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 accessAbstract
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.
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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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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
“One study showed no effect.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Data extraction and analysis · plain
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
“All studies showed that task shifting for mental health was feasible and acceptable in the given contexts”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“perceptions of quality of care provided by lay providers remain uncertain”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA 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
“some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Strength:boosted· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Almost all studies displayed positive findings on mental health using task shifting.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Results.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Of the 30 studies, 25 (83%) included mention of the six WHO health system building blocks other than service delivery and health workforce (Table 6).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Thirteen papers were qualitative evaluations using surveys, interviews, focus groups, action research, implementation research, or case study methodology”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Some studies mentioned demand-side financing as a barrier to improved mental health delivery, citing the ability to pay for basic mental health services from the patient's perspective (Neuner et al. 2008; Nimgaonkar & Menon, 2015; Abas et al. 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 Neuner et al. 2008
- Not checked yetcites Nimgaonkar & Menon, 2015
- Not checked yetcites Abas et al. 2016
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“The discrepancies between training and service delivery in prescribing practices were a challenge in task shifting for mental health (Agyapong et al. 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. 2016
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Supporting patients through advice for socioeconomic well-being and links to income-generating projects was a means through which lay providers tried to address demand-side financial barriers (Baker-Henningham et al. 2005; 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 > Intervention effects across the building blocks
What the sources say
- Not checked yetcites Baker-Henningham et al. 2005
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Lorenzo et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Finally, 10 studies (50%) mentioned leadership and governance issues with reference to task shifting for mental health.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe 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
“Eleven studies (55%) considered the implications of the medicines and medical devices.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Ensuring that referrals were made to services covered by social protection mechanisms, was raised as an important element of providing sustainable and effective mental health service delivery by lay providers (Lorenzo et al. 2015; Padilla et al. 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 Lorenzo et al. 2015
- Not checked yetcites Padilla et al. 2015
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Lack of financial incentives for lay providers and their supervisors was another challenge raised (Mendenhall et al. 2014; Abas et al. 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 Mendenhall et al. 2014
- Not checked yetcites Abas et al. 2016
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“The bias towards medication as treatment also created challenges for prioritization of psychotherapy and behavioural interventions, affecting demand-side acceptability (Mendenhall et al. 2014).”
§ 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 Mendenhall et al. 2014
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Twelve papers were randomized controlled trials”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“All 30 studies included some aspect of the seventh additional building block (communities and people) through community engagement and/or efforts to understand community needs in order to best integrate lay providers.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Sixteen studies of the 25 (80%), considered the role of information and technology.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Barriers to scaling up mental health services identified across studies included: stigma around mental health in the community (Ali et al. 2010; Nimgaonkar & Menon, 2015; Padilla 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 Ali et al. 2010
- Not checked yetcites Nimgaonkar & Menon, 2015
- Not checked yetcites Padilla et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In larger, multi-country studies, lack of clarity in lay provider roles and confidentiality issues undermined integration of programmes from a supply-side perspective (Mendenhall et al. 2014).”
§ 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 Mendenhall et al. 2014
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe 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
“Leadership and governance structures were also barriers to integration.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“Eight studies touched on efforts made beyond the health sector.”
§ 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
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In addressing disability challenges, social development and transport sectors were involved to make the lived environment more supportive of those living with both physical and mental disabilities (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 Lorenzo et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Other studies referenced the need for policy support to integrate mental health services by lay providers into existing practice, citing governance structures as facilitators in scale-up and integration of mental health services through decentralization of these services (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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Despite the global call to action to improve scale-up and integration of lay provider programmes, the evidence base around implementation, scale-up, and integration of task-shifting strategies for mental health remains limited in both quantity and breadth (GHWA, 2013; Weinmann & Koesters, 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 GHWA, 2013
- Not checked yetcites Weinmann & Koesters, 2016
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe 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
“In programmes targeted at vulnerable populations, such as refugees and orphans, continuity was a challenge as these populations are mobile.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results > Intervention effects across the building blocks
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Four studies had formal arrangements for embedding intersectoral practice in the task shifting (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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“One study highlighted health promotion activities through working with community resources, such as schools and churches, as an enabling factor (Wright & Chiwandira, 2016).”
