Jalisco’s Virtual mhGAP Training Program: A Success Story in Expanding Mental Health Care Access

The Jalisco Ministry of Health, in collaboration with the National Institute of Psychiatry Ramón de la Fuente Muñiz and the Pan American Health Organization/World Health Organization (PAHO/WHO), embarked on a groundbreaking initiative to bolster mental health care access in Jalisco, Mexico. Recognizing the critical need to equip primary care providers (PCPs) with the necessary skills to address mental health concerns, they developed a virtual training program centered on the Mental Health Gap Action Programme (mhGAP) Intervention Guide. Leveraging the accessibility of Facebook as a learning platform, this program transcended geographical barriers and provided a flexible, cost-effective solution to enhance mental health service delivery across the state. This innovative approach not only demonstrated significant knowledge gains among participating PCPs but also achieved remarkable reach and participant satisfaction, solidifying its potential as a model for scalable mental health training in resource-constrained settings.

The program experienced remarkable growth over the study period, with membership in the dedicated Facebook group soaring by 133.3%, representing an average annual growth rate of 22.2%. This expansion was driven by strategic outreach campaigns targeting PCPs across Jalisco’s public health institutions, the integration of the program into the Jalisco Decentralized Public Health Service Agency’s Department of Preventive Medicine, and the promotion of specialized training events like the Hybrid Seminar on mhGAP Mental Health Care and the Statewide mhGAP Guide Training Week. While membership growth was robust, active participation in educational activities lagged behind, suggesting a need for strategies to encourage greater engagement among members. This gap underscores the ongoing challenge of translating membership into active learning and highlights the importance of developing engaging content and fostering a vibrant learning community within the online environment.

Over 1,000 PCPs completed both pre- and post-training assessments, offering valuable insights into the program’s impact on knowledge acquisition. The program demonstrated remarkable effectiveness in improving participants’ understanding of mhGAP principles, with average knowledge scores increasing from 58.2% on the pre-test to 81.4% on the post-test. This significant improvement is a testament to the program’s well-designed curriculum and its ability to translate complex mental health concepts into accessible and actionable knowledge for PCPs. Importantly, these knowledge gains were consistent across various demographic groups, including different age groups, years of experience, and geographical locations, reflecting the program’s broad appeal and its ability to cater to the diverse needs of Jalisco’s healthcare workforce.

Further analysis revealed nuanced variations in effect sizes among different subgroups. While females constituted the majority of participants, they demonstrated a smaller effect size compared to their male counterparts. Interestingly, older participants, especially those aged 65 and above, exhibited larger effect sizes, suggesting that the program effectively addressed their specific learning needs. Social workers also experienced substantial knowledge gains, underscoring the program’s relevance across different professional roles within the healthcare system. Regional differences in effect sizes highlighted the influence of local factors and the importance of tailoring program implementation to address specific regional contexts. The program’s success in enhancing knowledge across diverse demographics and professional backgrounds underscores its potential as a scalable and adaptable model for mental health training.

The program’s impact extended beyond general mhGAP principles, demonstrably improving participants’ understanding of specific mental health conditions like depression, psychosis, and substance use disorders. This targeted knowledge enhancement reflects the program’s comprehensive coverage of key mental health challenges and its ability to equip PCPs with practical tools for diagnosing and managing these conditions in primary care settings. The visualized data showcasing pre- and post-test scores for individual modules further illuminate the program’s effectiveness in improving learner outcomes across the mhGAP curriculum. This granular analysis allows for the identification of modules with particularly strong educational outcomes and those requiring further refinement, enabling continuous improvement of the program’s content and delivery.

Participant feedback overwhelmingly endorsed the program’s quality and utility. Over 92% of participants rated the overall program quality as "adequate" or "very good," highlighting the program’s effectiveness in meeting their learning needs. The flexibility and convenience of the online format emerged as key advantages, allowing participants to learn at their own pace and overcome geographical barriers. Participants lauded the program’s relevance to their clinical practice, particularly the practical application of the mhGAP Intervention Guide and case studies. The interactive nature of webinars and discussion forums further enriched the learning experience, fostering engagement and peer-to-peer learning. While some participants encountered challenges related to medication availability and technical issues, the overall positive feedback underscored the program’s success in providing a valuable and accessible learning experience. The program’s positive reception and demonstrated impact on knowledge acquisition position it as a promising model for expanding mental health care access in similar settings.

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