Supervision of Task-Shared Mental Health Care in Low-Resource Settings: A Commentary on Programmatic Experience

June 27, 2019
Authors: Christopher G. Kemp, Inge Petersen, Arvin Bhana and Deepa Rao
Organization: Global Health: Science and Practice

In low- and middle-income countries (LMICs) and other low-resource settings, 75% of people in need of treatment for mental disorders never receive care.  Few health systems in LMICs can rely exclusively on specialists to deliver mental health interventions.  One promising approach has been to deliver psychosocial or pharmacological services via task sharing. Task sharing is an arrangement in which generalists—nonspecialist health professionals, lay workers, affected individuals, or informal caregivers—receive training and appropriate supervision by mental health specialists and screen for or diagnose mental disorders and treat or monitor people affected by them.

This qualitative study sought to further describe and learn from models for supervision that have been developed for task-shared mental health services in low resource settings.  Researchers found that task-shared mental health care programs in low-resource settings often incorporate supervisory structures that would be difficult to implement at scale, and many rely on foreign specialist experts as supervisors.  They recommend that future programs could leverage peer supervision, technology, competency assessments/fidelity checklists, and other tools. Mental health care specialists will require training, support, and incentives to supervise generalist care providers.