Cited by 144Mental Health Treatment and AccessHealth Policy Implementation SciencePsychiatric care and mental health services

The DOI matches its Crossref record; 69 of the 74 references it cites were found in a registry or an index; none of the 167 sources its claims cite is checked for support yet.

Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence

Open access

Javadi, D., Feldhaus, I., Mancuso, A., Ghaffar, A.·2017·Global Mental Health

DOI 10.1017/gmh.2017.15PMC PMC5719475

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Abstract

Objective.: This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Methods.: Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Results.: Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. Conclusions.: There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

AI snapshot

Written from the paper’s full text.

TL;DR

This review of 30 studies in LMICs found task shifting for mental health using lay providers was generally feasible and effective, but evaluations rarely applied systems thinking. No included study explicitly used systems thinking tools, though some captured system-wide elements across WHO health system building blocks.

Key findings

Thirty studies were included; almost all showed positive mental health findings and one showed no effect. Task shifting was generally feasible and acceptable, but perceptions of quality of care provided by lay providers remained uncertain.
Twenty-five of 30 studies (83%) mentioned at least one WHO building block beyond service delivery and health workforce; all 30 included the added community/people building block. Among the 25, 16 (80%) considered information/technology, 11 (55%) medicines/medical devices, 15 (70%) financing, and 10 (50%) leadership/governance.
No studies explicitly employed systems thinking tools or system dynamics modelling, but six studies took a more comprehensive approach to capturing system implications, such as stakeholder perspectives, feedback, and intersectoral effects.
Barriers included stigma, poor documentation/follow-up, medicine access and prescribing-training gaps, demand-side financial/geographic barriers, heavy workloads, weak collaboration with traditional/spiritual healers, and provider–decision-maker disconnect. Facilitators included lay providers’ community relatability, specialist support, technology/telemedicine supervision, integrated livelihood/social supports, and existing networks.

Methods

Systematic review: PubMed, CINAHL, and Cochrane were searched 5 September–30 October 2016. From 1357 records, 249 duplicates were removed, 1108 titles/abstracts were screened, 147 met first-stage criteria, and 30 papers were included. Two independent reviewers screened, with a blinded third reviewer resolving discrepancies; inclusion required LMIC setting, mental health focus, task shifting to lay providers with fewer than 3 years of training, research article, English, and not a pilot.
Data extraction and analysis used CASP tools for quality and coded studies against the six WHO building blocks plus a seventh community/people block, along with systems thinking characteristics such as stakeholder perspectives, network/process mapping, feedback mechanisms, and system dynamics. No meta-analysis was done because interventions were diverse, conducted at multiple scales, and included qualitative evaluations.

Limitations

Stated: the wide variety of mental health interventions, populations, and outcome measures may make broader conclusions difficult to apply to unique mental health conditions; some studies may have considered system-wide effects but not reported them in final manuscripts.
Stated/evident: the search was limited to January 1996–September 2016, English peer-reviewed research articles, and excluded pilot studies; no meta-analysis was performed.
Evident: because no included study explicitly used systems thinking tools, conclusions about system-wide effects rely on implicit mentions; the review also highlighted interventions primarily in the health sector, with few cross-sector task-shifting examples.

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Integrity signals

Registry

Crossref · 10.1017/gmh.2017.15

Cites

69 of 69 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 167 cited sources checked · 0 supported · 0 flagged

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies explicitly employed systems thinking tools”
- Also stated in: § Data extraction and analysis · plain
  “Use of system dynamics theory, causal loop diagrams, and other system modelling techniques were also included in the extraction criteria, but none were found.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
None of the sources cited for this claim have been checked yet.
In the paper
“Perception surveys in Ghana directly involved policy directors, which provided an improved understanding of the gap between perceptions of lay provider programmes by policy directors and realities in the field (Agyapong et al. 2015a, b, 2016).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Agyapong et al. 2015a
- Not checked yetcites Agyapong et al. 2015b
- Not checked yetcites Agyapong et al. 2016
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
In the paper
“That is, lay providers, not trained in prescription of psychotropic medicines, found themselves prescribing them due to community needs (Agyapong et al. 2015a).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Agyapong et al. 2015a
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes

Show all 76 claims

Probably not a substantial claim. 42
It may state two separate claims as one. 30
The quote only partly states this claim. 2

