Digital Technology for Building Capacity of Nonspecialist Health Workers for Task Sharing and Scaling Up Mental Health Care Globally
Open accessAbstract
Workforce shortages pose major obstacles to delivering adequate mental health care and scaling up services to address the global treatment gap. Mounting evidence demonstrates the clinical effectiveness of having nonspecialist health workers, such as community health workers, lay health workers, midwives, or nurses, deliver brief psychosocial treatments for common mental disorders in primary care settings. With rapidly increasing access to, and use of, digital technology worldwide, new opportunities are available to leverage these emerging digital technologies to support nonspecialist health workers and increase mental health workforce capacity. This Perspectives article considers the potential that digital technology holds for supporting nonspecialist health workers in delivering evidence-based mental health care. Specifically, from our search of the academic literature, we identified seven promising examples from primary care settings in different low- and middle-income countries (India, Pakistan, Zimbabwe, Peru, China, and Nigeria) where digital platforms are being used to support delivery of mental health care from a variety of nonspecialist providers by offering training, providing digital tools for diagnosis, guiding treatment, facilitating supervision, and integrating services. We summarize these examples and discuss future opportunities to use digital technology for supporting the development of a trained, effective, and sustainable mental health workforce. We also consider the potential to leverage these technologies for integrating mental health care into existing health systems in low-resource settings.
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- Findingown data
The seven identified examples came from six low-income and middle-income countries: India, Pakistan, Zimbabwe, Peru, China, and Nigeria.
“These studies were from six low-income and middle-income countries, including India, Pakistan, Zimbabwe, Peru, China, and Nigeria.”
Quote in the paperNot a substantial claim - Findingown data
The paper's search identified seven examples of interventions using digital technology to support non-specialist health workers in delivering mental health care.
“We identified seven examples of interventions using digital technology for supporting non-specialist health workers in the delivery of mental health care.”
Quote in the paperSubstantial claim - Findingnone given
Mostly, digital technology served to support or reinforce existing evidence-based mental health programs.
“Importantly, digital technology was largely used to support or strengthen the delivery of existing evidence-based programs for mental health care.”
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Several projects introduced more sophisticated platforms for supervision, care coordination, and ongoing support.
“Several projects also introduced more sophisticated platforms to support supervision, care coordination, and ongoing support for non-specialist health workers.”
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Few studies in the review reported clinically meaningful effectiveness outcomes.
“We found that few studies reported clinically meaningful effectiveness outcomes.”
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- Findingown data
Many projects used widely available technology such as text messaging, voice calls, and smartphones to facilitate supervision and send reminders to patients.
“Many of the projects leveraged technology that is widely available, such as text messaging, voice calls, and smartphones to facilitate supervision of non-specialist health workers, and to allow non-specialist health workers to send reminders and supportive messages to their patients.”
Quote in the paperNot a substantial claim - Findingcitation
For three of the interventions summarized, large-scale evaluations of effectiveness are currently ongoing.
“Importantly, for three of the interventions using digital technology that we summarized here, large-scale evaluations of effectiveness are currently ongoing (published protocols for these studies were included).25,34,37”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [25] Zafar S, Sikander S, Hamdani SU, The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan–study protocol for a randomized controlled trial. Trials. 2016; 17(1): 188. 27048477 PMC4822299 source
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- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221 source
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- cites [37] Gureje O, Oladeji BD, Araya R, Expanding care for perinatal women with depression (EXPONATE): study protocol for a randomized controlled trial of an intervention package for perinatal depression in primary care. BMC psychiatry. 2015; 15(1): 136. 26122982 PMC4486135 source
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- Findingreasoning
The authors concluded that technology seems to be a valuable tool for task-sharing mental health care.
“Importantly, we found that technology appears to offer an important tool for supporting task-sharing of mental health care.”
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No study in the review explicitly described efforts to ensure safety or reduce risks.
“None of the studies described here specifically mentioned efforts to uphold safety or minimize risks.”
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In the reviewed studies, technology was important for enabling communication between non-specialist health workers and their patients or supervisors.
“Among the studies summarized here we found that technology played an important role in facilitating communication, either directly between non-specialist health workers and their patients, or between non-specialist health workers and their supervisors or more specialized providers.”
Quote in the paperSubstantial claim - Findingown data
The authors found two studies that used digital methods to build skills and knowledge among non-specialist health workers.
“We identified two studies that employed digital approaches for supporting skill building and knowledge acquisition among non-specialist health workers.”
Quote in the paperSubstantial claim - Premisecitation
The SMART Mental Health project in Andhra Pradesh, India, used task-sharing and mobile technology to support primary care health workers in providing evidence-based mental health care in remote villages.
“The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health project involved task-sharing and use of mobile technology to support primary care health workers in providing evidence-based mental health care in remote villages in Andhra Pradesh, India.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- cites [29] Maulik PK, Tewari A, Devarapalli S, Kallakuri S, Patel A. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: development and testing of electronic decision support system and formative research to understand perceptions about mental health in rural India. PloS one. 2016; 11(10): e0164404. 27732652 PMC5061375 source
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- Premisecitation
Non-specialist health workers can deliver brief psychosocial treatments for common mental disorders in primary care with clinical effectiveness.
“There is mounting evidence demonstrating the clinical effectiveness of having non-specialist health workers, such as community health workers, lay health workers, midwives, or nurses, deliver brief psychosocial treatments for common mental disorders in primary care settings.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Singla DR, Kohrt BA, Murray LK, Anand A, Chorpita BF, Patel V. Psychological treatments for the world: Lessons from low-and middle-income countries. Annual review of clinical psychology. 2017; 13: 149– 181. PMC5506549 28482687 source
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The Friendship Bench clinical team used mobile phones, including voice calls and text messaging, to supervise lay health workers and provide guidance for challenging cases.
“The clinical team also used mobile phones, including voice calls and text messaging, to provide supervision to the lay health workers as well as guidance and support for responding to challenging cases.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
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- Premisecitation
Many studies, largely from higher income countries, have demonstrated the acceptability and early effectiveness of digital technologies for improving the quality, reach, and impact of mental health care.
“Many studies, largely from higher income countries, have demonstrated the acceptability and early effectiveness of digital technologies, such as mobile phones, telepsychiatry applications, online programs or remote sensors, for improving the quality, reach and impact of mental health care.17”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Naslund JA, Marsch LA, McHugo GJ, Bartels SJ. Emerging mHealth and eHealth interventions for serious mental illness: a review of the literature. Journal of Mental Health. 2015; 24(5): 321– 332. 26017625 PMC4924808 source
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- Premisecitation
TACTS is a digital tablet-based program for supporting training of community health workers, called lady health workers, in Pakistan to deliver the Thinking Healthy Program for perinatal depression.
