WHO Global Program — Mental Health Gap Action Programme

The Mental Health Gap Action Program (mhGAP) is a WHO global program aimed at increasing access to mental health services by involving primary care (PHC) professionals in the provision of services to patients with mental disorders.

The program was launched by the World Health Organization in 2008 to improve access to mental health services. It is implemented in 100 countries of the world, and its materials have been translated into more than 20 languages, including Ukrainian.

In Ukraine, the mhGAP program began its activities in 2019. From that time until November 2022, 669 people were trained. But the full-scale stage of the war caused a significant increase in the need for psychological services. Therefore, the Ministry of Health of Ukraine, together with partners — WHO and the National Health Service of Ukraine (NHSHU) — started scaling training under the mhGAP program to increase patients’ access to psychological services. For this, in particular, the mhGAP online course “Support and treatment of adults and children with mental disorders at the primary level of medical care” was launched at the end of last year. As of today, almost 24,500 people have received certificates of completion of the mhGAP online course, among them 4 employees of the Department of Psychiatry, Narcology, Medical Psychology and Psychotherapy of ONMedU, who were trained on the platform of the Academy of NSHU.

Currently, the WHO mhGAP program is part of the priority project of the Ministry of Health within the framework of the implementation of the All-Ukrainian mental health program “How are you?”, initiated by the first lady of Ukraine, Olena Zelenska.

The mhGAP guideline and its humanitarian emergency version provide general practitioners with protocols for the diagnosis and management of common mental disorders and other critical tools and knowledge.

The listeners, in particular, are taught:

to provide assistance to persons with common mental disorders (depression, acute stress reaction, anxiety, post-traumatic stress disorder, suicidal behavior, disorders related to the use of psychoactive substances, other mental health complaints);
to communicate effectively with the patient and his relatives;
to assess priority disorders;
to manage such disorders, if they are of mild or moderate severity, and the person does not want to go to a narrow specialist (psychiatrist, psychotherapist, psychologist);
to refer the persons to specialists and relevant services (for example, social services, rehabilitation centers, etc.).
At the same time, the specialist does not become a psychiatrist: if he sees that the situation is beyond the competence of the primary health care unit, he refers the patient to narrow specialists.

Specialists who have completed the course note that after training they have increased confidence and competence in working with patients who need psychological help, it is easier for them to determine the presence or absence of a disorder, to recognize it. They also point to destigmatization and reduction of prejudiced attitudes towards persons with mental disorders.

mhGAP is currently being implemented in Ukraine by various international and national partners: WHO, the United Nations Children’s Fund (UNICEF), the International Medical Corps, “Doctors of the World”, the “MH4U” and “HOPE” projects, the Academy of Family Medicine of Ukraine, the NGO “Proliska”, the USAID project “Development of a sustainable system of public health in Ukraine”, NGO “Save the Children”, Ukrainian Public Health Foundation and others.

Employees of the Department of Psychiatry, Narcology, Medical Psychology and Psychotherapy of  Odesa National Medical University are preparing to undergo face-to-face training from the WHO and partners, which will provide an opportunity to deepen their knowledge, practice the skills of managing mental disorders, analyze practical cases, and learn more about the aspects of managing mental disorders by medical workers in general practice , get answers to the questions that arise and implement the acquired knowledge and skills in the educational process of ONMedU.