§ 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 Wright & Chiwandira, 2016
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“One study highlighted the siloed effect of multiple vertical programmes addressing disability across different sectors with no oversight or horizontal coordination (Lorenzo et al. 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 Lorenzo et al. 2015
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Several studies raised social determinants of mental health, such as socioeconomic status, employment, lack of education, and violence as risk factors that needed to be addressed in order to enhance the positive effect of task shifting for mental health (Petersen et al. 2011; Mendenhall et al. 2014; Thurman et al. 2014; Lorenzo et al. 2015; Nimgaonkar & Menon, 2015; Wright & Chiwandira, 2016).”
§ 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 Thurman et al. 2014
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe 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
“System dynamics theory or modelling tools were not directly used in any of the included studies”
§ 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
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe 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
“however, six studies took a more comprehensive approach in capturing system implications of the intervention being studied.”
§ 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
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA 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
“None of the included studies systematically studied system elements; however, many touched upon the WHO building blocks of the health system other than those directly related to task shifting (i.e. service delivery and health workforce).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA 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
“None of the included studies systematically studied system elements; however, many touched upon the WHO building blocks of the health system other than those directly related to task shifting (i.e. service delivery and health workforce).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe 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
“While information and technology tools appear to be facilitators for optimizing service delivery by lay providers, care must be taken in the selection of technology solutions.”
§ 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
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“and lack of access to community resources to support social determinants of mental health (Tomlinson et al. 2011; Thurman et al. 2014; Rotheram-Borus 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 Tomlinson et al. 2011
- Not checked yetcites Thurman et al. 2014
- Not checked yetcites Rotheram-Borus et al. 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“gender differences in responding to treatment (Larson-Stoa 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 Larson-Stoa et al. 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“poor documentation and loss of follow-up due to lack of robust data management and patient management tools (Agyapong et al. 2015b);”
§ 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 Agyapong et al. 2015b
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Even where formal mechanisms are in place for intersectoral collaboration (i.e. where formal engagement of health, education and development sectors are embedded in programme design), participation was erratic and uncertain without senior officials present (Petersen et al. 2011).”
§ 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 Petersen et al. 2011
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“poor collaboration with spiritual and traditional healers (Agyapong et al. 2015a);”
§ 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 Agyapong et al. 2015a
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“disconnect between providers and decision makers (Agyapong et al. 2015a, 2016; Rotheram-Borus 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 Agyapong et al. 2015a
- Not checked yetcites Agyapong et al. 2016
- Not checked yetcites Rotheram-Borus et al. 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“integrated interventions that include life skill building for sustainable livelihood practice, social interaction, and self-care (Petersen et al. 2011; Chatterjee et al. 2014);”
§ 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 Petersen et al. 2011
- Not checked yetcites Chatterjee et al. 2014
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“use of technology and telemedicine to support supervisory practice (Patel et al. 2011; Tomlinson et al. 2011; Magidson 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 > 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 Tomlinson et al. 2011
- Not checked yetcites Magidson et al. 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Despite policy support, implementation and scale-up of integrated approaches to strengthening community mental health remains a challenge (Hanlon et al. 2014).”