“The Technology-assisted Cascade Training and Supervision (TACTS) is a digital tablet-based program for supporting the training of community health workers, referred to as lady health workers in Pakistan, to deliver the evidence-based Thinking Healthy Program for perinatal depression.25”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25] Zafar S, Sikander S, Hamdani SU, The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan–study protocol for a randomized controlled trial. Trials. 2016; 17(1): 188. 27048477 PMC4822299 source
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- Premisecitation
In the same trial, Friendship Bench participants had significantly greater reductions in PHQ-9 depressive symptoms than controls at 6 months (adjusted mean difference −6.36; 95% CI −6.45 to −5.27; P<0.001).
“Friendship Bench participants also showed significant reduction in depressive symptoms measured using the 9-item Patient Health Questionnaire (PHQ-9) compared to control group participants at 6-months follow up (adjusted mean difference in PHQ-9 score, −6.36; 95% CI, −6.45 to −5.27; P < 0.001).13”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] Chibanda D, Weiss HA, Verhey R, Effect of a primary care–based psychological intervention on symptoms of common mental disorders in Zimbabwe: a randomized clinical trial. Jama. 2016; 316(24): 2618– 2626. 28027368 source
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- Premisecitation
A review of 27 trials of psychosocial treatments for common mental disorders in adults delivered by non-specialist health workers in low-income and middle-income countries found a pooled effect size of 0.49 (95% CI 0.36-0.62) favoring the interventions over control conditions.
“A recent review of 27 trials involving delivery of psychosocial treatments for common mental disorders in adults by non-specialist health workers in low-income and middle-income countries demonstrated effectiveness of these interventions as reflected by a pooled effect size of 0.49 (95% confidence interval 0.36–0.62), favoring the interventions compared to control conditions.10”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Singla DR, Kohrt BA, Murray LK, Anand A, Chorpita BF, Patel V. Psychological treatments for the world: Lessons from low-and middle-income countries. Annual review of clinical psychology. 2017; 13: 149– 181. PMC5506549 28482687 source
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- Premisecitation
TACTS is currently being evaluated against in-person training by mental health specialists in a non-inferiority randomized controlled trial in post-conflict rural Pakistan, with lady health worker competence as the primary outcome.
“This program is currently being evaluated compared to in-person training delivered by mental health specialists as part of a non-inferiority randomized controlled trial in a post-conflict rural area of Pakistan. The primary outcome is competence of the lady health workers for delivering the intervention.25”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] Zafar S, Sikander S, Hamdani SU, The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan–study protocol for a randomized controlled trial. Trials. 2016; 17(1): 188. 27048477 PMC4822299 source
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- Premisecitation
In SMART, community health workers called Accredited Social Health Activists and primary care doctors were trained to screen, diagnose, and manage common mental disorders using an electronic decision support system.
“In this project, community health workers referred to as Accredited Social Health Activists (ASHAs) and primary care doctors were trained to screen, diagnose and manage common mental disorders using an electronic decision support system.28,29”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- cites [29] Maulik PK, Tewari A, Devarapalli S, Kallakuri S, Patel A. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Project: development and testing of electronic decision support system and formative research to understand perceptions about mental health in rural India. PloS one. 2016; 11(10): e0164404. 27732652 PMC5061375 source
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- Premisecitation
In a 573-patient randomized controlled trial, Friendship Bench participants (n=286) had significantly greater reductions in SSQ-14 symptoms than standard care controls (n=287) at 6 months (adjusted mean difference −4.86; 95% CI −5.63 to −4.10; P<0.001).
“In a randomized controlled trial with 573 patients, those randomized to the Friendship Bench intervention (n=286) showed significant reductions in symptoms measured using the 14-item Shona Symptom Questionnaire (SSQ-14) compared to patients in the standard care control group (n=287) at 6-months follow up (adjusted mean difference in SSQ-14 score, −4.86; 95% CI, −5.63 to −4.10; P < 0.001).13”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] Chibanda D, Weiss HA, Verhey R, Effect of a primary care–based psychological intervention on symptoms of common mental disorders in Zimbabwe: a randomized clinical trial. Jama. 2016; 316(24): 2618– 2626. 28027368 source
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- Premisecitation
Access to and use of digital technology continues to increase rapidly in most countries worldwide.
“The access to and use of digital technology, ranging from mobile phones to web applications, continues to increase rapidly in most countries worldwide.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Kemp S Digital in 2018: World’s Internet Users Pass the 4 Billion Mark. 2018; https://wearesocial.com/blog/2018/01/global-digital-report-2018. Accessed May 9, 2018.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Friendship Bench lay health workers deliver a manualized six-session problem-solving intervention on a bench outside the clinic.
“Trained lay health workers deliver a manualized intervention to patients on a bench situated outside the clinic.27 In total, there are 6 sessions aimed at teaching the participating patients effective techniques for problem solving.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
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- Premisecitation
Low-cost digital tools were used in Atmiyata to enhance learning and feedback.
“Furthermore, low-cost digital tools were used to enhance learning and feedback.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
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- Premisecitation
A 2016 report of over 140 projects found mobile technology was primarily used for data collection, electronic decision support, provider training, and provider-to-provider communication.
“In comparison, a 2016 report summarizing over 140 projects using mobile technology for supporting frontline health workers in lower income countries found that mobile technology was primarily used for supporting data collection and electronic decision support, as well as facilitating provider training and education and provider-to-provider communication.41”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [41] Agarwal S, Rosenblum L, Goldschmidt T, Carras M, Labrique A. Mobile technology in support of frontline health workers. A comprehensive overview of the landscape knowledge gaps and future directions. Johns Hopkins University Global mHealth Initiative; 2016.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
The SMART decision-making algorithm was based on World Health Organization mhGAP guidelines.
“The algorithm to support decision-making related to diagnosis and management was based on guidelines outlined in the World Health Organization (WHO) mhGAP program.30”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [30] World Health Organization. mhGAP training manuals for the mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings-version 2.0 (for field testing). Geneva, Switzerland: World Health Organization; 2017.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Among SMART participants who screened positive for depression or anxiety at baseline, GAD-7 anxiety scores decreased at 3 months (adjusted mean difference −1.3; SE=0.4; P=0.004).
“and a reduction in anxiety measured using the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire (adjusted mean difference in GAD-7, −1.3; SE = 0.4; P = 0.004).28”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- Premisecitation
The Allillanchu program trains primary care providers to use a mobile screening tool for detection and management of depression, anxiety, psychosis, convulsive disorders, and problematic alcohol use.
“This program involves training primary care providers to use a mobile screening tool for the detection and management of depression, anxiety, psychosis, convulsive disorders, and problematic alcohol use.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
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- Premisecitation
Mobile technology was integrated into EXPONATE to provide ongoing monitoring and supervision for community midwives.
“Mobile technology was integrated into the EXPONATE intervention as a way to provide ongoing monitoring and supervision for the midwives.37”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [37] Gureje O, Oladeji BD, Araya R, Expanding care for perinatal women with depression (EXPONATE): study protocol for a randomized controlled trial of an intervention package for perinatal depression in primary care. BMC psychiatry. 2015; 15(1): 136. 26122982 PMC4486135 source
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- Interpretationcitation
The LEAN digital platform enhances task-sharing by facilitating structured digital communication and information sharing between patients and lay health supporters, who are connected with mental health administrators, village doctors, and municipal psychiatrists.
