Needs Assessment for Development of a Mental Health Curriculum for Village/Lay Health Workers to Manage Caregiver Burden in Zimbabwe

AimsGrowing interest has been shown in the use of peers as lay health workers in maternal healthcare. This review aimed to examine published evidence on the effectiveness of lay support models for the management of postnatal depression (PND).MethodsMEDLINE, EMBASE, PsycINFO and the Cochrane Library were searched for randomised controlled trials (RCTs) of interventions conducted by lay health workers in postnatal women, published between 1980 and August 2010. The search revealed seven studies, totaling 16,095 participants, which reported outcomes in PND and mothers’ mental health/self-esteem.ResultsThe value of lay support models depends on the intervention type and the population targeted. Telephone based peer support, for women identified as high-risk for PND, showed a statistically significant reduction in Edinburgh Postnatal Depression Scale (EPDS) scores at 12 weeks. Universal provision of peer mentoring has been shown to significantly improve self-esteem at one year postpartum, but no studies have shown statistical significance on PND or mental health outcomes (measured by EPDS/SF-36). In poor populations, women's groups led by peer facilitators have been shown to reduce moderate depression by 57%, compared to controls. However, another study, which evaluated community group support showed a low uptake (19%) resulting in no statistical significance. Similarly there was no significant improvement in PND with self-help manuals, despite one study reporting favorable feedback.ConclusionsThere is some evidence from RCTs that high-risk groups and specific demographics can benefit from targeted peer support. However, no particular model can be strongly recommended, and further research is required.

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The experiences of lay health workers trained in task-shifting psychological interventions: a qualitative systematic review

International Journal of Mental Health Systems ◽

10.1186/s13033-019-0320-9 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Ujala Shahmalak ◽

Amy Blakemore ◽

Mohammad W. Waheed ◽

Waquas Waheed

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Health Workers ◽

Common Mental Disorders ◽

Task Shifting ◽

Alternative Methods ◽

Psychological Interventions ◽

Lay Health Workers ◽

The Impact ◽

Therapy Delivery

Abstract Introduction The prevalence of common mental disorders, such as depression and anxiety, is high and the demand for psychological interventions and talking therapies is increasing. In order to meet this need, it is necessary to explore alternative methods to deliver talking therapies. Training lay health workers (LHWs) to deliver psychological interventions might be one possible solution to address current gaps in service provision. A number of studies have successfully used this approach to deliver psychological interventions in order to meet the demand for mental health care. Despite increased interest in this area, the evidence has not been synthesised or systematically reviewed. Methods Electronic databases (MEDLINE, EMBBASE, PsycINFO and CINHAL) were systematically searched to specifically capture studies on task-shifting psychological interventions for common mental disorders. Data were extracted on the experiences of the lay-workers on training and therapy delivery. Thematic analysis was used to analyse the data. Themes and subthemes of LHWs views on receiving training, barriers and facilitators to therapy delivery, factors required to become a successful therapist and the impact of training and therapy delivery on the therapists are described. Results 10 studies were eligible for inclusion. Key messages were: LHWs were satisfied with training but wanted more robust supervision; not enough time was given to training on understanding mental health problems; LHWs grew in confidence and this impacted on their personal relationships with others. Conclusion This is the first review to explore LHWs experiences in training and therapy delivery by synthesising existing qualitative research. A number of key messages derived out of this review can help in further improving the quality of the training programmes and highlighting the benefits that are available for the LHW in delivering psychological interventions.

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A Model of Mental Health Care Involving Trained Lay Health Workers for Treatment of Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part I Adaptation and Implementation

The Canadian Journal of Psychiatry ◽

10.1177/0706743719839318 ◽

2019 ◽

Vol 64 (9) ◽

pp. 621-629 ◽

Cited By ~ 2

Author(s):

Ashok Malla ◽

Mushtaq Margoob ◽

Srividya Iyer ◽

Ridha Joober ◽

Shalini Lal ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Mental Disorders ◽

Health Services ◽

Health Workers ◽

Theory Of Change ◽

Personal Contact ◽

Lay Health Workers ◽

Service Model ◽

Middle Income

Objectives: In low- and middle-income countries (LMIC), major mental disorders often remain untreated because of barriers related to access and resources. In rural areas and in conflict-ridden regions, the problem can be exacerbated by increased rates of mental illness and by reduced access to care. This paper describes a project designed to provide mental health services for major mental disorders among youth using a low-cost model in a rural district of the troubled Kashmir valley. Methods: We describe the geographic and political context, the guiding principles and adaptation of the service model (through partnership with a voluntary organization and use of technology), and the implementation of the model using Theory of Change framework. The core of the intervention was to train a pool of lay health workers (LHWs) to provide mental health services to young (aged 14-30 years) people with major mental disorders in their own communities, supported by clinical professionals. Results: Despite political turmoil and major floods, 40 (male and female) LHWs were trained. The LHWs efficiently engaged in case identification, basic interventions, and data collection on outcomes. Several different stakeholders were engaged in activities relevant to the objectives of the project; however, the use of technologies was moderated by several challenges, including access to internet services and patient preference for personal contact. Conclusions: This service model is applicable in an environment where protracted political and armed conflict, low resources, and geographical isolation make exclusive reliance on scarce professional services impractical.

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Lessons learned through piloting a community-based SMS referral system for common mental health disorders used by female community health volunteers in rural Nepal

10.21203/rs.2.23695/v1 ◽

2020 ◽

Author(s):

Anvita Bhardwaj ◽

Prasansa Subba ◽

Sauharda Rai ◽

Chaya Bhat ◽

Renasha Ghimire ◽

...

Keyword(s):

Mental Health ◽

Financial Incentives ◽

Health Workers ◽

Mental Health Disorders ◽

Lessons Learned ◽

Lay Health Workers ◽

Case Record ◽

Record Keeping ◽

Health Disorders

Abstract Objectives: The Community Informant Detection Tool (CIDT) is a paper-based proactive case detection strategy with evidence for improving help-seeking behavior by patients for mental health disorders. Key implementation barriers for the paper-based CIDT include delayed reporting of cases and lack of active follow up. We used mobile phones and structured short message system to improve timeliness of case reporting, follow up and case record keeping. Thirty-six lay health workers piloted this mobile CIDT (mCIDT) for three months in 2017 in rural Nepal.Results: Eight cases were identified by lay health workers using mCIDT, but only two of these cases engaged with health services post-referral. Accuracy with the mCIDT was considerably lower compared to the paper-based CIDT. Higher education levels of lay health workers was associated with greater mCIDT accuracy. Qualitative findings revealed new implementation challenges among cases not following through on referrals due to perceived lack of staff at health facilities, assumptions among lay health workers that all earthquake-related mental health needs had been met, and lack of financial incentives for use of mCIDT. Based on study findings, we present recommendations for introducing a new technology in low resource health systems.

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