Family Physicians' Experience of the WHO Mental Health Gap Action Programme in Nigeria: A qualitative enquiry

Background The World Health Organization’s Mental Health Gap Action Programme (mhGAP) intervention guide (IG), provides evidence-based guidance and tools for assessment and integrated management of priority disorders. It is aimed to bridge the mental health gap but this gap still persists, with significant disparities in care access and quality. Family physicians play a crucial role in addressing this gap, but their awareness and involvement levels in the implementation of mhGAP remain unclear. This study explored family physicians’ awareness and involvement levels in the implementation of mental health service in Nigeria and also explored the perceived facilitators and barriers influencing their level of engagement in contributing to the “Mental Health Gap Action Programme”. Methods A descriptive cross-sectional qualitative study using key-informant interview semi-structured questionnaire to obtain information from 23 Family Physicians across the country (cutting across the six geopolitical zones). Responses were transcribed verbatim, typeset and coded inductively and analysed using content analysis process. The findings were presented using thematic representation (by identifying the key themes and patterns). Results Family physicians demonstrated varying awareness of mental health guidelines and interventions. Involvement levels ranged from minimal to proactive as there were no national unified guide. Facilitators to mhGAP involvement and implementation included training of physicians, patient relationships, and multidisciplinary collaboration while barriers included time constraints, stigma, and systemic gaps. Conclusions This study reveals the varying levels of mhGAP awareness and involvement among Nigerian family physicians. While some are proactive, many show limited engagement. Training, patient relationships, and collaboration facilitate involvement, while time constraints, stigma, and systemic gaps hinder it. Targeted interventions are needed to bridge the mental health action gap.