs examined a total of 733 patients during their routine consultations and completed 762 screenings. The chronic diseases (49.9%, 380/762) and antenatal care services (36.7%, 380/762) had the higher number of screenings. Time constraints and workload were the main barriers to implementing the screening, whereas the use of technology, training, and supervision of the PHCPs by the research team were identified as facilitators.

Of the 733 patients, 21.7% (159/733) screened positively and were advised to seek specialized care. Out of the 159 patients with a positive screening result, 127 had a follow-up interview, 72.4% (92/127) reported seeking specialized care, and 55.1% (70/127) stated seeing a specialist. Both patients and PHCPs recognized the utility of the screening and identified some key challenges to its wider implementation.

Contact:

Jorge Toyama, BA
jorge.toyama.g@upch.pe