“The digital platform specifically enhances task-sharing by facilitating structured digital communication and information sharing between patients and lay health supporters, who are then connected with mental health administrators and village doctors, and then with municipal psychiatrists.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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- Premisecitation
Integrating mental health services into primary care and shifting provision of evidence-based psychosocial treatments to non-specialist health workers has emerged as a highly promising approach.
“Integrating mental health services into primary care and shifting the provision of evidence-based psychosocial treatments to non-specialist health workers such as community health workers, lay persons, and other frontline health workers has emerged as a highly promising approach.5,6”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [5] Hoeft TJ, Fortney JC, Patel V, Unützer J. Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review. The Journal of rural health. 2018; 34(1): 48– 62. 28084667 PMC5509535 source
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- cites [6] Kroenke K, Unutzer J. Closing the false divide: sustainable approaches to integrating mental health services into primary care. Journal of general internal medicine. 2017; 32(4): 404– 410. 28243873 PMC5377893 source
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- Interpretationcitation
LEAN is unique because technology provides an opportunity to facilitate family member engagement in supporting care for relatives with schizophrenia.
“This approach is also unique because technology provides an opportunity to facilitate the engagement of family members in supporting care for relatives living with schizophrenia.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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- Interpretationcitation
LEAN is novel because it leverages mobile technology to strengthen the health system by integrating care provided by lay health supporters, village doctors, mental health administrators, and psychiatrists.
“This program is novel because it leverages mobile technology as an approach for strengthening the health system by integrating care provided by lay health supporters, village doctors, mental health administrators, and psychiatrists.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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- Premisecitation
In an Allillanchu implementation evaluation, 22 primary care providers, consisting of 12 midwives, 8 nurses, and 2 nursing assistants, were trained.
“As part of an implementation evaluation of this program, 22 primary care providers, consisting of midwives (n=12), nurses (n=8) and nursing assistants (n=2), were trained to deliver this care model.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
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- Premisecitation
In SMART, 21 community health workers and two primary care doctors were trained over two years across 30 villages.
“As part of the program, 21 community health workers and two primary care doctors were trained over a two-year period across 30 villages.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- Interpretationnone given
Sharing mental health care tasks with non-specialist health workers is a highly promising way to overcome workforce shortages and support detection and treatment of common mental disorders.
“Task-sharing mental health care to non-specialist health workers represents a highly promising approach for overcoming workforce shortages to support detection and treatment of common mental disorders.”
Quote in the paperSubstantial claim - Premisecitation
Among SMART participants who screened positive for depression or anxiety at baseline, PHQ-9 depression scores decreased at 3 months (adjusted mean difference −3.6; SE=0.6; P<0.001).
“At 3-months follow up, there was a reduction in depression measured using the PHQ-9 (adjusted mean difference in PHQ-9, −3.6; SE = 0.6; P < 0.001)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- Premisecitation
The Allillanchu Project in low-income areas of Lima, Peru, uses task-sharing through a multi-component digital platform to support primary care providers, including midwives, nurses, and nursing assistants, in early detection, referral, and access to treatment for common mental disorders.
“The Allillanchu Project is based in low-income areas of Lima, Peru, and employs task-sharing through use of a multi-component digital platform for supporting primary care providers, including midwives, nurses, and nursing assistants, in promoting early detection, referral and access to treatment for patients with common mental disorders in primary care settings.32”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
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- Premisecitation
In Allillanchu, patients who screened positive received text messages over 2 weeks with reminders about where and when to find mental health care and encouragement to seek help.
“Patients who screened positive are sent text messages over a 2-week period designed to further motivate them to seek mental health care. The messages consisted of reminders about where and when to find mental health care, as well as motivation and encouragement to seek help to address potential barriers to help seeking.33”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [33] Toyama M, Diez-Canseco F, Busse P, Del Mastro I, Miranda J. Design and content validation of a set of SMS to promote seeking of specialized mental health care within the Allillanchu Project. Global Health, Epidemiology and Genomics. 2018; 3: e2. PMC5870406 29868227 source
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- Premisecitation
LEAN lay providers are supported by a digital e-platform that uses mobile text and voice messaging to send medication reminders to patients and alert lay providers when patients are non-adherent and at risk of relapse.
“The lay providers are supported by a digital e-platform that allows mobile text and voice messaging to provide medication reminders to patients with schizophrenia and to alert the lay providers when patients are non-adherent and at risk of relapse.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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- Premisecitation
The Allillanchu platform sends motivational and reminder text messages to patients in need of treatment to support adherence.
“The platform can also send patients in need of treatment for common mental disorders motivational and reminder text messages to support treatment adherence.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
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- cites [33] Toyama M, Diez-Canseco F, Busse P, Del Mastro I, Miranda J. Design and content validation of a set of SMS to promote seeking of specialized mental health care within the Allillanchu Project. Global Health, Epidemiology and Genomics. 2018; 3: e2. PMC5870406 29868227 source
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- Premisecitation
In SMART, individuals increased their use of mental health services following screening and referral to primary care doctors.
“A key finding was that individuals increased their use of mental health services following screening and referral to the primary care doctor.31”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [31] Tewari A, Kallakuri S, Devarapalli S, Jha V, Patel A, Maulik PK. Process evaluation of the systematic medical appraisal, referral and treatment (SMART) mental health project in rural India. BMC psychiatry. 2017; 17(1): 385. 29202773 PMC5715622 source
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- Premisecitation
The LEAN e-platform integrates lay health supporters and patients with local village doctors, the mental health system, and psychiatrists.
“Lastly, the e-platform integrates the efforts of the lay health supporters and their patients with the local village doctors, as well as the mental health system and psychiatrists.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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- Premisecitation
The SMART program supported with mobile technology was considered feasible and acceptable for use in the rural setting.
“The SMART program supported with mobile technology was considered both feasible and acceptable for use in this rural setting.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
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- Interpretationcitation
Digital technology can potentially support the integration of mental health care into existing health systems.
“Integration of mental health care into existing health care systems is essential46, and digital technology can potentially support these efforts.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [46] Patel V, Belkin GS, Chockalingam A, Cooper J, Saxena S, Unützer J. Grand challenges: integrating mental health services into priority health care platforms. PloS medicine. 2013; 10(5): e1001448. 23737736 PMC3666874 source
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- Premisecitation
Non-specialist health workers are typically embedded in the same communities as their patients and are therefore well positioned to tailor treatments to patients' culture and explanatory models.
“In contrast to specialist mental health clinicians, non-specialist health workers are typically embedded within the same communities as the patients they treat, and are therefore ideally situated to tailor treatments to the culture and explanatory models of illness of their patients.43,44”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [43] Witmer A, Seifer SD, Finocchio L, Leslie J, O’neil EH. Community health workers: integral members of the health care work force. American journal of public health. 1995; 85(8_Pt_1): 1055– 1058. 7625495 PMC1615805 source
Not checked in the free run.