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirty studies were included.”
- Also stated in: § Results · plain
  “a final set of 30 papers were included”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Shortage of medicines and the resulting limitations placed on lay providers were impediments in achieving improved health outcomes and demoralized providers who were unable to provide adequate care (Petersen et al. 2011; Nimgaonkar & Menon, 2015).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Nimgaonkar & Menon, 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Across these different contexts, community mental health programmes were variable in nature with some being more integrated into existing health systems”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
What the sources say
- Not checked yetcites Patel et al. 2010b
- Not checked yetcites Patel et al. 2011
- Not checked yetcites Petersen et al. 2011
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one. The quote only partly states this claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Facilitators identified to support this need were the use of step sheets for enhanced fidelity to interventions and training on documentation of patient visits on mobile phones (Bolton et al. 2014; Rotheram-Borus et al. 2015; Murray et al. 2015b).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Bolton et al. 2014
- Not checked yetcites Rotheram-Borus et al. 2015
- Not checked yetcites Murray et al. 2015b
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This building block was often mentioned in terms of use of technology for screening of mental illness (Hung et al. 2014; Padilla et al. 2015), use of mobile technology for supervision of lay providers (Tomlinson et al. 2011; Magidson et al. 2015; Agyapong et al. 2016), and need for improved data management tools to ensure adequate follow-up patients at-risk of poor mental health (Agyapong et al. 2”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Hung et al. 2014
- Not checked yetcites Padilla et al. 2015
- Not checked yetcites Tomlinson et al. 2011
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Programme-level supervision of lay providers, which was raised as a challenge across most of the studies included, was not captured as an overarching leadership and governance issue in this review as it is not sufficiently addressing system-level leadership and governance (Schneider & Lehmann, 2016).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Schneider & Lehmann, 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Fifteen studies (70%) raised financing issues in task shifting for mental health with most referring to lack of funds as a limitation to scale-up, pointing to the need to prove cost-effectiveness as a means of ensuring investment by policy and decision makers (Agyapong et al. 2015a, 2016; Murray et al. 2015b).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Agyapong et al. 2015a
- Not checked yetcites Agyapong et al. 2016
- Not checked yetcites Murray et al. 2015b
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Another mentioned the lack of such collaboration with other sectors as a barrier in seeing improved treatment outcomes (Thurman et al. 2014).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Thurman et al. 2014
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“These interventions focused on the education sector, where peer group support for AIDS counselling (Kumakech et al. 2009) or support for disability management (Lorenzo et al. 2015) would take place; across non-governmental organizations for vulnerable populations (Bolton et al. 2014); and with the criminal and social services sectors (Murray et al. 2015b).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Kumakech et al. 2009
- Not checked yetcites Lorenzo et al. 2015
- Not checked yetcites Murray et al. 2015b
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These studies demonstrated the range of actors necessary for successful integration and showed that actors may have different interpretations of challenges, and different strengths in mitigating these challenges.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
Load-bearingStrength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: An important element of systems thinking is understanding roles, characteristics, and interactions of the players involved.
None of the sources cited for this claim have been checked yet.
In the paper
“Leadership and governance issues beyond the health sector played a heavy role in the ability of lay providers to provide necessary mental health services; therefore, collaboration with other officials was raised as being important to the intervention (Neuner et al. 2008; Murray et al. 2015b).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Neuner et al. 2008
- Not checked yetcites Murray et al. 2015b
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“One such example is the referral of patients to income-generating programmes within the agricultural sector (Petersen et al. 2011).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Petersen et al. 2011
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“These studies included qualitative methods that allowed them to capture some of the interactions within the system and highlight barriers, facilitators and effects that fell outside the limited scope of the task-shifting intervention (Petersen et al. 2011; Lorenzo et al. 2015; Nimgaonkar & Menon, 2015; Padilla et al. 2015; Agyapong et al. 2016).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
What the sources say
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Lorenzo et al. 2015
- Not checked yetcites Nimgaonkar & Menon, 2015
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“implementation research methods facilitate this, making adjustments for context and cultural needs”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Mendenhall et al. 2014
- Not checked yetcites Murray et al. 2014
- Not checked yetcites Nimgaonkar & Menon, 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The quote only partly states this claim.
