Facilitators and barriers to optimum mental health services in primary care units: evidence from a national scale-up project
DOI:
https://doi.org/10.64838/jmht.2026.282347Keywords:
barriers, facilitators, mental health service, primary careAbstract
Objective: To examine facilitators and barriers associated with the optimum mental health services in primary care units (PCUs) in Thailand.
Methods: This cross-sectional study utilized secondary data from the Scale-Up Project of Mental Health Service Standards Using the “Transformative Mental Health in Primary Care” guidelines, conducted in pilot PCUs across four regions of Thailand. Associations between RE-AIM-based self-reported factors and service coverage (defined as the proportion of standard mental health service components delivered) were analyzed using Fisher’s exact test, independent t-test, and Pearson’s correlation.
Results: Of the 30 PCUs with complete data, four (13.3%) met the service coverage criterion (≥ 80% of standard service components) after project implementation. No factors were significantly associated with meeting the criterion. However, higher service coverage was associated with providers’ satisfaction with the guidelines (r = 0.582, p = .010) and the presence of external funding (t = −3.727, p < .001). In addition, public awareness of mental health service was significantly positively correlated with several factors, including service accessibility, leadership engagement, behavioral change among service users, and providers’ satisfaction with the guidelines, with these factors also showing significant intercorrelations.
Conclusion: Providers’ acceptance and funding play an important role in integrating mental health services into primary care. Leadership support facilitates providers’ acceptance, while promoting mental health literacy among the public may be a key mechanism for the success of services at the local level. Efforts to scale up mental health service standards should therefore focus on strengthening providers’ readiness alongside sustained system-level support.
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