title: Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: the PRIME study.
abstract: BACKGROUND
  An essential element of mental health service scale up relates to an assessment of resource requirements and cost implications.
  
  
  OBJECTIVE
  To assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia.
  
  
  METHODS
  The resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage.
  
  
  RESULTS
  The cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population.
  
  
  CONCLUSIONS
  Estimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up.
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK chisholmd@who.int.
authors.forename: Dan
authors.initials: D
authors.lastname: Chisholm
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Soumitra
authors.initials: S
authors.lastname: Burman-Roy
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Abebaw
authors.initials: A
authors.lastname: Fekadu
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Kathree
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Kizza
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Nagendra P
authors.initials: NP
authors.lastname: Luitel
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Inge
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Rahul
authors.initials: R
authors.lastname: Shidhaye
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: De Silva
authors.affiliation: Dan Chisholm, PhD, Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Soumitra Burman-Roy, MSc, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Abebaw Fekadu, MD, Department of Psychiatry, Addis Ababa University, Ethiopia; Tasneem Kathree, MSc, University of KwaZulu Natal, Durban, South Africa; Dorothy Kizza, PhD, Butabika Mental Hospital, Kampala, Uganda; Nagendra P. Luitel, MA, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal; Inge Petersen, PhD, University of KwaZulu Natal, Durban, South Africa; Rahul Shidhaye, MD, Public Health Foundation of India, Bhopal, Madhya Pradesh, Delhi, India; Mary De Silva, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
mesh_terms: D003156:Community Mental Health Services / Q000191:economics*; D003906:Developing Countries; D005002:Ethiopia; D017048:Health Care Costs; D006280:Health Workforce / Q000191:economics*; D006801:Humans; D007194:India; D001523:Mental Disorders / Q000628:therapy*; D009390:Nepal; D010347:Patient Care Planning / Q000191:economics*; D013019:South Africa; D014454:Uganda