Expanding mental health services in low- and middle-income countries: A task-shifting framework for delivery of comprehensive, collaborative, and community-based care.

Journal: Global mental health (Cambridge, England)

Volume: 10

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. HealthRight International, New York, NY, USA. Zanmi Lasante (Partners In Health), Mirebalais, Haiti. World Vision International, Nairobi, Kenya. International Rescue Committee, New York, NY, USA. National Mental Health Programme, Ministry of Public Health, Lebanese Government, Beirut, Lebanon. Socios En Salud Sucursal (Partners In Health), Lima, Peru. University of KwaZulu-Natal, Durban, South Africa. University of New South Wales, Sydney, NSW, Australia. The MHPSS Collaborative, Copenhagen, Denmark. Centre for Mental Health, University of Melbourne VCCC, School of Population and Global Health, Global and Cultural Mental Health Unit, Parkville, VIC, Australia. SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. Department of Psychiatry and Behavioral Sciences and Department of Global Health, UW Consortium for Global Mental Health and International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA. United Nations High Commissioner for Refugees, Public Health Section, Geneva, Switzerland. CBM Global Disability Inclusion, London, UK. Peace in Practice, Amsterdam, The Netherlands. King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, London, UK. Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. International Medical Corps, Santa Monica, CA, USA. King's College London, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, London, UK. United States Agency for International Development, Washington, DC, USA.

Abstract summary 

This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health programs with health and non-health community-based services. It addresses gaps in previous models including lack of community-based psychotherapeutic and social services, difficulty in addressing comorbidity of mental and physical conditions, and how workers interact with respect to referral and coordination of care. The framework is based on task-shifting of services to non-specialized workers. While the framework draws on the World Health Organization's Mental Health Gap Action Program and other global mental health models, there are important differences. The C4 Framework delineates types of workers based on their skills. Separate workers focus on: basic psychoeducation and information sharing; community-level, evidence-based psychotherapeutic counseling; and primary medical care and more advanced, specialized mental health services for more severe or complex cases. This paper is intended for individuals, organizations and governments interested in implementing mental health services. The primary aim is to provide a framework for the provision of widely accessible mental health care and services.

Authors & Co-authors:  Raviola Upadhaya Eustache Koyiet Wondimu El Chammay Contreras Petersen Silove Ugo Mahoney Stein Smith Collins Ventevogel Eaton Snider Thornicroft Murray Bass West Whitney Jordans Bolton

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S, Abdulmalik J, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH and Bruffaerts R (2018) Treatment gap for anxiety disorders is global: Results of the world mental health surveys in 21 countries. Depression and Anxiety 35(3), 195–208.
Authors :  24
Identifiers
Doi : e16
SSN : 2054-4251
Study Population
Male,Female
Mesh Terms
Other Terms
community-based initiatives;global mental health;global mental health delivery;healthcare system;mental health
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England