- cites [44] Mendenhall E, De Silva MJ, Hanlon C, Acceptability and feasibility of using non-specialist health workers to deliver mental health care: stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda. Social science & medicine. 2014; 118: 33– 42. 25089962 PMC4167946 source
Not checked in the free run.
- Interpretationreasoning
Digital technology could support ongoing program evaluation and data collection for quality improvement.
“Furthermore, digital technology could serve an important function for enabling real-time program evaluation and capturing data to inform quality improvement efforts.”
Quote in the paperNot a substantial claim - Premisecitation
Wireless connectivity often fluctuates in poor settings, rural areas, and bad weather.
“For example, fluctuations in wireless connectivity are common in impoverished settings and rural areas, and during poor weather conditions.50,51”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [50] Wallis L, Blessing P, Dalwai M, Shin SD. Integrating mHealth at point of care in low-and middle-income settings: the system perspective. Global health action. 2017; 10(sup3): 1327686. PMC5645717 28838302
Not checked in the free run.
- cites [51] Siedner MJ, Lankowski A, Musinga D, Optimizing network connectivity for mobile health technologies in sub-Saharan Africa. PLoS One. 2012; 7(9): e45643. 23029155 PMC3460947
Not checked in the free run.
- Interpretationcitation
As digital technologies support data collection, outcome reporting, surveillance, and communication, there are opportunities to improve health system efficiency and quality of care.
“As digital technologies support non-specialist health workers in data collection, outcome reporting, surveillance, and communication with patients and supervisors, there are important opportunities to inform continuous improvements to the efficiency of health systems and the quality of care delivered.23,49”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [23] Agarwal S, Perry HB, Long LA, Labrique AB. Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review. Tropical medicine & international health. 2015; 20(8): 1003– 1014. 25881735 PMC4692099 source
Not checked in the free run.
- cites [49] Laktabai J, Platt A, Menya D, A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers. PloS one. 2018; 13(2): e0191968. 29389958 PMC5794091 source
Not checked in the free run.
- Premisecitation
In the Atmiyata program in rural India, basic educational videos were disseminated to community members via mobile applications on smartphones.
“In the Atmiyata program in a rural setting in India, basic educational videos were disseminated to community members using mobile applications accessible through a smartphone.24”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
- Interpretationreasoning
Because many evidence-based treatments for common mental disorders involve high human contact, using technology for communication may offer an alternative way to facilitate these connections.
“As many evidence-based treatments for common mental disorders involve a high degree of human contact, emphasis on using technology for communication may offer an alternative to facilitate these connections.”
Quote in the paperSubstantial claim - Interpretationreasoning
Technology holds promise for maximizing human resources capacity by allowing non-specialist health workers to screen and triage mental health concerns during patient visits.
“Furthermore, technology holds promise for maximizing available human resources capacity by allowing non-specialist health workers to screen patients and triage the mental health concerns encountered during their visits with patients.”
Quote in the paperSubstantial claim - Interpretationcitation
Through iterative design, digital content can be adapted to non-specialist health workers' explanatory models, contexts, and language, which could support cultural relevance and user engagement.
“Through iterative design processes, it is possible to extend beyond simply transmitting clinical information and to adapt digital content to non-specialist health workers’ existing explanatory models, diverse contexts, and local language, which could support the cultural relevance of the program materials and promote ownership and engagement among users.45”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [45] Källander K, Tibenderana JK, Akpogheneta OJ, Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low-and middle-income countries: a review. Journal of medical Internet research. 2013; 15(1). PMC3636306 23353680 source
Not checked in the free run.
- Interpretationnone given
In countries with an established cadre of non-specialist health workers, digital technology could play an especially important role in developing their skills and competencies to deliver evidence-based mental health care.
“In countries where there is an established cadre of non-specialist health workers, digital technology could serve an especially important role for developing skills and competencies among these health workers to deliver evidence-based mental health care.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The authors may have seen the same recruitment issue, since non-specialist health workers who accept digital technology are probably already interested and willing to use it.
“We may have observed the same concern here, where non-specialist health workers who agree to use digital technology for supporting delivery of mental health care are likely already interested and willing to use these technologies in their work, and may also be aware of the importance of treating or preventing mental disorders.”
Quote in the paperNot a substantial claim - Premisecitation
This concern is especially relevant for digital interventions for people with mental illness, where technologies are built for those who will use them, not for the larger group who need them.
“This concern is especially prominent in the evaluation of digital interventions for persons living with mental illness, whereby technologies are usually designed for people who will use them, rather than for the larger population of individuals who need them and who are most likely to benefit from them.39”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39] Mohr DC, Weingardt KR, Reddy M, Schueller SM. Three problems with current digital mental health research… and three things we can do about them. Psychiatric services. 2017; 68(5): 427– 429. 28412890 PMC6903906
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- Premisecitation
In digital technology research, recruitment typically favors people already interested in using the technologies, which may represent only a small portion of the broader target population.
“In research with digital technology, recruitment typically favors people who are already interested in using these technologies, which may only represent a small portion of the broader target population.39”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39] Mohr DC, Weingardt KR, Reddy M, Schueller SM. Three problems with current digital mental health research… and three things we can do about them. Psychiatric services. 2017; 68(5): 427– 429. 28412890 PMC6903906
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- Interpretationcitation
The examples add to growing evidence that non-specialist health workers can effectively provide many evidence-based mental health treatments in diverse global settings.
“The examples described in this perspectives article contribute to mounting evidence demonstrating that non-specialist health workers can effectively deliver a wide range of evidence-base mental health treatments across diverse settings globally.5,10”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [5] Hoeft TJ, Fortney JC, Patel V, Unützer J. Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review. The Journal of rural health. 2018; 34(1): 48– 62. 28084667 PMC5509535 source
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- cites [10] Singla DR, Kohrt BA, Murray LK, Anand A, Chorpita BF, Patel V. Psychological treatments for the world: Lessons from low-and middle-income countries. Annual review of clinical psychology. 2017; 13: 149– 181. PMC5506549 28482687 source
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- Premisecitation
In Pakistan, community health workers are currently being trained via a tablet-based system to deliver the Thinking Healthy Program for perinatal depression.
“In another example, a tablet-based system is currently being used to train community health workers to deliver the evidence-based and culturally tailored Thinking Healthy Program involving psychological treatment for perinatal depression in Pakistan.25”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] Zafar S, Sikander S, Hamdani SU, The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan–study protocol for a randomized controlled trial. Trials. 2016; 17(1): 188. 27048477 PMC4822299 source
Not checked in the free run.
- Premisecitation
Reliable wireless internet access is still a major problem in many areas, even as device ownership grows.
“Another consideration is the importance of having consistent and reliable wireless internet access, which remains a key challenge in many regions despite increasing device ownership.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 20
- May combine two claims. 39
Classified as probably not a substantial claim. May combine two claims.