- Rests on an assumption: An important element of systems thinking is understanding roles, characteristics, and interactions of the players involved.
None of the sources cited for this claim have been checked yet.
In the paper
“The perceptions surveys conducted in Ghana, the phenomenological approach across South Africa, Botswana and Malawi, the multi-country stakeholder perspective mapping, and the cross-country comparison of South Africa and Uganda through interviews and focus groups captured such perspectives and allowed for improved understanding of gaps to ensure successful scale-up and integration into the health”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Mendenhall et al. 2014
- Not checked yetcites Agyapong et al. 2015a
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: An important element of systems thinking is understanding roles, characteristics, and interactions of the players involved.
None of the sources cited for this claim have been checked yet.
In the paper
“lack of access to psychotropic medicines and/or lack of sufficient training for rational prescribing practice (Patel et al. 2011; Agyapong et al. 2015a; Nimgaonkar & Menon, 2015);”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Barriers and facilitators of scaling up mental health care by the building blocks
What the sources say
- Not checked yetcites Patel et al. 2011
- Not checked yetcites Agyapong et al. 2015a
- Not checked yetcites Nimgaonkar & Menon, 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“The six building blocks of the health system – service delivery, health workforce, information technology, medical products, financing, and leadership – are made dynamic, adaptive, and interactive through a systems thinking lens as it is designed to explore how different elements are connected in a system and the impact and implications of these connections”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Using systems thinking to evaluate the impact of task shifting
What the sources say
- Not checked yetcites Adam et al. 2012
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Mental and physical health are interconnected, and early detection can lead to improved health outcomes and increase cost-effectiveness for the health system”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction
What the sources say
- Not checked yetcites WONCA, 2008
- Not checked yetcites Levin & Chisholm, 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Few studies focus on the wider impact of task shifting across the health system and, likewise, the scale-up of mental health strategies”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Applying evidence for success in capacity building for mental health care
What the sources say
- Not checked yetcites Eaton et al. 2011
- Not checked yetcites Yaya Bocoum et al. 2013
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In resource-poor settings, task shifting has been an effective approach to addressing health workforce challenges and strengthening systems for mental health”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Recognizing task shifting as a system intervention for mental health
What the sources say
- Not checked yetcites Eaton et al. 2011
- Not checked yetcites Kakuma et al. 2011
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This weakness in the literature undermines the complexity of interactions and changes that take place in health systems, and stymies the potential scale-up and sustainable integration of promising task-shifting strategies”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Applying evidence for success in capacity building for mental health care
What the sources say
- Not checked yetcites Adam et al. 2012
- Not checked yetcites Yaya Bocoum et al. 2013
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“The World Health Organization (WHO) estimates that there is a need for 1.18 million mental health workers to move towards closing the mental health treatment gap”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction
What the sources say
- Not checked yetcites Fulton et al. 2011
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Systems thinking also incorporates another key health systems element: communities and people”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Using systems thinking to evaluate the impact of task shifting
What the sources say
- Not checked yetcites Adam et al. 2012
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Poor policy implementation, inadequate human resource allocation to support the process, poor community engagement, and low access to medicines are among the challenges of integration”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Applying evidence for success in capacity building for mental health care
What the sources say
- Not checked yetcites Patel et al. 2007
- Not checked yetcites Eaton et al. 2011
- Not checked yetcites van Ginneken et al. 2013
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“it requires primary care providers to be trained in identifying poor mental health and taking action towards treatment”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction
What the sources say
- Not checked yetcites WONCA, 2008
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“By enhancing understanding of different perspectives across multiple interacting agents, the changing context in which they interact, and the changes resulting from new patterns created over time, systems thinking can serve as an important policy toolkit”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Using systems thinking to evaluate the impact of task shifting
What the sources say
- Not checked yetcites Adam et al. 2012
- Not checked yetcites Peters, 2014
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence.
None of the sources cited for this claim have been checked yet.
In the paper