§ 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 Hanlon et al. 2014
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“and integration into existing networks with robust service delivery models that support lay providers (Petersen et al. 2011; 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 Petersen et al. 2011
- Not checked yetcites Nimgaonkar & Menon, 2015
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Facilitators to scaling up mental health services identified across studies included: suitability of lay providers due to their ability to relate to the community and their patients (Baker-Henningham et al. 2005; Padilla et al. 2015; Abas et al. 2016);”
§ 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 Baker-Henningham et al. 2005
- Not checked yetcites Padilla et al. 2015
- Not checked yetcites Abas et al. 2016
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“existing heavy workload of lay providers (Petersen et al. 2011; Hung et al. 2014);”
§ 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 Petersen et al. 2011
- Not checked yetcites Hung et al. 2014
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“geographic and financial demand-side barriers to access of mental health services (Baker-Henningham et al. 2005; Petersen et al. 2011; Mendenhall et al. 2014; Agyapong et al. 2015a);”
§ 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 Baker-Henningham et al. 2005
- Not checked yetcites Petersen et al. 2011
- Not checked yetcites Mendenhall et al. 2014
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“support from specialized mental health professionals (Agyapong et al. 2015a, b);”
§ 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 Agyapong et al. 2015a
- Not checked yetcites Agyapong et al. 2015b
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Financial and procurement barriers impede access to essential psychotropic medicines, impeding the delivery of appropriate mental health care to those who require pharmacotherapy (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 Agyapong et al. 2015a
- Not checked yetcites Nimgaonkar & Menon, 2015
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe 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
“Few included studies employed task-shifting strategies across other sectors to enhance mental health promotion.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Availability and scale-up of essential health services to achieve health system goals is often impeded by health workforce shortages”
§ 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 WHO, 2006
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“This is especially true of mental health in low- and middle-income countries (LMICs), where availability of services is not matched to population needs”
§ 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 Weinmann & Koesters, 2016
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Conditions such as regular supervision, availability of resources and tools, access to medicines, quality training, and exposure to technological updates through in-service training are enabling factors in ensuring successful redistribution of tasks among health workforce teams”
§ 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 Yaya Bocoum et al. 2013
- Not checked yetcites Agyapong et al. 2016
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Mental health service delivery is highly context-specific with culturally defined interpretations of stigma, trust, and utility affecting success and impact”
§ 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 Weinmann & Koesters, 2016
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“perceptions of a loss of hierarchal structures, shift in earnings, and burden of supervision are examples of barriers that higher professional cadres may experience regarding task shifting”
§ 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 Niekerk, 2008
- Not checked yetcites Philips et al. 2008
- Not checked yetcites Zachariah et al. 2009
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Integration of mental health services into primary care presents a strategic opportunity to overcome some of these access barriers and reach the largest number of people while minimizing stigma and discrimination”
§ 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Several systematic reviews have supported the use of task shifting for mental health focused on specific populations, such as with people living with HIV/AIDS or mothers with postpartum depression”
§ 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 Rahman et al. 2013
- Not checked yetcites van Ginneken et al. 2013
- Not checked yetcites Chowdhary et al. 2014
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Buy-in and acceptance of task-shifting interventions across a wide range of stakeholders is also important in their success”
§ 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 Yaya Bocoum et al. 2013
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA 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
“There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Abstract > Conclusions.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Task shifting requires various parts of the system to be working in harmony in order to be successful”
§ 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 GHWA, 2007
- Not checked yetcites Yaya Bocoum et al. 2013
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“To ensure that LMICs can expand large-scale mental health strategies and achieve integration into primary care, a system-wide approach can be an effective tool in understanding, evaluating, and implementing bespoke 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 WHO, 2007b
- Not checked yetcites AHPSR, 2009
Tests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passes- Rests on an assumption: 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.
In the paper
“Moving from fragmentation to integration requires a move beyond issues specific to lay provider programmes, such as remuneration, training, and supervision (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 Schneider & Lehmann, 2016
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Collaboration with the judicial system was also important in cases where abuse and neglect were part of the diagnosis (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 Murray et al. 2015b
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“This rich knowledge, combined with appropriate training, puts them in the optimal position to refer patients to relevant social services (Paudel et al. 2014).”
§ 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 Paudel et al. 2014
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Mental health is often a comorbidity in chronic disease management; training programmes should also prepare lay providers with the knowledge and skills necessary to understand such linkages and to refer appropriately (Rotheram-Borus 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 Rotheram-Borus et al. 2015
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Scaling up mental health treatment by lay providers without addressing access to medicines in parallel will prove unsuccessful by undermining the quality and impact of additional service provision (WHO, 2009).”
§ 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 WHO, 2009
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“By being community-based and having a deep understanding of community needs and assets, lay providers have an enhanced ability to identify social determinants of mental health within a given context (Richters et al. 2013; Padilla 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 Richters et al. 2013
- Not checked yetcites Padilla et al. 2015
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Inefficiencies in the system can also be found in poor access to medicines (WHO, 2009).”
