Integrating Mental Health Services into Primary Care Settings: A Multiple Case Study of Congolese Experiences testing the Feasibility of the WHO’s mental health Gap Action Programme

Some experiences of integrating mental health into primary care settings, testing the feasibility of the WHO’s mental health Gap Action Programme (mhGAP) approach, have been launched in the Democratic Republic of the Congo to address treatment gaps. However, they have not yet been documented to look at scaling up. This study described the health outcomes and lessons learned from two of these experiences. A multiple case study was conducted on two integration experiences in the urban Tshamilemba district (2021-25) in the Haut-Katanga province and in the rural Mangembo district (2022-26) in the Kongo Central province, called Programmes U (for Urban) and R (for Rural), respectively. Data were collected between July and August 2024 from focus group discussions, interviews, document reviews, including routine health information systems. We carried out descriptive statistical analyses to measure indicators of accessibility and the use of services, and content analysis to explore the lessons learned. A total of 1,719 individuals with mental disorders were treated in primary care settings between 2021/22 and 2024 under both programmes. From 2021 to 2024, the curative consultations rate for mental disorders, which was nil at the start of both programmes, reached 14.4 New Cases/1,000 inhabitants/year in programme U and 14.2 New Cases/1,000 inhabitants/year in programme R. Several lessons were learned, related to each phase of mhGAP approach. The findings confirm the feasibility and effectiveness of the mhGAP approach in the Congolese context and highlight the need for concerted action to address the identified challenges.