“Integration of mental health into health systems, especially in primary care systems, is not without its challenges, particularly in resource-poor settings”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction > Applying evidence for success in capacity building for mental health care
What the sources say
- Not checked yetcites Patel et al. 2010a
- Not checked yetcites Eaton et al. 2011
- Not checked yetcites Weinmann & Koesters, 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“only 20% of persons with common mental disorders (CMDs) received treatment in the year prior to the survey, with only 10% receiving minimally adequate treatment”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction
What the sources say
- Not checked yetcites Wang et al. 2007
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In LMICs, not only are there limited mental health services available, utilization of existing services is also poor for a multitude of reasons, including geographic, cultural, and financial access barriers”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Introduction
What the sources say
- Not checked yetcites Murthy, 2011 source
- Not checked yetcites van Ginneken et al. 2013
- Not checked yetcites Chowdhary et al. 2014
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Critical Appraisal Skills Programme (CASP) tools were used to assess the quality of the studies”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Data extraction and analysis
What the sources say
- Not checked yetcites CASP, 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two stages of screens were done to ensure sensitivity.”
- Also stated in: § Search strategy · plain
  “A two-stage approach to inclusion was employed to ensure sensitivity.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Methods.
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Articles were screened by two independent reviewers with a third reviewer resolving discrepancies.”
- Also stated in: § Search strategy · plain
  “the titles and abstracts of all identified articles were independently reviewed by two authors”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Methods.
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The intersectoral fora created to support these programmes strengthened their ability to integrate into existing systems and provided a wider range of community referral pathways for lay providers to use in linking their patients to the resources necessary for thriving, thereby indirectly enhancing mental health (Petersen et al. 2011; Chatterjee et al. 2014; Lorenzo et al. 2015).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Chatterjee et al. 2014
- Not checked yetcites Lorenzo et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“A systems thinking approach can help capture these complexities and understand how to optimize community mental health systems (Peters, 2014).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
What the sources say
- Not checked yetcites Peters, 2014
Load-bearingStrength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence.
None of the sources cited for this claim have been checked yet.
In the paper
“In community mental health, robust referral pathways are an important piece of integration and working across stakeholders is necessary to ensure appropriate follow-up and service delivery for patients, not just within the health system, but also across other social sectors (Petersen et al. 2011; Lorenzo et al. 2015).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > The use of systems thinking tools in evaluation of interventions
What the sources say
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Lorenzo et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It needs an understanding of large-scale public sector involvement, interactions across key actors, mobilization of these actors, and monitoring and evaluation tools that capture the complex adaptive parts within the system as they shift and respond to scale-up toward a true community system (Hanlon et al. 2014; Schneider & Lehmann, 2016).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
What the sources say
- Not checked yetcites Hanlon et al. 2014
- Not checked yetcites Schneider & Lehmann, 2016
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Some tools require the interpretation and training of health professionals to be appropriately and efficiently used, suggesting that not all technologies are readily transferable across health workforce cadres (Jotheeswaran et al. 2015; Robbins et al. 2015).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Barriers and facilitators of scaling up mental health care by the building blocks
What the sources say
- Not checked yetcites Jotheeswaran et al. 2015
- Not checked yetcites Robbins et al. 2015
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It sometimes stems from physical, environmental, or sociocultural challenges and creates positive feedback loops that become difficult to break (Tomlinson et al. 2011; Thurman et al. 2014).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
What the sources say
- Not checked yetcites Tomlinson et al. 2011
- Not checked yetcites Thurman et al. 2014
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Existing models and formal arrangements of intersectoral collaboration require additional incentives and governmental support.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Barriers and facilitators of scaling up mental health care by the building blocks
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Establishing networks and intersectoral linkages is not easy.
None of the sources cited for this claim have been checked yet.
In the paper
“Stigma, for instance, is an often-cited barrier in mental health seeking behaviours and even in provision of mental health care (van Ginneken et al. 2013; Nimgaonkar & Menon, 2015; Iheanacho et al. 2016; Weinmann & Koesters, 2016).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
What the sources say
- Not checked yetcites van Ginneken et al. 2013
- Not checked yetcites Nimgaonkar & Menon, 2015
- Not checked yetcites Iheanacho et al. 2016
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.

