Cited by 130Innovations in Medical EducationMental Health Treatment and AccessCompetency Development and Evaluation

Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

Open access
Kohrt, Brandon A., Schafer, Alison, Willhoite, Ann, van't Hof, Edith, Pedersen, Gloria A., Watts, Sarah, Ottman, Katherine, Carswell, Kenneth +1 more·2020·World Psychiatry

Abstract

Globally, the vast majority of people with mental health conditions do not receive effective care. Among people living with depression, only 1 in 5 persons in high-income countries and 1 in 27 in lower-middle income countries receive minimally adequate treatment1. There is a dearth of health workers trained in mental health care, with only one trained provider per 10,000 people in most countries2. One key action to improve access to mental health care is to expand psychological and psychosocial support services delivered by diverse cadres across settings3. There is now good evidence that persons who are not specialists in mental health can effectively deliver psychological interventions, but they must be adequately trained and supervised4. Non-specialist providers include primary care workers, community workers, psychosocial workers, teachers, family members and peers. However, unlike licensed professionals for whom there are professional associations to assure standards, there are usually no systems or mechanisms in place that check whether non-specialist providers have sufficient training and supervision to achieve minimum competency to effectively and safely deliver interventions. This raises the question: how can governments and the general population be assured that non-specialists provide quality care? One way to address this challenge is to establish competency-based training approaches and competency assessment measures that governments, non-governmental organizations and other institutions can use to benchmark skills for safe and effective care. Competency measures can be used to determine who is or is not competent as well as to tailor supervision and supplementary training to address gaps in skills. Having competency targets in mind can also inform training duration and content that may need to vary across sites or cadres. Competency-based training approaches have already demonstrated success in diverse areas of health care in low resource settings, including surgery and obstetric care5, 6. To facilitate competency-based training in psychosocial support, psychological treatments, and foundational helping skills, the World Health Organization (WHO) is developing the Ensuring Quality in Psychological Support (EQUIP) platform (https://www.who.int/mental_health/emergencies/equip/en/). The EQUIP platform aligns with WHO's work on universal health coverage, that is establishing competency frameworks across fields of health care. EQUIP will be an online resource to help program managers and trainers utilize competency assessments to evaluate trainings and to feedback those competency results to support trainee development and modify curricula. The full suite will comprise tutorials on implementing competency assessments, including how to achieve interrater reliability with global rating standards and how to use role plays to assess competency. It will include guidance for trainers on delivering competency-based training programs, and for implementation and adaptation of psychological interventions. In addition, the EQUIP platform will offer training modules on common factors that can be selected based on competency assessment outcomes. Common factors are general elements of psychosocial support and psychological care – such as communication skills, empathy, collaboration, and helper-client alliance – that are vital ingredients for any intervention to be effective7. Contents of the EQUIP platform have been informed by a theory of change workshop attended by mental health and psychosocial service stakeholders with different practice experiences from diverse global settings. The EQUIP team has reviewed manuals and training materials for interventions delivered by non-specialists with effectiveness demonstrated in randomized controlled trials. This has led to the identification of competencies for both common factors and specific classes of psychological interventions (e.g., cognitive, interpersonal, problem solving, behavioral and trauma-focused techniques). EQUIP will encompass a competency evaluation tool, the Enhancing Assessment of Common Therapeutic Factors (ENACT), that has been developed for role-play based assessment of mental health and psychosocial support skills for non-specialist and specialist providers across cultures, context and types of interventions8, 9. In addition, a suite of competency assessment tools based on ENACT is being developed and tested. Below we briefly outline who, how, where and when EQUIP can be used. Who can use EQUIP? EQUIP is intended for trainers, supervisors and project managers implementing psychosocial support and psychological interventions. How can EQUIP be used? EQUIP can be used to improve implementation plans, competency assessments of trainees, and training and supervision curricula in common factors to accompany manualized interventions. Competency assessments may also be used to aid selection of trainees and to guide institutional certification after achiev

AI snapshot

Written from the paper’s full text.

TL;DR

The World Health Organization is developing EQUIP, an online/offline platform to support competency-based training and assessment for psychological and psychosocial support delivered by diverse cadres. EQUIP aims to help trainers, supervisors, and project managers assure minimum competency, including through tools such as ENACT, and will be piloted before materials are available in English, Arabic, and Spanish.

Key findings

  • Most people with mental health conditions do not receive effective care: among people with depression, only 1 in 5 in high-income countries and 1 in 27 in lower-middle income countries receive minimally adequate treatment, and most countries have only one trained provider per 10,000 people.
  • Non-specialists can effectively deliver psychological interventions if adequately trained and supervised, but unlike licensed professionals, there are usually no systems to check whether they achieve minimum competency for safe and effective care.
  • WHO is developing EQUIP to provide competency-based training and assessment resources, including tutorials, guidance on role-play assessment and interrater reliability, common-factors training modules, and the ENACT competency evaluation tool.
  • EQUIP is intended for trainers, supervisors, and project managers; it will be an online platform with offline formats, developed using human-centered design, piloted in multiple countries, and after piloting made available in English, Arabic, and Spanish.

Methods

  • This is a program description/letter, not an empirical study; it outlines the rationale, development, intended users, and planned contents of the WHO EQUIP platform.
  • EQUIP contents were informed by a theory of change workshop with mental health and psychosocial service stakeholders from diverse global settings, and by review of manuals and training materials for non-specialist-delivered interventions with effectiveness demonstrated in randomized controlled trials.
  • The paper reports no sample size, outcome data, or statistical analysis; it states that EQUIP is being developed using a human-centered design approach and piloted in multiple countries.