§ 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 WHO, 2009
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Mental health is rarely an isolated problem.”
§ 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:plain· not yet calibratedTests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passesIn the paper
“A study of church-based lay providers showed that higher education was correlated with improved bio-psychosocial perspectives on mental health and fewer displays of stigma-based behaviour (Iheanacho et al. 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 Iheanacho et al. 2016
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Such actors include caregivers, non-governmental entities that support social determinants of mental health, employers, spiritual leaders, and other social sectors (e.g., education, agriculture, transport, social development, etc.) (Schneider & Lehmann, 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 Schneider & Lehmann, 2016
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Results · plain
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
“No studies were excluded on the basis of quality.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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
“Two papers included economic evaluation”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one. The quote only partly states this claim.
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
“Outcome measures used included mental health assessment tools, such as the 10-item Edinburgh Postnatal Depression Scale (EPDS-10), the Center for Epidemiological Studies Depression Scale (CES-D), Psychiatric Symptom Score, UCLA Post-Traumatic Stress Disorder Reaction Index, Aga Khan University Anxiety and Depression Scale (AKUADS), and the Positive and Negative Syndrome Scale (PANSS).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
“Studies were conducted in India, Ghana, Zimbabwe, Pakistan, Malawi, South Africa, Uganda, Indonesia, Iraq, Argentina, Botswana Jamaica, Ethiopia, Zambia, and Thailand, primarily at the district (includes village) level (see Table 5).”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
“However, all eligible references were already captured in the search.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Search strategy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
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
“Three papers were pre/post- or prospective cohort studies”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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
“Qualitative measures of impact included participatory action research, implementation research, case study, and other qualitative approaches with an aim to explore broader systems components.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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
“This review demonstrates that there is space for more systematic approaches to studying health systems elements that affect and/or are impacted upon by task-shifting interventions for mental health.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion
Load-bearingStrength:boosted· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably 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
“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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
“While the majority of studies did not explicitly use a systems thinking approach, some studies indicated implicit consideration of systems thinking characteristics.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
“There is a lack of systematic approaches to exploring this complexity in the evaluation of task-shifting interventions.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Conclusions
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
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
“This review shows the complexity of task-shifting interventions by exploring interactions of intervention elements and actors across the six WHO building blocks.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Conclusions
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
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
“Therefore, task shifting is a system-wide intervention that has implications beyond the players and programmes directly involved in its implementation; it reallocates resources across the health system to trigger change.”
§ 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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
Tests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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 study authors read all included full texts and extracted the following data”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Data extraction and analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“Further, the references of included articles were searched to identify additional citations that were not captured in the search as a means of ensuring the robustness of the study.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Search strategy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“In the case of inter-rater disagreement, a third reviewer was consulted on the inclusion or exclusion of the article in question. The third reviewer was blinded and has expertise in health systems research.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Search strategy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“Risk of bias and limitations of included studies were then assessed using more detailed items found on CASP checklists”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Data extraction and analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“Where length of training was not specified, we used our collective judgment to determine whether task shifting was towards a provider with minimal mental health training.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Search strategy
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
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
“A meta-analysis of outcome measures was not done as the interventions were diverse, conducted at multiple scales, and included qualitative evaluations of stakeholder perceptions.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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
“By looking at the level and range of stakeholder engagement, we were able to identify instances were roles and interactions of stakeholders not directly involved in the intervention were explored”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Data extraction and analysis
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Search strategy · plain
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
“The building blocks model allowed for a systematic way to determine whether the impact of the intervention was assessed beyond the specific building blocks in which they were implemented”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Data extraction and analysis
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Search strategy · plain
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
“The training criteria was articulated with input from a health workforce specialist”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Methods > Search strategy
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably 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 calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt 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
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt 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
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably 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.
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
“The barriers and facilitators outlined here showcase the complexity involved in task shifting for mental health and the need for a broader systems approach to mitigating barriers and leveraging facilitators.”
