Objectives The WHO’s Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) has been widely used in low and middle-income countries. We reviewed literature describing interventions and training programmes beyond the mhGAP-IG, in primary healthcare (PHC) and community-based healthcare (CBH). Design We searched studies excluded from our updated mhGAP-IG systematic review, and included in other relevant systematic reviews, for evidence and experience of initiatives integrating mental health into PHC and CBH. Our 24 November 2020 mhGAP-IG search encompassed MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, ScieELO, Cochrane, PubMed databases, 3ie and Google Scholar. Although heterogeneity prevented meta-analysis, we descriptively summarised the evidence-base. Results Out of 1827 results, we identified 208 relevant records. They described randomised controlled trials of mental health interventions (98 studies, n=55 523 participants), non-randomised studies measuring clinical outcomes (22 studies, n=7405), training outcomes (36 studies, n=12 280) and implementation outcomes (21 studies, n=1090), plus descriptive accounts (18 studies, n=2526), baseline surveys and exploratory studies (6 studies, n=17 093) and commentaries (7 studies). Most (40%) were conducted in the African region, region of the Americas (16%), and South-East Asia (13%). Randomised and non-randomised studies reported improved symptoms, substance use, functioning, parenting and child outcomes. Non-randomised studies reported improved clinical knowledge, confidence and skills following training. Conclusions The literature beyond the mhGAP-IG is extensive and shares common findings. Future priorities are less-studied regions, interventions for severe mental illness, exploring ways that mhGAP-IG and alternative approaches complement each other in different contexts and scaling-up mental health integration. PROSPERO registration number CRD42017068459. Data sharing not applicable as no datasets generated and/or analysed for this study.

中文翻译：

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初级和社区环境中的精神卫生保健：《世界卫生组织精神卫生差距行动规划》(mhGAP) 干预指南之外的证据

目标 WHO 的《心理健康差距行动计划干预指南》(mhGAP-IG) 已在低收入和中等收入国家得到广泛应用。我们回顾了描述初级保健 (PHC) 和社区保健 (CBH) 中超越 mhGAP-IG 的干预措施和培训计划的文献。设计 我们搜索了从我们更新的 mhGAP-IG 系统评价中排除并包含在其他相关系统评价中的研究，以寻找将心理健康纳入 PHC 和 CBH 的举措的证据和经验。我们 2020 年 11 月 24 日的 mhGAP-IG 搜索包括 MEDLINE、Embase、PsycINFO、Web of Knowledge、Scopus、CINAHL、LILACS、ScieELO、Cochrane、PubMed 数据库、3ie 和 Google Scholar。虽然异质性阻碍了荟萃分析，但我们描述性地总结了证据基础。结果 在 1827 个结果中，我们确定了 208 个相关记录。他们描述了心理健康干预的随机对照试验（98 项研究，n=55523 名参与者）、测量临床结果的非随机研究（22 项研究，n=7405）、培训结果（36 项研究，n=12280）和实施结果（21 项研究，n=1090），加上描述性说明（18 项研究，n=2526）、基线调查和探索性研究（6 项研究，n=17093）和评论（7 项研究）。大多数 (40%) 是在非洲地区、美洲地区 (16%) 和东南亚地区 (13%) 进行的。随机和非随机研究报告了症状、物质使用、功能、育儿和儿童结果的改善。非随机研究报告说，经过培训后，临床知识、信心和技能得到了提高。结论 mhGAP-IG 之外的文献非常广泛并且具有共同的发现。未来的重点是研究较少的地区、严重精神疾病的干预措施、探索 mhGAP-IG 和替代方法在不同情况下相互补充的方式以及扩大精神卫生整合。PROSPERO 注册号 CRD42017068459。数据共享不适用，因为没有为本研究生成和/或分析数据集。