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Cited by 619Mental Health Treatment and AccessGlobal Health Workforce IssuesPsychiatric care and mental health services

Task-sharing approaches to improve mental health care in rural and other low-resource settings: a systematic review

Open access
Hoeft, Theresa J., Fortney, John C., Patel, Vikram, Unützer, Jürgen·2018·The Journal of Rural Health
DOI 10.1111/jrh.12229PMC PMC5509535
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Abstract

Purpose: Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low‐resource areas. This review focuses on task‐shifting approaches and highlights future directions for research in this area. Methods: Systematic review on task sharing of mental health care in rural areas of high‐income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer‐reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low‐ and middle‐income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision‐making tools. Findings: The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature. Conclusions: Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low‐resource settings, though important questions remain. We recommend promising research directions to address these questions.

Integrity signals

Registry

Crossref · 10.1111/jrh.12229

Cites

70 of 70 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 65 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The literature shows task sharing already occurring via CHWs, non-mental-health primary care providers, and mental health specialists.

    “The literature describes task sharing that is happening already through the work of CHWs, non-mental health providers in primary care, and mental health specialists.”
    Quote in the paperSubstantial claim
  • Findingnone given

    CHWs can participate in mental health care through community outreach or clinics.

    “Community health workers may be involved in mental health care delivery, either through community outreach or clinics.”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    In collaborative care, mental health specialists assist primary care providers by reaching out to patients, tracking depression symptoms, recommending treatment changes, and communicating until remission.

    “these mental health specialists support providers in primary care through outreach to patients, monitoring and tracking depression symptoms, suggesting changes in treatment plan when needed, and communicating with the team until the patient’s depression is in remission.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Most primary care task sharing focused on collaborative care for common mental disorders.

    “Most primary care task sharing centered on collaborative care for common mental disorders.10,32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] Unutzer J Katon W Callahan CM Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial JAMA 2002 288 2836 2845 12472325 source

      Not checked in the free run.

    • cites [32] Archer J Bower P Gilbody S Collaborative care for depression and anxiety problems Cochrane Database Syst Rev 2012 10 Cd006525 PMC11627142 23076925

      Not checked in the free run.

  • Findingcitation

    The Alaska Native Tribal Health Consortium BHA Program indicates potential for behavioral-health-trained CHWs integrated into primary care.

    “The Alaska Native Tribal Health Consortium Behavioral Health Aide (BHA) Program highlights the potential for CHWs trained in behavioral health and integrated into primary care.29”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] BHA Behavioral Health Aide Program 2013 3 Anchorage, AK Alaska Native Tribal Health Consortium

      Not checked in the free run.

  • Classified as probably not a substantial claim. 9
  • May combine two claims. 30

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

    Findingown data

    Those 55 articles comprised 8 grey-literature and 47 peer-reviewed items.

    “These articles included 8 from the grey literature and 47 peer-reviewed articles.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The review found 271 items, examined 199 full texts, and kept 182 in the final set.

    “We located 271 articles, reports, and presentations from the peer-reviewed and grey literature, of which 199 full-text articles, reports, and presentations were reviewed and 182 items were retained in the final review”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A CHW-led depression project with immigrant Latinas used a fotonovela and improved depression knowledge and treatment-seeking efficacy while reducing treatment stigma.

    “A CHW-led project on depression with an immigrant Latina population created a fotonovela, a small illustrated storybook, which resulted in improved depression knowledge and efficacy to seek treatment alongside decreased stigma toward depression treatment.24”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] Hernandez MY Organista KC Entertainment-education? A fotonovela? A new strategy to improve depression literacy and help-seeking behaviors in at-risk immigrant Latinas Am J Community Psychol 2013 52 224 235 23907442 source

      Not checked in the free run.

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

    Findingown data

    Grey literature provides little detail on mental health care delivery but reveals growing CHW workforce focus on mental health.

    “The grey literature lacks detail on mental health care delivery, but it gives us insight on this developing focus within the CHW workforce.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The articles described 23 distinct programs.

    “Among these articles, 23 different programs were outlined and are described in Tables 1 and 2.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Five content areas were found in 55 articles and synthesized by theme.

    “Content in these 5 areas was identified in 55 of the articles and synthesized thematically for this review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Telehealth can aid task sharing by supporting care delivery through a remote team member and by educating providers.

    “Telehealth can assist sharing of tasks both through supporting care delivery with the help of a remote team member and through provider education.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Many CHW articles in this review were grey literature (7 of 14) and addressed less severe, common concerns like stress and substance abuse.

    “Many of the CHW articles in this review came from the grey literature (ie, 7 of 14 on CHWs) and focused on less severe, more common mental health concerns such as stress management and substance abuse.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Collaborative care effectiveness studies have included rural populations, and some focused mainly on rural populations.

