Integrated care for people with long-term mental and physical conditions in low- and middle-income countries: narrative review

Integrated care is defined as health services that are managed and delivered so that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease-management, rehabilitation and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector and, according to their needs, throughout the life course. This narrative review paper aims to describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, to assess the strength of evidence base for these models in high income countries (HICs) and in low- and middle-income countries (LMICs) through a conceptual overview and a structured narrative review, and to identify opportunities to further test the feasibility and impact of such integrated care models. The results of the review are presented in terms of; (i) the rationale for integrating care for people with mental disorders into chronic care; (ii) models of integrated care; (iii) evidence of the effects of integrating care in HICs and in LMICs; (iv) the key organisational challenges in LMICs to implement integrated chronic care; and (v) practical steps to realise a vision of integrated care in the future.