ArticleInternational review of psychiatry (Abingdon, England)2018
How competent are non-specialists trained to integrate mental health services in primary care? Global health perspectives from Uganda, Liberia, and Nepal.
Article in International review of psychiatry (Abingdon, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The role of community health worker-based care in post-conflict settings: a systematic review.Health policy and planning · 2023Pooled it
- Mental Health Gap Action Programme intervention Guide (mhGAP-IG) for Child and Adolescent Mental Health in Low- and Middle-Income Countries (LMIC): A Systematic Review.Community mental health journal · 2023Pooled it
- Educational and Training Interventions Aimed at Healthcare Workers in the Detection and Management of People With Mental Health Conditions in South and South-East Asia: A Systematic Review.Frontiers in psychiatry · 2021Pooled it
- An App-Based WHO Mental Health Guide for Depression Detection: A Cluster Randomized Clinical Trial.JAMA network open · 2025Trial
- A community case detection tool to promote help-seeking for mental health care among children and adolescents in Ugandan refugee settlements: a stepped wedge cluster randomised trial.The Lancet. Child & adolescent health · 2024Trial
- Evaluation of competency-driven training for facilitators delivering a psychological intervention for children in Lebanon: a proof-of-concept study.Epidemiology and psychiatric sciences · 2022Trial
- Treatment Preferences for Pharmacological versus Psychological Interventions among Primary Care Providers in Nepal: Mixed Methods Analysis of a Pilot Cluster Randomized Controlled Trial.International journal of environmental research and public health · 2022Trial
- Collaboration With People With Lived Experience of Mental Illness to Reduce Stigma and Improve Primary Care Services: A Pilot Cluster Randomized Clinical Trial.JAMA network open · 2021Trial
- Effectiveness of Group Problem Management Plus, a brief psychological intervention for adults affected by humanitarian disasters in Nepal: A cluster randomized controlled trial.PLoS medicine · 2021Trial
- Improving mental health literacy of frontline community health workers in a rural district of Pakistan: mPareshan project.BJPsych open · 2026Article
- PATIENT PATHWAYS TO UGANDA'S FIRST SPECIALISED EARLY INTERVENTION IN PSYCHOSIS SERVICE AND RELATION TO THEIR CLINICAL OUTCOMES.medRxiv : the preprint server for health sciences · 2026Article
- Delivering low-intensity psychological interventions in low- and middle-income countries: A systematic review and meta-ethnographic synthesis of lay health workers' experiences.Global mental health (Cambridge, England) · 2026Review
- Strengthening care in collaboration with people with lived experience of psychosis in Uganda (SCAPE-U): A protocol for a cluster randomized controlled feasibility trial.Pilot and feasibility studies · 2025Article
- Supporting the mental health of adolescent mothers in Kenya and Mozambique: pilot protocol for the Thriving Mamas programme.Pilot and feasibility studies · 2025Article
- Competency-based training and supervision: development of the WHO-UNICEF Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) initiative.The lancet. Psychiatry · 2025Article
- Adapting the comprehensive assessment of acceptance and commitment therapy processes (CompACT) questionnaire for contextual relevance in Uganda: A comprehensive approach.Global mental health (Cambridge, England) · 2025Article
- Integrating mental health into primary health care in fragile and conflict-affected settings: a scoping review of mhGAP effectiveness.Cadernos de saude publica · 2025Article
- Assessing the Quality of Maternal Mental Illness Care Across Maternity Care Settings in Southwestern Uganda.Cureus · 2024Article
- Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda.International journal of mental health systems · 2024Article
- Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study.JMIR formative research · 2024Article
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Authors and funding
10 authors.
Funding
Abstract
Evaluations to objectively assess minimum competency are not routinely implemented for training and supervision in global mental health. Addressing this gap in competency assessment is crucial for safe and effective mental health service integration in primary care. To explore competency, this study describes a training and supervision program for 206 health workers in Uganda, Liberia, and Nepal in humanitarian settings impacted by political violence, Ebola, and natural disasters. Health workers were trained in the World Health Organization's mental health Gap Action Programme (mhGAP). Health workers demonstrated changes in knowledge (mhGAP knowledge, effect size, d = 1.14), stigma (Mental Illness: Clinicians' Attitudes, d = -0.64; Social Distance Scale, d = -0.31), and competence (ENhancing Assessment of Common Therapeutic factors, ENACT, d = 1.68). However, health workers were only competent in 65% of skills. Although the majority were competent in communication skills and empathy, they were not competent in assessing physical and mental health, addressing confidentiality, involving family members in care, and assessing suicide risk. Higher competency was associated with lower stigma (social distance), but competency was not associated with knowledge. To promote competency, this study recommends (1) structured role-plays as a standard evaluation practice; (2) standardized reporting of competency, knowledge, attitudes, and clinical outcomes; and (3) shifting the field toward competency-based approaches to training and supervision.
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