Task sharing Flashcards
What are the benefits to task sharing?
Cheaper
More accessible
More acceptable
Centralised
What are the roles of those involved in MHgap task sharing?
What is the important distinction with regards to task sharing evidence?
Good evidence of what we should do, not much for how it is applied.
What does the evidence suggest regarding specific task sharing interventions in LMIC?
Depression and anxiety:
CBT, IPT, counselling,etc
Remission of depression, symptoms, but NOT functional impairment.
Low quality, heterogeneity and bias
In the collaborative care model:
Some favourable evidence for prevalence and severity
Very Low quality, bias and one study-dominated results
What other disorders do the systematic reviews show favourable results for?
PTSD, Dementia, Substance abuse- Limited evidence
Maternal depression- Best research
What is the general findings for Task Sharing?
Low evidence for general interventions
No evidence for psychosis
Why the lack of research into Psychosis?
Need for clinical assessment
Cost of study
Lack of clinical researchers
Consent controversy
Stigma of being involved
Why the lack of research into Psychosis?
Need for clinical assessment
Cost of study
Lack of clinical researchers
Consent controversy
Stigma of being involved
What does the systematic review show in regards to task-sharing in feasibility and acceptability?
Service users see it as useful, but not complete
Not seen as an easy fix
What are the further challenges for Task sharing?
Quality of care
Fidelity of intervention
Sustainability
System barriers-turnover, medication, leadership
What is PRIME?
Programme for Improving Mental Health care.
mhGAP implementation in 5 countries: SA. Nepal, Ethiopia, India, Uganda
Designed to implant mhGAP in a broad policy as opposed to isolated interventions.
Designed to work at the lowest level of Health systems.
How does PRIME’s evaluation differ from others?
Instead of concentrating on knowledge pre and post, PRIME looks at improvements in the treatment gap.
How well practitioners detect new cases
How appropriate the treatment initiated is.
How does PRIME’s evaluation differ from others?
Instead of concentrating on knowledge pre and post, PRIME looks at improvements in the treatment gap.
How well practitioners detect new cases
How appropriate the treatment initiated is.
What two studies do PRIME implement for Neurological, substance abuse and mental disorders?
Cohort studies pre and post-to see benefits in functioning and economic status.
Case studies: Process data, qualitative exploration, documentation of context:
What did and didn’t work, why, reasons for variation
What was the purpose and design of TaSCS?
Looking specifically at psychosis in Ethiopia.
Using RCT: good to test success, but not for how to improve.
Some TAU, others task share- outcome 12 months and 18 months