Findingown dataThe authors summarized seven promising examples from six countries, with evidence ranging from large-scale randomized controlled trials to early stage demonstration and implementation projects.
“We summarized seven promising examples from six different countries with evidence ranging from large-scale randomized controlled trials, cohort studies, and early stage demonstration and implementation projects.”
Quote in the paperSubstantial claimMay combine two claims.
FindingreasoningIn the examples, technology largely served to enhance the role of non-specialist health workers by enabling patient connection, training, supervision, and data collection.
“As highlighted in the examples here, technology largely served as a tool for enhancing the role of non-specialist health workers by allowing them to connect with and support their patients, access opportunities for training and skill development, receive supervision and support from more specialized providers, and improve data collection and care coordination.”
Quote in the paperSubstantial claimMay combine two claims.
FindingcitationOf the seven examples, four focused on common mental disorders in primary care or community settings, two on perinatal depression, and one on schizophrenia.
“Four projects focused on common mental disorders in the primary care or community setting24,27,28,32, two projects focused on perinatal depression25,37, and one project leveraged community contacts for supporting care for persons living with schizophrenia.34”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationOf the seven examples, four were in rural settings, one in both urban and rural settings, and two in urban areas.
“Four projects were focused in rural settings24,25,28,34, one study was based in both urban and rural settings37, and two projects were based in urban areas.13,32”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationThe SMART mobile decision support system was developed for basic Android devices and used an OpenMRS platform for secure cloud-based data sharing between community health workers and primary care doctors.
“This mobile decision support system was developed for use on basic Android devices, and used an OpenMRS platform allowing community health workers and primary care doctors to share clinical data securely using the cloud-based servers.28”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
Not checked in the free run.
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PremisecitationThe Atmiyata program includes Android mobile applications, one for champions and one for the public, with e-learning videos and knowledge questions.
“The program also includes Android mobile applications, with one version for the Atmiyata champions and a separate version for the general public and community members. The mobile app contains basic e-learning videos on mental health for the Atmiyata champions with questions built into the app following each training video to test knowledge of mental health topics.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
May combine two claims.
PremisecitationIn Friendship Bench, mobile technology in the form of text messages and phone calls is used to reinforce program content and promote adherence, with up to six messages or calls per patient.
“Mobile technology in the form of text messages and phone calls is used to reinforce program content and to promote adherence among patients enrolled in the intervention.27 Lay health workers send patients up to 6 text messages or phone calls during the program.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAfter the fourth Friendship Bench session, patients can choose a peer group led by prior participants; lay health workers can refer non-improvers after six sessions to a mental health-trained supervisor.
“After the fourth session, participating patients can choose to access a peer group led by prior participants in the Friendship Bench program. The lay health workers can then refer patients who do not improve following the initial 6 sessions to a supervisor with training in mental health for additional support and treatment.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
Not checked in the free run.
May combine two claims.
PremisecitationIn Zimbabwe primary care, 90% of individuals accessing services own mobile phones, making technology a promising approach for reaching patients.
“Technology was identified as a promising approach for reaching patients given that most individuals (90%) accessing primary care services own mobile phones.27”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAtmiyata champions and mitras were provided smartphones to access videos for ongoing training and to refresh their knowledge and skills.
“Atmiyata champions and mitras were provided smartphones to access videos for ongoing training tools to learn about mental health concepts and to refresh their knowledge and skills.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
May combine two claims.
PremisecitationAtmiyata champions were trained to detect mental health problems, provide basic support and counseling, and facilitate referral to mental health professionals.
“The program involved training community volunteers as “Atmiyata champions” to support the detection of mental health problems, provide basic support and counseling to community members with common mental health disorders, and to facilitate referral to mental health professionals when necessary.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
May combine two claims.
PremisecitationAtmiyata is a community-based mental health program in rural India that trains and mobilizes community volunteers to promote wellness, raise awareness, and reduce distress.
“Atmiyata is a community-based mental health program focused on promoting wellness, raising awareness, and reducing distress by training and mobilizing community volunteers.24”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
May combine two claims.
PremisecitationThe Atmiyata project was implemented in 41 villages in rural Maharashtra, India, and trained 59 champions and 264 mitras.
“This project was developed and implemented in 41 villages across rural Maharashtra, India. In total, 59 Atmiyata champions were trained and 264 Atmiyata Mitras were trained.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] Shields-Zeeman L, Pathare S, Walters BH, Kapadia-Kundu N, Joag K. Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach. International journal of mental health systems. 2017; 11(1): 6. 28066505 PMC5210275 source
Not checked in the free run.
May combine two claims.
PremisecitationWorkforce shortages are major obstacles to delivering adequate mental health care and scaling up services to address the global treatment gap, with the shortage of mental health providers being most severe in low-income and middle-income countries.
“Workforce shortages pose major obstacles to delivering adequate mental health care, with the paucity of mental health providers being most severe in low-income and middle-income countries.3,4”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [3] Patel V, Chisholm D, Parikh R, Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities. The Lancet. 2016; 387(10028): 1672– 1685. 26454360 source
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- cites [4] Kakuma R, Minas H, van Ginneken N, Human resources for mental health care: current situation and strategies for action. The Lancet. 2011; 378(9803): 1654– 1663. 22008420 source
Not checked in the free run.
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PremisecitationUse of digital technologies for mental health is not as common in most lower income countries, though interest and growth have increased in recent years.
“Use of digital technologies for mental health is not as common in most lower income countries18, though this has been an important area of increasing interest and growth in recent years.19,20”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [18] Farrington C, Aristidou A, Ruggeri K. mHealth and global mental health: still waiting for the mH 2 wedding? Globalization and health. 2014; 10(1): 1. 24670011 PMC3986901 source
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- cites [19] Naslund JA, Aschbrenner KA, Araya R, Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature. The Lancet Psychiatry. 2017; 4(6): 486– 500. 28433615 PMC5523650 source
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- cites [20] Fairburn CG, Patel V. The impact of digital technology on psychological treatments and their dissemination. Behaviour research and therapy. 2017; 88: 19– 25. 28110672 PMC5214969 source
Not checked in the free run.
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PremisecitationTACTS consists of a tablet-based package with five training sessions covering core techniques and principles of the Thinking Healthy Program, using animated avatars and interactive role-plays.
“TACTS consists of a tablet-based package with five training sessions covering core techniques and principles of the Thinking Healthy Program. Animated ‘avatars’ depict culturally appropriate characters that narrate the sessions and convey the instructional content. The sessions are interactive, and include role-plays to address real-life challenging situations and to reinforce the content and key”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] Zafar S, Sikander S, Hamdani SU, The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan–study protocol for a randomized controlled trial. Trials. 2016; 17(1): 188. 27048477 PMC4822299 source
Not checked in the free run.
May combine two claims.
PremisecitationThere is widespread consensus that integrating mental health services into primary and community healthcare settings and task-sharing are essential for addressing the global treatment gap.
