Integrating mental health into primary care for conflict-affected internal forced migrants in Northern Sri Lanka (COMGAP-S)

COMGAPSince the end of conflict in 2009, Northern Sri Lanka is seeing a rapid rehabilitation and rebuilding process in health and other infrastructure. However, the need for human resources is the least being met, as the rate of capacity building and training new cadres are significantly below that of the growing need in the region.

The COMGAP-S project aims to improve the skills of existing primary care health work force in integrating mental health into primary care services in Northern Sri Lanka.

The relative political, social and economic stability that the region is enjoying after three decades of conflict is highly conducive to training new cadre of healthcare workers and increasing the capacity of existing health work force.

This project, already having being implemented in pilot form in the Northern Province, aims to improve the skills of existing primary care health work force in integrating mental health into primary care services across all districts of the Northern Province.


This project has two specific aims:

Cross-sectional Study

A comprehensive cross-sectional study was completed in 2015-2016 to identify the mental disorder burden at primary care level in the region.The setting was all 5 districts in Northern Sri Lanka and will focus on populations who are conflict-affected, forced internal migrants and returnees. Understanding mental health care burden and needs in the region will inform the intervention development and delivery to adequately address the treatment gap at primary care level.

mhGAP Training

The second aim is to use an adapted version of the World Health Organization mental health gap programme (WHO mhGAP) to train primary care practitioners and public health personnel to deliver mental health treatment within the primary care health system in Northern Sri Lanka.

This project will also include an economic evaluation component to explore cost-effectiveness of integrating mental health into primary health care. Additionally, programme monitoring and evaluation will be conducted to evaluate success of the training programme implementation and impact on patient outcomes.

This project hopes to:

  • provide a comprehensive account of the prevalence of mental disorders at primary care level within post-conflict Northern Sri Lanka,
  • narrow the treatment gap, and
  • improve patient outcomes by integrating mental health into the primary health care system.


This is a five-year programme, funded by the Office of Global Health, Centers for Disease Control & Prevention (CDC) in the US.


Centers for Disease Control and Prevention (CDC)

Faculty of Medical Science, Anglia Ruskin University

Dr. Chesmal Siriwardhana (Principal Investigator)

The THEME Institute, Sri Lanka

Dr. Kolitha Wickramage

Ms. Giselle Dass

Institute of Psychiatry, Psychology & Neuroscience, King’s College London

Prof. Robert Stewart

Dr. Melanie Abas

London School of Hygiene & Tropical Medicine

Dr. Bayard Roberts

University of Jaffna, Sri Lanka

Education, Training and Research Unit. Ministry of Health, Sri Lanka