Psychiatric Nurse in Lesotho providing counselling

Assessing System Readiness

By assessing context, implementers consider the local factors which may impact the quality, success, and direction of a mental health program. This component of the matrix provides tools and examples to help implementers assess factors such as mental health burden, relevant stakeholders and potential program partners, potential challenges, and program priorities. 

Evaluate Mental Health Systems

Situational Analyses

When establishing or growing mental health systems, it is important to understand contextual factors that may affect people with mental health conditions and serve as facilitators or barriers to mental health integration into the general health system. Below are tools to help teams identify contextual factors around mental health delivery.

Additional Resources

Model for Understanding Success in Quality (MUSIQ)

Several contextual factors can impact the viability of a program. This MUSIQ tool groups these factors into several broad categories:  the team working, the microsystem in which they function, local support and capacity, the organization in which someone works, and the environment external to an organization to allow for analysis and action.

Additional Resources

Assess Disease Burden

Report on the Burden of Disease at PIH 

The Report on the Burden of Disease Attributable to Mental Illness at PIH offers an assessment of the burden of mental health conditions across PIH-supported sites. It also provides useful insight for assessing resource needs and making data-informed decisions to deliver mental health care within these contexts, using Institute for Health Metrics and Evaluation (IMHE) data.

Burden of Disease Report 

PIH’s Universal Health Coverage  Monitoring and Planning Tool

PIH has developed and tested a Universal Health Coverage (UHC) Monitoring and Planning Tool to assist with the planning and implementation of health interventions by projecting disease burden and UHC needs at the facility and catchment area level and determining estimates of required health system inputs. This resource pulls information from the World Health Organization’s compendium of data.

ACcess PIH UHC Tool

Qualitative Analysis

Using qualitative assessment methods rather than purely quantitative data-based information is crucial to understanding many community issues and needs. Numbers work well to show comparisons, progress, and statistics of community efforts, but they cannot express motives, opinions, feelings, or relationships. Several qualitative methods can be used in assessing issues or community needs, such as individual interviews, group interviews, community or other large meetings, observations, and interpretation of records or transcripts. This section discusses how PIH has used these qualitative methods to help inform mental health programs.


The Lived Experience of Psychosis in Haiti and Malawi

Patient talking to healthcare worker

Dr. Joseph Reginald Fils-Aimé conducted a qualitative study to better understand the local knowledge, the lived experience, and the best paths to recovery for people living with psychosis and their families in Mirebalais and Petite-Rivière de l’Artibonite Region of Haiti. In addition, Chenjezo Grant Gonani sought to understand the experiences of family caregivers of patients living with severe mental health conditions by exploring the cultural dimensions of family caregiving practices and the effects of family caregiving on both patients and caregivers through qualitative interviews in Neno District, Malawi.


Validating a Depression Screening Tool in Mexico

Dr. Jafet Arrieta conducted research looking to better understand the experience of people in Chiapas, Mexico living with and seeking care for depression, and to assess this diagnostic screening instrument for depression. The results complemented similar PIH findings in rural primary care clinics in Haiti, Liberia, and Rwanda, highlighting the importance of investing in community-based mental health screening, diagnosis, and treatment.

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Self-Help Groups in Rwanda

Community workers teaching a classroom

Sifa Dorcas and Dr. Nina Sreshta conducted a qualitative analysis to describe the “self-help groups” (SHGs) of patients and families in Burera District, Rwanda to better understand the impacts these groups have on people with mental health conditions. These self-help groups are a group of people who gather voluntarily, sharing a common desire to overcome mental illness or increase their level of cognitive, social, and emotional wellbeing.

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