A surreal illustration representing the gap between mental health needs and care, bridged by the WHO's mhGAP program.

Bridging the Mental Health Gap: How the WHO's mhGAP is Transforming Care in Low-Resource Settings

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Kai Mendoza in Health & Wellness December 2025 • 5 min read.

"A deep dive into the Mental Health Gap Action Programme, its implementation, and impact on communities with limited access to mental healthcare."


Mental, neurological, and substance use (MNS) disorders affect millions worldwide, yet a significant gap persists between those who need care and those who receive it. This disparity is especially pronounced in low- and middle-income countries (LMICs), where resources are scarce and access to specialized mental healthcare is limited. To address this challenge, the World Health Organization (WHO) launched the Mental Health Gap Action Programme (mhGAP).

The mhGAP Intervention Guide (mhGAP-IG), introduced in 2010, provides evidence-based guidance and tools for assessing and managing priority MNS disorders in LMICs. Designed for use by non-specialized healthcare providers, the mhGAP-IG aims to integrate mental healthcare into primary care settings, making it more accessible to those who need it most. This initiative has been implemented in over 90 countries, demonstrating its global reach and potential impact.

This article will delve into a systematic review of the evidence surrounding mhGAP-IG implementation in LMICs, examining its practical applications, evaluations, and reported outcomes. By exploring the successes, challenges, and adaptations of the mhGAP-IG, we can gain valuable insights into how to effectively bridge the mental health gap and improve the lives of individuals and communities in need.

mhGAP-IG in Action: Training and Clinical Practice

A surreal illustration representing the gap between mental health needs and care, bridged by the WHO's mhGAP program.

The mhGAP-IG has been widely adopted as a training tool for healthcare workers in LMICs. A review of 33 studies revealed that 15 focused on mhGAP-IG use in training programs. These courses, conducted across Africa, the Middle East, and Asia, primarily targeted non-medical primary healthcare staff, equipping them with the skills to identify and manage priority MNS disorders.

Training programs vary in length and content, most incorporate a blend of lectures, videos, role-playing exercises, and discussions. Modules on depression, psychosis, substance use disorders, epilepsy, and suicide are commonly included. While some programs cover all mhGAP-IG modules, others focus on specific areas based on local needs and priorities.

  • Training Healthcare Workers: Equipping primary healthcare staff with essential skills.
  • Adapting to Local Needs: Tailoring mhGAP-IG modules to address specific regional challenges.
  • Focusing on Key Disorders: Prioritizing depression, psychosis, and substance use in training.
Beyond training, the mhGAP-IG has also been implemented in clinical practice. Nine studies explored its use in real-world settings, with healthcare staff utilizing the guide to address a range of MNS disorders. Some studies focused on specific conditions like depression or alcohol use disorder, while others took a broader approach, addressing a set of priority MNS disorders. These practical applications highlight the mhGAP-IG's versatility and potential to improve mental healthcare delivery in LMICs.

Challenges, Adaptations, and the Future of mhGAP-IG

While the mhGAP-IG has shown promise in improving mental healthcare access in LMICs, its implementation is not without challenges. Studies have highlighted the importance of addressing contextual factors, such as limited resources, lack of administrative support, and difficulties with participant retention. To overcome these barriers, local adaptations of the mhGAP-IG are crucial.

Several studies have documented successful adaptations of the mhGAP-IG to suit specific cultural and regional contexts. These adaptations involve tailoring the guide's content, language, and delivery methods to align with local beliefs, practices, and resources. By engaging local stakeholders and incorporating their feedback, implementers can ensure that the mhGAP-IG is culturally sensitive and relevant to the communities it serves.

The mhGAP-IG represents a significant step towards bridging the mental health gap in LMICs. By providing evidence-based guidance and tools for non-specialized healthcare providers, the program has the potential to transform mental healthcare delivery in resource-constrained settings. As implementation efforts continue, it is crucial to address contextual challenges, foster local adaptations, and prioritize rigorous evaluation to maximize the mhGAP-IG's impact and ensure its long-term sustainability.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/eb-2017-102750, Alternate LINK

Title: Who Mental Health Gap Action Programme (Mhgap) Intervention Guide: A Systematic Review Of Evidence From Low And Middle-Income Countries

Subject: Psychiatry and Mental health

Journal: Evidence Based Mental Health

Publisher: BMJ

Authors: Roxanne C Keynejad, Tarun Dua, Corrado Barbui, Graham Thornicroft

Published: 2017-09-13

Everything You Need To Know

1

What is the main purpose of the Mental Health Gap Action Programme (mhGAP)?

The World Health Organization's (WHO) Mental Health Gap Action Programme (mhGAP) is a global initiative created to address the significant disparity between those who need mental healthcare and those who receive it, particularly in low- and middle-income countries (LMICs). It focuses on making mental healthcare more accessible in resource-constrained environments.

2

What is the mhGAP Intervention Guide (mhGAP-IG), and why is it important?

The mhGAP Intervention Guide (mhGAP-IG) is a core component of the Mental Health Gap Action Programme. It provides evidence-based guidance and tools designed for non-specialized healthcare providers in LMICs. Its importance lies in its role in integrating mental healthcare into primary care settings, allowing healthcare workers to assess and manage priority mental, neurological, and substance use (MNS) disorders.

3

How is the mhGAP-IG used to train healthcare workers?

The mhGAP-IG is mainly implemented by training healthcare workers. These training programs equip primary healthcare staff with the skills to identify and manage priority mental, neurological, and substance use (MNS) disorders. Training involves lectures, videos, role-playing, and discussions. The content and duration of the training programs vary depending on local needs, but often cover areas like depression, psychosis, substance use disorders, epilepsy, and suicide.

4

What are some of the challenges in implementing the mhGAP-IG, and how are they addressed?

Challenges to implementing the mhGAP-IG include limited resources, a lack of administrative support, and difficulties with participant retention. To address these issues, it is crucial to adapt the mhGAP-IG to local needs. This adaptation may involve tailoring the training modules or modifying the clinical practices to suit the specific context and available resources in the LMICs.

5

What does the future hold for the Mental Health Gap Action Programme (mhGAP)?

The future of the Mental Health Gap Action Programme (mhGAP) involves further integration of the mhGAP-IG into clinical practice and continued efforts to adapt the program to local needs in low- and middle-income countries (LMICs). This includes providing ongoing training and support for healthcare workers and addressing the challenges of limited resources and administrative support to bridge the mental health gap effectively.

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