Table 2 Facilitators, barriers and strategies for improvement

• Availability of the guidelines, protocols and awareness raising materials

• Provision of refresher trainings, clinical supervision, coaching system

• Provision of referral system

• Provision of patient record keeping system

• Provision of community awareness and linkages

• Provision of home based care by FCHVs

• Efforts in maintaining privacy and confidentiality.

• Provision of psychosocial counseling and other protocolized psychosocial interventions

• System level co-ordination

• Provision of free treatment

• Frequent transfer of trained staff

• Lack of separate space for counseling

• Limited number of health staffs/ workload

• Shortage of medicines time and again (psychotropic drugs)

• Health workers’ grievances on incentives/transportation costs

• Defaulters in referral as well as in treatment follow up

• Patients not going to the referred places

• Stigma for people with mental illness

• Lack of data captured in national HIMS

• Limited awareness about mental health in the community

• Develop provisions for dedicated staff available at health facility at all times

• Allocate confidential space for counseling

• Improve on incentives/motivational benefits to existing health staff to compensate work burden

• Organize policy level advocacy for mental health.

• Improve overall drug supply chain management

• Improve overall training mechanisms and supervision system

• Improve the mental health data collection forms (simplifying the language used in the form)

• Strengthen the two-way referral system

• Increase the engagement of recovered patients and their family member in stigma prevention programs

• Focus upon the factors on scale up and sustainability of the program