Limitations

  • The paper states no formal limitations.
  • Evident from the text: EQUIP is still being developed and piloted, so no empirical results on usability, competency assessment reliability/validity, implementation, or impact on care quality are reported.
  • The text provides no data on whether competency-based training or EQUIP tools improve provider skills or patient outcomes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/wps.20704

Cites

8 of 8 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 9 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    A review by the EQUIP team of manuals and training materials for non-specialist-delivered interventions that had proven effective in randomized trials resulted in identifying competencies for common factors and for particular types of psychological interventions.

    “The EQUIP team has reviewed manuals and training materials for interventions delivered by non-specialists with effectiveness demonstrated in randomized controlled trials.This has led to the identification of competencies for both common factors and specific classes of psychological interventions (e.g., cognitive, interpersonal, problem solving, behavioral and trauma-focused techniques).”
    Quote in the paperSubstantial claim
  • Premisecitation
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    Competency-based training has been shown to work in various low-resource health care fields, such as surgery and obstetric care.

    “Competency-based training approaches have already demonstrated success in diverse areas of health care in low resource settings, including surgery and obstetric care 5,6 .”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] source

      Not checked in the free run.

    • cites [6] source

      Not checked in the free run.

  • Premisecitation
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    The ENACT tool was created to assess mental health and psychosocial support skills through role plays, for both specialist and non-specialist providers, across different cultures, contexts, and intervention types.

    “EQUIP will encompass a competency evaluation tool, the Enhancing Assessment of Common Therapeutic Factors (ENACT), that has been developed for role-play based assessment of mental health and psychosocial support skills for non-specialist and specialist providers across cultures, context and types of interventions 8,9 .”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8] source

      Not checked in the free run.

    • cites [9] source

      Not checked in the free run.

  • Premisecitation
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    A major way to increase access to mental health care is to scale up psychological and psychosocial support provided by various types of workers in different settings.

    “One key action to improve access to mental health care is to expand psychological and psychosocial support services delivered by diverse cadres across settings 3 .”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] source

      Not checked in the free run.

  • Premisecitation
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    People without specialist mental health training can deliver psychological interventions effectively, provided they receive sufficient training and supervision.

    “There is now good evidence that persons who are not specialists in mental health can effectively deliver psychological interventions, but they must be adequately trained and supervised 4 .”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 1
  • May combine two claims. 2
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § Who can use EQUIP? EQUIP is intended for trainers, supervisors and project managers implementing psychosocial support and psychological interventions.

    The EQUIP platform is being created with a human-centered design method to improve usability and engagement, and it is being tested in several countries.

    “To refine the platform and its materials, EQUIP is being developed using a human-centered design approach to enhance usability and engagement, and piloted in multiple countries.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation
    § Ensuring Quality in Psychological Support (WHO EQUIP): developing a competent global workforce

    In high-income countries, about one-fifth of people with depression receive minimally adequate treatment, compared with roughly one in twenty-seven in lower-middle-income countries.

    “Among people living with depression, only 1 in 5 persons in high-income countries and 1 in 27 in lower-middle income countries receive minimally adequate treatment 1 .”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] source

      Not checked in the free run.

2 of 2
  • The paper relies on this without support.

    In most settings, no established systems verify that non-specialist providers have enough training and supervision to reach the minimum competence needed for safe and effective delivery of interventions.

    “However, unlike licensed professionals for whom there are professional associations to assure standards, there are usually no systems or mechanisms in place that check whether non-specialist providers have sufficient training and supervision to achieve minimum competency to effectively and safely deliver interventions.”
  • The paper relies on this without support.

    Meeting mental health and psychosocial needs demands a major expansion of the global workforce so that psychosocial support and evidence-based psychological interventions can be delivered safely and effectively.

    “Addressing mental health and psychosocial needs requires radical growth in the global workforce to ensure safe and effective delivery of psychosocial support and evidence-based psychological interventions.”
  • The paper relies on this without support.

    Competency assessments can identify who is competent and can guide supervision and additional training to fill skill gaps.

    “Competency measures can be used to determine who is or is not competent as well as to tailor supervision and supplementary training to address gaps in skills.”
  • The paper relies on this without support.

    Setting competency targets can help determine how long training should last and what it should cover, which may differ by location or worker group.

    “Having competency targets in mind can also inform training duration and content that may need to vary across sites or cadres.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. World Health Organization, 2018, Mental health atlas 2017

Cited by

Sorted by citations

Authors
Kohrt, B. A., Schafer, A., Willhoite, A., van't Hof, E., Pedersen, G. A., Watts, S., Ottman, K., Carswell, K., & van Ommeren, M.
Affiliations
  • George Washington University (US)
  • World Health Organization (CH)
  • United States Agency for International Development (US)
  • Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
Venue
World Psychiatry
Publisher
Wiley
Published
2020-01-10
Volume
19
Issue
1
Pages
115-116
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
OpenAlex
W2999310245
Cited by
130
References
8
Citations by year
2026: 7 · 2025: 16 · 2024: 19 · 2023: 48 · 2022: 19 · 2021: 14 · 2020: 6 · 2019: 1
FWCI
16.31
Type
journal article
Language
en
Open access
Locations
  • World Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • United States Agency for International Development
  • World Health Organization
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Social Psychology › Competency Development and Evaluation
Keywords
mental health professionals, competency-based training, competency assessment, psychosocial support, psychological intervention, inter-rater reliability, role-play assessment, training supervision, access to mental health care, resource-limited settings, curriculum adaptation, universal health coverage, peer support, community workers, primary care providers, teacher mental health

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review