Table 3

Necessary and sufficient causes for high mental health service utilisation

ConditionsNecessary causesSufficient causes
Complex solutionIntermediate solution
12312
Medication****
Trained staffFacility*****
Community*
SupervisionFacility*
Community
Community-level activitiesCIDT use**
Community awareness***
Services availablePsychosocial care*
mhGAP*
Referral*
ConditionConsistency0.970.970.9210.940.890.890.850.88
Coverage0.740.700.770.630.440.490.210.460.68
SolutionConsistency1.000.870.84
Coverage0.630.680.74
  • Each column under sufficient causes is one causal pathway. Each condition in the causal pathway should be combined with a logical AND. For example: Medication AND Trained Facility Staff AND Absence of community supervision AND Community awareness.

  • *Indicates presence of condition in causal pathway and — indicates absence of the condition.

  • CIDT, community informant detection tool; mhGAP, Mental Health Gap Action Programme.