“There is widespread consensus that integrating mental health services into primary and community healthcare settings and task-sharing are essential for addressing the global treatment gap.7,8”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [7] Baingana F, Al’Absi M, Becker AE, Pringle B. Global research challenges and opportunities for mental health and substance-use disorders. Nature. 2015; 527(7578): S172– S177. 26580324 PMC6368440 source
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- cites [8] Fairburn CG, Patel V. The global dissemination of psychological treatments: a road map for research and practice. American Journal of Psychiatry. 2014; 171(5): 495– 498. 24788281 source
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PremisecitationBy early 2018, there were over 5.1 billion unique mobile users, over 3.1 billion social media users, and over 4 billion Internet users.
“By early 2018, it was estimated that there were over 5.1 billion unique mobile users, representing over two thirds of the world’s population, over 3.1 billion social media users, and over 4 billion Internet users.16”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Kemp S Digital in 2018: World’s Internet Users Pass the 4 Billion Mark. 2018; https://wearesocial.com/blog/2018/01/global-digital-report-2018. Accessed May 9, 2018.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
PremisecitationAgarwal and colleagues' framework conceptualizes digital technology support for frontline health workers hierarchically along their professional careers.
“Furthermore, in the framework proposed by Agarwal and colleagues (2015), the ways in which digital technology can support frontline health workers is conceptualized according to a hierarchical framework along the duration of their professional careers.23”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [23] Agarwal S, Perry HB, Long LA, Labrique AB. Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review. Tropical medicine & international health. 2015; 20(8): 1003– 1014. 25881735 PMC4692099 source
Not checked in the free run.
May combine two claims.
PremisecitationThe Friendship Bench intervention is delivered by lay health workers in Zimbabwe and focuses on individual problem-solving for depression and other common mental disorders.
“The Friendship Bench intervention is delivered by lay health workers and focuses on individual problem-solving, and is based on an extensive body of prior research and community efforts focused on targeting depression and other common mental disorders in Zimbabwe.27”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Chibanda D, Bowers T, Verhey R, The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. International journal of mental health systems. 2015; 9(1): 21. 27408619 PMC4940904 source
Not checked in the free run.
May combine two claims.
PremisecitationThe Thinking Healthy Program is a culturally adapted psychosocial intervention delivered by lady health workers that previously demonstrated effectiveness for treating perinatal depression in Pakistan.
“The Thinking Healthy Program is a culturally adapted intervention involving psychosocial treatment delivered by lady health workers that has previously demonstrated effectiveness at successfully treating perinatal depression in Pakistan.26”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [26] Rahman A, Malik A, Sikander S, Roberts C, Creed F. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. The Lancet. 2008; 372(9642): 902– 909. PMC2603063 18790313 source
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PremisecitationThe LEAN digital platform uses checklists to help lay health supporters and patients detect relapse signs, monitor medication use, and deliver educational content about schizophrenia, treatment, and rehabilitation.
“Through the digital platform, checklists are used to assist lay health supporters and patients in detecting signs of relapse, monitoring medication use, and delivering general educational content about schizophrenia, treatment, and rehabilitation.34”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
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PremisecitationAllillanchu primary care providers reported feeling more aware of the importance of patients' mental health and having more knowledge and skills to provide mental health care.
“The primary care providers reported that they felt more aware of the importance of caring for their patients’ mental health concerns, and indicated that they had more knowledge and skills needed to provide mental health care.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn SMART, pre-recorded messages were sent to individuals who screened positive to promote adherence and continuation of care.
“Pre-recorded messages were also sent to individuals who screened positive to promote adherence and continuation of care as recommended by the community health workers and primary care doctors.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
Interpretationnone givenThe success of new digital technology strategies likely depends on whether they can integrate seamlessly into fragmented and under-resourced health systems.
“The success of new strategies involving use of digital technology likely will depend on whether these technologies can integrate seamlessly into already fragmented and heavily under-resourced health systems.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationLEAN involves lay health supporters, mostly family members or community volunteers, who assist with supervising medication use, monitoring relapse and side effects, and supporting referrals and urgent hospital access.
“The LEAN program actively involves lay health supporters who are mostly family members or community volunteers to assist with supervising medication use, monitoring relapse and side effects, and supporting referrals and access to urgent hospital care.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
Not checked in the free run.
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PremisecitationThe Allillanchu mobile screening app yields immediate results about symptoms requiring treatment and provides treatment recommendations and follow-up guidance.
“The mobile screening app yields immediate results about patients’ symptoms that may require treatment, and provides guidance regarding treatment recommendations and follow up to ensure that effective action was taken.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIn Allillanchu, screening data is captured in real time on a web-based platform that allows the research team to monitor progress continuously.
“When primary care providers screen patients using the mobile application, data is captured in real time using a web-based data collection platform that allows the research team to continuously monitor progress.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationLEAN seeks to capitalize on China's '686' initiative and address poor medication adherence and high relapse rates.
“The program seeks to capitalize on the recent ‘686’ countrywide initiative in China to provide practical community-based mental healthcare services35, and address ongoing challenges with poor medication adherence and high rates of relapse.36”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [35] Good BJ, Good M-JD. Significance of the 686 Program for China and for global mental health. Shanghai archives of psychiatry. 2012; 24(3): 175– 177. 25324623 PMC4198850 source
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- cites [36] Li Q, Huang X, Wen H, Liang X, Lei L, Wu J. Retrospective analysis of treatment effectiveness among patients in Mianyang Municipality enrolled in the national community management program for schizophrenia. Shanghai archives of psychiatry. 2012; 24(3): 131– 139. 25324617 PMC4198844 source
Not checked in the free run.
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PremisecitationWhile access to digital technology remains lower in rural or highly impoverished settings, a substantial proportion of the global population has gained access to mobile devices, web platforms, smartphones, and other digital applications in recent years.
“While access to digital technology remains lower in rural areas or in highly impoverished settings, a substantial proportion of the global population has gained access to mobile devices, web platforms, smartphones, and other digital applications in recent years, thereby highlighting new opportunities to make evidence-based mental health interventions available to those in need.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Kemp S Digital in 2018: World’s Internet Users Pass the 4 Billion Mark. 2018; https://wearesocial.com/blog/2018/01/global-digital-report-2018. Accessed May 9, 2018.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationLEAN's effectiveness is currently being evaluated against usual community care in a large-scale randomized controlled trial in 9 villages in rural townships of Hunan province, with medication adherence as primary outcome and symptoms and functioning as secondary outcomes.
“The effectiveness of this program is currently being evaluated compared to usual community care within a large scale randomized controlled trial in 9 villages in rural townships of Hunan province, with medication adherence as the primary outcome, and symptoms and functioning as secondary outcomes.34”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
Not checked in the free run.
May combine two claims.
PremisecitationOver a 9-week Allillanchu period, 1772 patients were enrolled, 733 were screened, 159 (22%) screened positive for a mental disorder, primarily depression or anxiety (n=125), 155 were referred, and all positive patients received follow-up texts.