69 of 69

The paper relies on this without support.
Effective integration of mental health into primary care requires strengthened primary care systems.
“However, effective integration requires strengthened primary care systems.”
The paper relies on this without support.
Systems thinking contributes to documenting the system-wide impact of a given intervention, as well as enhancing the ability to predict both intended and unintended consequences of the intervention, critical in designing successful large-scale reform.
“Systems thinking contributes to documenting the system-wide impact of a given intervention, as well as enhancing the ability to predict both intended and unintended consequences of the intervention, critical in designing successful large-scale reform.”
The paper relies on this without support.
An important element of systems thinking is understanding roles, characteristics, and interactions of the players involved.
“An important element of systems thinking is understanding roles, characteristics, and interactions of the players involved.”
The paper relies on this without support.
More examples of intersectoral collaboration exist, especially in education and social services.
“More examples of such collaboration exist, especially in education and social services.”
The paper relies on this without support.
Establishing networks and intersectoral linkages is not easy.
“Establishing networks and intersectoral linkages is not easy.”

5 of 5

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?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

Randomized-trial arm sizes exceed the reported total
Major
The reported intervention and control groups sum to 347 participants, not the stated total of 247.
Reported 247 · recomputed 347
Information and technology percentage is incorrect
Minor
Sixteen of 25 studies is 64%, not 80%.
Reported 80 · recomputed 64
Three cohort or pre/post papers are claimed, but five are listed
Minor
The sentence describes three papers while naming five distinct papers in its supporting citations.
Financing percentage is incorrect
Minor
Using the stated denominator of 25 studies, 15 studies represent 60%, not 70%.
Reported 70 · recomputed 60
Medicines and medical devices percentage is incorrect
Minor
Using the stated denominator of 25 studies, 11 studies represent 44%, not 55%.
Reported 55 · recomputed 44

5 of 5

Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D., Johns, N., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)61611-6 · Cited by 6,006 · cited 3×
“Three papers were pre/post- or prospective cohort studies (Adam et al. 2012; Whiteford et al. 2013; Yaya Bocoum et al. 2013; Hung et al. 2014; Padilla et al. 2015).”
Background
The World Health report 2006 1 : Working together for health 2
Guilbert, J.-J. (2006) · Education for Health · doi:10.1080/13576280600937911 · Cited by 2,652 · cited 1×
“Availability and scale-up of essential health services to achieve health system goals is often impeded by health workforce shortages (WHO, 2006).”
Background
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition
Murray, C. J. L., Barber, R. M., Foreman, K. J., Özgören, A. A., Abd-Allah, F., Abera, S. F., Aboyans, V., Abraham, J. P., Abubakar, I., Abu-Raddad, L. J., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)61340-x · Cited by 1,966 · cited 9×
“(Continued) globalm entalhealth orphans, refugees and torture survivors (BakerHenningham et al. 2005; Neuner et al. 2008; Kumakech et al. 2009; Ali et al. 2010; Bolton et al. 2014; Murray et al. 2014; Larson-Stoa et al. 2015; Magidson et al. 2015; Murray et al. 2015b).”
Influential
The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., Üstün, T. B., & Wang, P. S. (2009) · Epidemiologia e Psichiatria Sociale · doi:10.1017/s1121189x00001421 · Cited by 1,895 · cited 1×
“Recent estimates from the WHO Mental Health Surveys indicate an interquartile range of lifetime DSM-IV disorder prevalence between 18.1% and 36.1% (Kessler et al. 2009).”
BackgroundInfluential
Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61414-7 · Cited by 1,655
Gene-Wide Analysis Detects Two New Susceptibility Genes for Alzheimer's Disease
Escott-Price, V., Bellenguez, C., Wang, L.-S., Choi, S.-H., Harold, D., Jones, L., Holmans, P., Gerrish, A., Vedernikov, A., Richards, A., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0094661 · Cited by 1,398
Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial
Rahman, A., Malik, A., Sikander, S., Roberts, C., & Creed, F. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61400-2 · Cited by 993 · cited 2×
“Twelve papers were randomized controlled trials (Ali et al. 2003; Baker-Henningham et al. 2005; Rahman et al. 2008; Kumakech et al. 2009; Patel et al. 2010b, 2011; Tomlinson et al. 2011; Chatterjee et al. 2014; Pradeep et al. 2014; RotheramBorus et al. 2015).”
BackgroundMethod
Human resources for mental health care: current situation and strategies for action
Kakuma, R., Minas, H., van Ginneken, N., Dal Poz, M. R., Desiraju, K., Morris, J. E., Saxena, S., & Scheffler, R. M. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61093-3 · Cited by 979 · cited 2×
“Recognizing task shifting as a system intervention for mental health In resource-poor settings, task shifting has been an effective approach to addressing health workforce challenges and strengthening systems for mental health (Eaton et al. 2011; Kakuma et al. 2011).”
Background
Treatment and prevention of mental disorders in low-income and middle-income countries
Patel, V., Araya, R., Chatterjee, S., Chisholm, D., Cohen, A., De Silva, M., Hosman, C., McGuire, H., Rojas, G., & van Ommeren, M. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61240-9 · Cited by 930 · cited 3×
“Global mental health has seen attention in academic circles through special series in The Lancet and PLoS, which highlight integration of mental health into primary care as a key strategy (Patel et al. 2007; Patel & Thornicroft, 2009).”
Background
Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial
Patel, V., Weiss, H. A., Chowdhary, N., Naik, S., Pednekar, S., Chatterjee, S., De Silva, M. J., Bhat, B., Araya, R., King, M., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61508-5 · Cited by 752 · cited 18×
“Was an adequate sensitivity analysis performed? global mental health included although two of these reported on the same randomized controlled trial on MANAS in India (Patel et al. 2010b, 2011), and three were based on different perspectives of the community mental health programme in Ghana (Agyapong et al. 2015a, b,…”
BackgroundInfluential