§ 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 calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
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
“Due to the nature of the search strategy, this review highlighted interventions that were conducted primarily in the health sector.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
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
“Taking a systems thinking approach to unpacking task-shifting interventions for mental health will unveil extant opportunities and threats in the current system.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
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
“Overcoming stigma is therefore not necessarily limited to the role of the health sector; the education sector can play an important part in addressing stigma by talking about mental health and raising awareness.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably 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
“Limitations of this review may include the wide variety of mental health interventions, populations studied, and outcome measures included, making it potentially difficult or inappropriate to apply this review's broader conclusions to unique mental health conditions.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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
“With appropriate evidence describing the roles and contributions of diverse sectors to mental health outcomes, there is potential to facilitate strategic intersectoral investment for optimal health impact as well as cost-effectiveness.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. 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
“A system-level understanding of interventions will allow for improved integration and effective engagement of important actors overlooked in the traditional model of implementation and evaluation.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Discussion > Implications for future research
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
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 calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
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
“Task shifting for mental health has been demonstrated as an acceptable and effective approach to addressing the mental health gap in LMICs.”
§ Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclearIt may state two separate claims as one.
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.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Additionally, these and other reviews (for example, see [23]) have not been explicitly situated in an implementation science framework, limiting the applicability of the results to other task-sharing interventions, models, or settings.”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [23]
Experimental — accuracy not yet measuredIn the citing paper
“This is sometimes achieved by the use of “task-shifting” in which delivery of an EBP is accomplished by much lower level—and thus lower cost—staff members such as community health workers or peer coaches [29].”
From Implementation science issues in understanding, collecting, and using cost estimates: A multi-stakeholder perspective (2021) · cites this paper as [29]
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
MajorThe reported intervention and control groups sum to 347 participants, not the stated total of 247.
Reported 247 · recomputed 347
“247 participants (intervention n = 182; wait list controlled n = 165)”
Information and technology percentage is incorrect
MinorSixteen of 25 studies is 64%, not 80%.
Reported 80 · recomputed 64
“Sixteen studies of the 25 (80%), considered the role of information and technology.”
Three cohort or pre/post papers are claimed, but five are listed
MinorThe sentence describes three papers while naming five distinct papers in its supporting citations.
“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).”
Financing percentage is incorrect
MinorUsing the stated denominator of 25 studies, 15 studies represent 60%, not 70%.
Reported 70 · recomputed 60
“Fifteen studies (70%) raised financing issues in task shifting for mental health”
Medicines and medical devices percentage is incorrect
MinorUsing the stated denominator of 25 studies, 11 studies represent 44%, not 55%.
Reported 55 · recomputed 44
“Eleven studies (55%) considered the implications of the medicines and medical devices.”
Citations
Cites
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).”
BackgroundThe 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).”
BackgroundMurray, 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).”
InfluentialThe 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).”
BackgroundInfluentialWang, 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
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).”
BackgroundMethodHuman 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).”
BackgroundTreatment 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).”
BackgroundPatel, 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
Flagged first, then by citations
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
Cited by
Sorted by citations
Firth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30132-4 · Cited by 1,531
Future Directions in Single-Session Youth Mental Health Interventions
Schleider, J. L., Dobias, M. L., Sung, J. Y., & Mullarkey, M. C. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1683852 · Cited by 335
Le, P. D., Eschliman, E. L., Grivel, M. M., Tang, J., Cho, Y. G., Yang, X., Tay, C., Li, T., Bass, J., & Yang, L. H. (2022) · Implementation Science · doi:10.1186/s13012-021-01179-z · Cited by 233
“Additionally, these and other reviews (for example, see [23]) have not been explicitly situated in an implementation science framework, limiting the applicability of the results to other task-sharing interventions, models, or settings.”
BackgroundMahmud, S. A. S., Hossain, S., Muyeed, A., Islam, M. M., & Mohsin, M. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e07393 · Cited by 222
Global mental health and COVID-19
Kola, L. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30235-2 · Cited by 181
Metadata
- 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.
- Venue
- Global Mental Health
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017
- Volume
- 4
- Pages
- e14-e14
- ISSN
- 2054-4251 (ISSN-L)
- 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
- 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
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.
A language model drew the claims from the paper on 2026-10-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-07 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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 ›
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