Program Planning and Clinical Guidelines Development
This component considers elements for detailed program planning and key resources for the development of clinical guidelines. It provides resources to help implementers examine and plan program activities, develop care pathways and clinical protocols, and develop systems for quality mental health care delivery.
Clinical Guideline Development
A clinical pathway, also known as a care pathway, integrated care pathway, critical pathway, or care map, is one of the main tools used to manage the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes. It aims to re-center the focus on the patient's overall journey, rather than a specific intervention or clinical specialty. The pathway design tries to capture the foreseeable actions which will most commonly represent best practice for most patients most of the time, and include prompts for them at the appropriate time in the pathway to ascertain whether they have been carried out and whether results have been as expected. Below are examples of care delivery sites' care pathways and clinical algorithms.
Peru's Depression Care Pathway
In 2021, PIH sought out to develop our Gender Equality (GE) Strategy. Led by Socios En Salud/PIH Peru, we asked all country teams to analyze their respective contexts to provide resources that inform and guide mental health implementers in the integration of gender equality and GBV-related strategies into their work. We aimed to gather information to inform our staff on how to integrate gender equality strategies into mental health work, as well as collect materials for implementers to know how to prevent, treat, and address GBV. This pilot project is a first step toward strengthening the mental health learning systems in Lesotho, Liberia, Mexico, and Peru, and the information provided will allow readers to gain knowledge, recognition, and awareness of gender equity at PIH sites.
Clinical Assessment Tools
Clinical assessment tools are used across all sites to help evaluate a patient's clinical condition, develop appropriate treatment plans, and track a patient’s improvement. Clinicians routinely perform clinical assessments to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient's condition. Click here to have a summary of tools that providers use across care delivery sites.
Tools for use in an integrated, community-based mental health system of care
Zanmi Lasante developed a reference document that outlines job aids and clinical tools across different disorder care pathways tailored to various providers (physicians, nurses, psychologists/social workers, and community health workers) in Haiti. These materials build on the World Health Organization’s mhGAP Intervention Guide and provide a replicable set of implementation steps that can be adapted to settings lacking formal mental health services.
Program Planning Guide
Before starting a mental health program it is important to develop a program’s goal, activities, and anticipated results. Outlining the goals, responsibilities, timelines, and strategies upfront can be helpful for consensus and project implementation. Furthermore, implementation challenges and gaps can arise,so regular review and adjustment of project plans and timelines is critical. Tools such as work plans, GANTT charts, Logframes, and Theory of Change templates can be helpful to develop the components of a program and its activities including relating them to one another. These tools help identify the measures which the anticipated results will be monitored.
There are numerous program planning tools that exist in the global mental health field. These documents provide a few such examples that PIH uses for the Cross-Site Mental Health Program and in general which can be adapted to your context as helpful.
Cross-Site Mental Health Program Planning Tools