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5 of the 74 references couldn’t be matched to a known paper.

Research works printed but not linked: 13

2007b, Joint WHO/OGAC Technical Consultation on Task Shifting: Key Elements of a Regulatory Framework in Support of In-country Implementation of Task Shifting
2007, Systems Support for Task-Shifting to Community Health Workers
2013, Joint Commitment to Harmonized Partners Action for Community Health Workers and Frontline Health Workers: Moving from Fragmentation to Synergy Toward Universal Health Coverage
1997, International Conference on Intersectoral Action for Health
2008, mhGAP Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological, and Substance Use Disorders
2008, Integrating mental health into primary care: a global perspective
Levin, 2015, Disease Control Priorities 3: Mental, Neurological, and Substance Use Disorders, 1
2010, Monitoring the Building Blocks of the Health System
2009, Systems Thinking for Health Systems Strengthening
2009, Improving Health Systems and Services for Mental Health
2007a, Everybody's Business: Strengthening Health Systems to Improve Health Outcomes
2016, Critical Appraisal Skills Program: Making Sense of Evidence
2006, World Health Report 2006: Working Together for Health

Sorted by citations

Items 101–135 of 135

Experiences of Telemental Health Providers and Support Staff Serving Indigenous Patients of Northern CanadaPreprint
Shang, Z., Arnaert, A., Hindle, Y., et al. (2020) · Research Square · doi:10.21203/rs.3.rs-36224/v1
New Frontiers in Mental Health
Metz, K. L., Figge, C. J., Alto, M. E., Kane, J. C., & Murray, L. K. (2021) · Springer eBooks · doi:10.1007/978-3-319-70134-9_145-1
Reply on RC2
Cunningham, S. (2021) · Natural hazards and earth system sciences · doi:10.5194/nhess-2020-402-ac2
Comment on nhess-2020-402
Cunningham, S. L., Schuldt, S., Chini, C. M., et al. (2021) · Natural hazards and earth system sciences · doi:10.5194/nhess-2020-402-rc1
Reply on RC1
Cunningham, S. (2021) · Natural hazards and earth system sciences · doi:10.5194/nhess-2020-402-ac1
Comment on nhess-2020-402
Cunningham, S. L., Schuldt, S., Chini, C. M., et al. (2021) · Natural hazards and earth system sciences · doi:10.5194/nhess-2020-402-rc2
Lessons from Research Innovations in Depression and HIV in Low- and Middle-Income Countries
Jopling, R., Yang, J. P., Meffert, S. M., Müller, M., Nyamayaro, P. C., & Abas, M. (2021) · Springer eBooks · doi:10.1007/978-3-030-57296-9_6
Lessons from Research Innovations in Depression and HIV in Low- and Middle-Income Countries
Jopling, R., Yang, J. P., Meffert, S. M., Müller, M., Nyamayaro, P. C., & Abas, M. (2020) · Springer eBooks · doi:10.1007/978-3-319-70134-9_6-2
Mental Health in Paralympic Athletes
Swartz, L. M. (2022) · Springer eBooks · doi:10.1007/978-3-031-08364-8_23
Scale-up costs and societal benefits of psychological interventions for alcohol use and depressive disorders in IndiaPreprint
Zadey, S. (2023) · medRxiv · doi:10.1101/2023.05.15.23289987
Decision: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R2/PR14
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr14
Recommendation: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R2/PR13
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr13
Review: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R2/PR12
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr12
Decision: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R1/PR10
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr10
Author comment: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R2/PR11
Stockton, M. A. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr11
Recommendation: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R1/PR9
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr9
Review: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R1/PR8
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr8
Review: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R1/PR7
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr7