“Over a 9-week period, 1772 patients were enrolled in the primary care facility, of which 733 were screened by the primary care providers using the digital platform. Of these, 159 (22%) screened positive for a mental disorder, primarily depression or anxiety (n=125). Most (n=155) were referred to mental health care, and all patients who screened positive received follow up text messages from the”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationLEAN includes an award system where patients earn points redeemable for small prizes for responding to reminder text messages.
“In this program, there is an award system to promote motivation by allowing patients to earn points that can be redeemed for small prizes for responding to reminder text messages sent from the e-platform.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
Not checked in the free run.
May combine two claims.
PremisecitationEXPONATE is a stepped care intervention for perinatal depression in Nigeria that uses mobile technology.
“EXPONATE (Expanding Care for Perinatal Women with Depression) is a multicomponent stepped care intervention for perinatal depression in Nigeria supported with mobile technology.37”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [37] Gureje O, Oladeji BD, Araya R, Expanding care for perinatal women with depression (EXPONATE): study protocol for a randomized controlled trial of an intervention package for perinatal depression in primary care. BMC psychiatry. 2015; 15(1): 136. 26122982 PMC4486135 source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based).
InterpretationreasoningWidespread access to and use of digital technology across most settings globally may yield new opportunities to build a proficient and sustainable mental health workforce.
“As we highlight in the following section, the widespread access to and use of digital technology across most settings globally may yield new opportunities to achieve this aim.”
Quote in the paperNot a substantial claim- Rests on an assumption: Across most lower-income settings, few efforts have used digital technologies specifically to support task-sharing and build non-specialist health worker capacity.
May combine two claims.
PremisecitationThis finding is consistent with a systematic review of 42 studies on digital technology for frontline health workers, which showed support for feasibility and acceptability but lacking robust effectiveness evidence.
“This is consistent with a systematic review of 42 studies broadly using digital technology to support the roles of frontline health workers for delivering care for a range of health conditions.23 This prior review showed that despite considerable support for the feasibility and acceptability of using digital approaches, robust evidence on effectiveness was lacking.23”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] Agarwal S, Perry HB, Long LA, Labrique AB. Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review. Tropical medicine & international health. 2015; 20(8): 1003– 1014. 25881735 PMC4692099 source
Not checked in the free run.
May combine two claims.
PremisecitationIn SMART, over 5000 patients were screened for common mental disorders, of whom 238 screened positive and were referred to primary care doctors.
“During this time, over 5000 patients were screened for common mental disorders of which 238 were identified as being positive and were referred to the primary care doctors for treatment.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] Maulik PK, Kallakuri S, Devarapalli S, Vadlamani VK, Jha V, Patel A. Increasing use of mental health services in remote areas using mobile technology: a pre–post evaluation of the SMART Mental Health project in rural India. Journal of global health. 2017; 7(1): 010408. 28400954 PMC5370210 source
Not checked in the free run.
May combine two claims.
PremisecitationThe Allillanchu digital platform appeared to be a successful tool for optimizing detection and referral and for supporting primary care providers in a low-resource setting.
“The digital platform appeared to be a successful tool for optimizing detection and referral processes, and for supporting primary care providers in a low-resource setting.32”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Diez-Canseco F, Toyama M, Ipince A, Integration of a Technology-Based Mental Health Screening Program Into Routine Practices of Primary Health Care Services in Peru (The Allillanchu Project): Development and Implementation. Journal of medical Internet research. 2018; 20(3): e100. 29588272 PMC5893885 source
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningWith rapidly increasing access to and use of digital technology worldwide, there may be new opportunities to leverage emerging digital technologies to support non-specialist health workers and increase mental health workforce capacity.
“With rapidly increasing access to and use of digital technology worldwide, there may be new opportunities to leverage these emerging digital technologies to support non-specialist health workers and increase mental health workforce capacity.”
Quote in the paperSubstantial claim- Rests on an assumption: Across most lower-income settings, few efforts have used digital technologies specifically to support task-sharing and build non-specialist health worker capacity.
Probably not a substantial claim: may not pass S2 (checkable).
PremisecitationIt is necessary to recruit sufficient personnel to train and supervise non-specialist health workers.
“It is necessary to recruit sufficient personnel to train and supervise these providers.15”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [15] Kazdin AE. Addressing the treatment gap: A key challenge for extending evidence-based psychosocial interventions. Behaviour research and therapy. 2017; 88: 7– 18. 28110678 source
Not checked in the free run.
May combine two claims.
PremisecitationEXPONATE was adapted from a Nigerian primary care depression stepped care program and included mhGAP recommendations.
“The EXPONATE intervention was adapted from a stepped care program for depression in primary care previously developed and tested in Nigeria38, and incorporated key treatment recommendations outlined in the mhGAP program.30”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [38] Oladeji BD, Kola L, Abiona T, Montgomery AA, Araya R, Gureje O. A pilot randomized controlled trial of a stepped care intervention package for depression in primary care in Nigeria. BMC psychiatry. 2015; 15(1): 96. 25929840 PMC4424568 source
Not checked in the free run.
- cites [30] World Health Organization. mhGAP training manuals for the mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings-version 2.0 (for field testing). Geneva, Switzerland: World Health Organization; 2017.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe community-based LEAN program in rural China aims to improve medication adherence and relapse prevention among people with schizophrenia.
“The community-based LEAN program aims to improve medication adherence and relapse prevention among people living with schizophrenia in rural China.34”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [34] Xu DR, Gong W, Caine ED, Lay health supporters aided by a mobile phone messaging system to improve care of villagers with schizophrenia in Liuyang, China: protocol for a randomised control trial. BMJ open. 2016; 6(1): e010120. PMC4735204 26792221
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationreasoningCollaborating closely with non-specialist health workers on digital intervention development could help uncover misperceptions and stigmatizing views about mental disorders and allow content to address them.
“By working closely with non-specialist health workers to develop digital interventions, it could also yield opportunities to identify misperceptions and stigmatizing views about mental disorders, making it possible to include content aimed at responding to these concerns.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningDigital technologies have great potential to boost the capacity, skills, and support of non-specialist health workers in low-resource settings, helping reduce the global mental health burden.
“There is immense potential to leverage the increasing availability and reach of digital technologies to enhance the capacity, skills, and support for non-specialist health workers in low-resource settings towards alleviating the global burden of mental disorders.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationIn that report, about 40% of projects used smartphones, and just one focused on mental health.
“Roughly 40% of the projects included in this prior report used smartphones, yet only one project targeted mental health.41”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [41] Agarwal S, Rosenblum L, Goldschmidt T, Carras M, Labrique A. Mobile technology in support of frontline health workers. A comprehensive overview of the landscape knowledge gaps and future directions. Johns Hopkins University Global mHealth Initiative; 2016.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningIndividuals with less severe depression or common mental disorders may be treated directly by non-specialist health workers, while those with complex disorders may be referred to specialists.
“For example, individuals who are distressed or who have less severe forms of depression or other common mental disorders may be treated directly by non-specialist health workers, while individuals with increasingly complex mental disorders may be referred to more specialized providers.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningThe literature search for this perspectives article was not systematic; it was a narrative review expanding on four recent reviews to select promising examples.
“First, our search of the literature was not systematic as we intentionally employed a narrative review expanding on four recent relevant reviews to identify the selection of highly promising examples summarized here.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNon-specialist health workers usually face many chronic health conditions in their work.
“This is especially relevant for non-specialist health workers, as they typically encounter a large burden of chronic health conditions in their work.47”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [47] Patel V, Chatterji S. Integrating mental health in care for noncommunicable diseases: an imperative for person-centered care. Health Affairs. 2015; 34(9): 1498– 1505. 26355051
Not checked in the free run.
May combine two claims.
InterpretationcitationBased on the examples, digital technology can aid communication, data collection, patient tracking, monitoring, and training, all needed to integrate evidence-based mental health care into services for other non-communicable diseases.
“Drawing from the examples summarized here, digital technology can facilitate communication, data collection, patient tracking and monitoring, and training and skill development, all of which are necessary for successfully integrating evidence-based mental health care within existing services for other non-communicable diseases.46”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [46] Patel V, Belkin GS, Chockalingam A, Cooper J, Saxena S, Unützer J. Grand challenges: integrating mental health services into priority health care platforms. PloS medicine. 2013; 10(5): e1001448. 23737736 PMC3666874 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningThe review drew only on published peer-reviewed examples, so it might have missed some evidence and unpublished projects.
“Further, we only considered examples from the published peer-reviewed literature. Therefore, we may not have fully captured the scope of evidence and possible unpublished projects.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Non-specialist health workers need ongoing supervision and support to prevent fatigue and burnout and to sustain high-quality care over time.
“Additionally, non-specialist health workers require ongoing supervision and support to prevent fatigue and worker burnout, and to ensure sustainability and continued delivery of high quality care.”
The paper relies on this without support.
Across most lower-income settings, few efforts have used digital technologies specifically to support task-sharing and build non-specialist health worker capacity.
“However, across most lower income settings, there have been few efforts to employ digital technologies for specifically supporting task-sharing and developing the capacity of non-specialist health workers to meet the care needs of individuals living with mental disorders.”
The paper relies on this without support.
Effective training programs for non-specialist health workers must be tailored to the culture and context of diverse settings.
“Despite successful task-sharing efforts, a key challenge is the need for effective training programs tailored to the culture and context of non-specialist health workers from diverse settings.”
The paper relies on this without support.
Training programs must ensure successful uptake of skills and knowledge for detecting and treating a range of mental disorders in different settings.
“Training programs need to be designed to ensure successful uptake of skills and knowledge for detecting and treating a range of mental disorders in different settings.”
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?
Mobile health technology is a promising but understudied tool to support providers and supervisors under task-shifting models.
“Mobile health technology is a promising but understudied tool to support providers and supervisors under task-shifting models (Naslund et al., 2019; Triplett et al., 2021).”
From Mobile technology and task shifting to improve access to alcohol treatment services in Mozambique (2022) · cites this paper as Naslund et al., 2019
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Depression effect estimate is off-center in its confidence interval
MajorThe reported PHQ-9 confidence interval has a midpoint of −5.86, rather than the stated adjusted mean difference of −6.36. Unlike the preceding SSQ-14 interval, it is markedly asymmetric around its estimate, suggesting that an endpoint or the estimate is misstated.
Reported -6.36 · recomputed -5.86
“adjusted mean difference in PHQ-9 score, −6.36; 95% CI, −6.45 to −5.27; P < 0.001”
Trained Mitras exceed the stated village allocation
MinorAt 4-5 Mitras per village, 41 villages would have at most 205 assigned Mitras, not 264. The text does not explain whether some trained Mitras were left unassigned.
Reported 5 · recomputed 6.439024
“This project was developed and implemented in 41 villages across rural Maharashtra, India. In total, 59 Atmiyata champions were trained and 264 Atmiyata Mitras were trained. There were 1–2 champions and 4–5 Mitras assigned to each village.”
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Mental Health Prevention and Promotion—A Narrative Review
Singh, V., Kumar, A., & Gupta, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.898009 · Cited by 255 · see citing works
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Self-citationDigital Mental Health: The Answer to the Global Mental Health Crisis?
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Mudiyanselage, K. W. W., De Santis, K. K., Jörg, F., Saleem, M., Stewart, R., Zeeb, H., & Busse, H. (2024) · BMC Public Health · doi:10.1186/s12889-023-17417-6 · Cited by 48 · see citing works
Mobile technology and task shifting to improve access to alcohol treatment services in Mozambique
O'Grady, M. A., Mootz, J., Suleman, A., Sweetland, A., Teodoro, E., Anube, A., Feliciano, P., Bezuidenhout, C., Dos Santos, P. F., Fumo, W., et al. (2022) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108549 · Cited by 24 · see citing works
Joshi, U., Naslund, J. A., Anand, A., Tugnawat, D., Vishwakarma, R., Bhan, A., Patel, V., & Lu, C. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2021.114299 · Cited by 24 · see citing works
Self-citationTriplett, N. S., Munson, S., Mbwayo, A., Mutavi, T., Weiner, B. J., Collins, P., Amanya, C., & Dorsey, S. (2021) · Implementation Science Communications · doi:10.1186/s43058-020-00102-9 · Cited by 30 · see citing works
Siddiqui, S., Gonsalves, P. P., & Naslund, J. A. (2022) · Mental Health in a Digital World · doi:10.1016/b978-0-12-822201-0.00004-6 · Cited by 7 · see citing works
Self-citation
- Authors
- Naslund, J. A., Shidhaye, R., & Patel, V.
- Affiliations
- Harvard University (US)
- Corresponding author
- Naslund, John A.
- Venue
- Harvard Review of Psychiatry
- Published
- 2019-05
- Volume
- 27
- Issue
- 3
- Pages
- 181-192
- ISSN
- 1067-3229 (ISSN-L)
- 1465-7309
- PMC
- PMC6517068
- OpenAlex
- W2927028788
- Cited by
- 159
- References
- 48
- Citations by year
- 2026: 22 · 2025: 17 · 2024: 46 · 2023: 31 · 2022: 13 · 2021: 19 · 2020: 8 · 2019: 3
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5u19mh113211-05)
- National Institute of Mental Health (U19 MH-113211)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- digital technologies, task sharing, community health workers, lay health workers, common mental disorders, primary care, low- and middle-income countries, digital training platform, clinical supervision, mental health integration, treatment gap
- MeSH terms
- Mental Disorders, Community Health Workers, Computer-Assisted Instruction, Developing Countries, Health Workforce, Humans, Psychotherapy, Brief, Randomized Controlled Trials as Topic, Capacity Building
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