Author comment: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R1/PR6
Stockton, M. A. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr6
Decision: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R0/PR5
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr5
Recommendation: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R0/PR4
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr4
Review: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R0/PR3
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr3
Review: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R0/PR2
Stockton, M. A., Mazinyo, E. W., Mlanjeni, L., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr2
Author comment: Validation of a brief screener for broad-spectrum mental and substance-use disorders in South Africa — R0/PR1
Stockton, M. A. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.89.pr1
Proning for COVID-19 Patients: A Task-Shifting Feasibility Study
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Saleem, S., Baig, A., Qureshi, O., Sajun, S., Bird, V. J., Priebe, S., & Pasha, A. (2025) · BJPsych International · doi:10.1192/bji.2025.4
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Endalamaw, A., Belay, Y. A., Wolka, E., Zewdie, A., & Assefa, Y. A. (2025) · Research Square · doi:10.21203/rs.3.rs-6173948/v1
Lay Counselor Delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): A Systematic Review
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Where is the art therapist? A systems approach to positioning the art therapist
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Lay Counselor Delivery of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): A Systematic Review
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The impact of policy shifts on mental health innovation, accessibility, and ethical considerations
Ebo, T. O., Osho, D., Ebo, D. M., Egbon, E., Okesanya, O. J., & Olawade, D. B. (2026) · Journal of Global Health Science · doi:10.35500/jghs.2026.8.e15
Existing practices, gaps and strategies to promote perinatal mental health in Ghana
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The efficacy of task shifting interventions: A case of a selected psychiatric hospital in Zimbabwe
Ngwabi, N. T., Mpofu, L., & Magunga, B. T. (2026) · South African Family Practice · doi:10.4102/safp.v68i1.6236
Lessons from Research Innovations in Depression and HIV in Low- and Middle-Income Countries
Yang, J. P., Jopling, R., Meffert, S. M., & Nyamayaro, P. C. (2026) · Springer eBooks · doi:10.1007/978-3-319-70134-9_6-3
A call for action: Guidelines for implementation of mental health services at the community level
Thobane, K. F., Mulaudzi, F. M., Lavhelani, N. R., & Gundo, R. (2026) · Health SA Gesondheid · doi:10.4102/hsag.v31i0.3287

Authors: Javadi, D., Feldhaus, I., Mancuso, A., & Ghaffar, A.
Affiliations: World Health Organization (CH)
Harvard University (US)
Johns Hopkins University (US)
Corresponding author: Javadi, D.
ORCID: Javadi, D.
Feldhaus, I.
Mancuso, A.
Ghaffar, A.
Venue: Global Mental Health
Publisher: Cambridge University Press (CUP)
Published: 2017
Volume: 4
Pages: e14-e14
ISSN: 2054-4251 (ISSN-L)
DOI: 10.1017/gmh.2017.15
PMC: PMC5719475
OpenAlex: W2739628147
Cited by: 144
References: 74
Citations by year: 2026: 8 · 2025: 12 · 2024: 29 · 2023: 24 · 2022: 10 · 2021: 36 · 2020: 12 · 2019: 8 · 2018: 4 · 2017: 1
FWCI: 1.05
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified, 211 d)
Locations: Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders: World Health Organization
University of Cambridge
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: task shifting, systems thinking, lay providers, community mental health system, mental health service delivery, low- and middle-income countries, systems strengthening, healthcare workers, stakeholder perspectives, unintended consequences, community building

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Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence

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