    “Effectiveness studies of collaborative care have included rural populations10 and some have primarily focused on rural populations.33,34”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [10] Unutzer J Katon W Callahan CM Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial JAMA 2002 288 2836 2845 12472325 source

      Not checked in the free run.

    • cites [33] Fortney JC Pyne JM Edlund MJ A randomized trial of telemedicine-based collaborative care for depression J Gen Intern Med 2007 22 1086 1093 17492326 PMC2305730 source

      Not checked in the free run.

    • cites [34] Fortney JC Pyne JM Mouden SB Practice-based versus telemedicine-based collaborative care for depression in rural federally qualified health centers: a pragmatic randomized comparative effectiveness trial Am J Psychiatry 2013 170 414 425 23429924 PMC3816374 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Setting boundaries and preventing burnout were major challenges in that study.

    “Setting boundaries and avoiding burnout were also substantial challenges.62”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Kaufman AV Scogin FR Burgio LD Morthland MP Ford BK Providing mental health services to older people living in rural communities J Gerontol Soc Work 2007 48 349 365 17210537 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Task sharing may bring challenges involving professional boundaries, confidentiality, burnout, and staff turnover.

    “Task sharing may involve challenges related to professional boundaries, confidentiality, burnout, and staff turnover.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Such consultations help providers treat patients locally and create a community of practice that enhances learning and reduces isolation.

    “Consults help providers treat patients in their communities but also offer a community of practice among providers to enhance learning and reduce feelings of isolation.39”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Scott JD Unruh KT Catlin MC Project ECHO: a model for complex, chronic care in the Pacific Northwest region of the United States J Telemed Telecare 2012 18 481 484 23209269 PMC3647034 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Teleconference training can standardize content for larger groups across distances, but provider time limits hinder completion.

    “Teleconference trainings can standardize the course to a larger group across large distances, but provider time constraints are a barrier to completing such trainings.51”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Hills DJ Robinson T Kelly B Heathcote S Outcomes from the trial implementation of a multidisciplinary online learning program in rural mental health emergency care Educ Health (Abingdon) 2010 23 351 20589605 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One study found potential low-grade turf wars between clinic medical assistants and CHWs.

    “One study highlighted potential low-grade “turf wars” that surfaced between medical assistants at the clinic and CHWs.30”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Waitzkin H Getrich C Heying S Promotoras as mental health practitioners in primary care: a multi-method study of an intervention to address contextual sources of depression J Community Health 2011 36 316 331 20882400 PMC3051073 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Telemedicine can support task sharing through didactic provider education, though distance education has drawbacks.

    “Telemedicine, defined as communications networks used to deliver health care services or medical education across geographic areas,50 can also support task sharing through didactic education for providers though such support must consider drawbacks of distance education.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [50] Sood S Mbarika V Jugoo S What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings Telemed J E Health 2007 13 573 590 17999619 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Agencies in that study reported severe understaffing, and staff had high caseloads with little extra time.

    “Agencies reported being severely understaffed, and staff had high caseloads with little additional time for these activities.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Kaufman AV Scogin FR Burgio LD Morthland MP Ford BK Providing mental health services to older people living in rural communities J Gerontol Soc Work 2007 48 349 365 17210537 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Small rural clinics can make confidential discussion space hard to find, as can home visits where providers meet family or friends.

    “Small rural clinics can present challenges to finding confidential space for discussions,45 as can home visits where providers may encounter family or friends.62”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [45] Gibson K O’Donnell S Coulson H Kakepetum-Schultz T Mental health professionals’ perspectives of telemental health with remote and rural First Nations communities J Telemed Telecare 2011 17 263 267 21824967 source

      Not checked in the free run.

    • cites [62] Kaufman AV Scogin FR Burgio LD Morthland MP Ford BK Providing mental health services to older people living in rural communities J Gerontol Soc Work 2007 48 349 365 17210537 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A New Zealand multidisciplinary rural telepsychiatry program spanning primary care and home visits addressed mental health needs and lowered primary care provider burnout.

    “This approach helped address mental health needs and reduced burnout among primary care providers.44”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Mahmood T Romans S Forbes L The future of specialist psychiatric services in rural New Zealand N Z Med J 2001 114 294 296 11480514

      Not checked in the free run.

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

    Findingcitation

    Some providers prefer personal experience, colleagues, meetings, and presentations over formal didactic training, and some prefer face-to-face workshops to telehealth.

    “Some providers prefer personal experience, colleagues, meetings, and presentations to learn new skills over formal didactic training,53 and some prioritize face-to-face workshops over telehealth delivery.54”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [53] Jameson JP Farmer MS Head KJ Fortney J Teal CR VA community mental health service providers’ utilization of and attitudes toward telemental health care: the gatekeeper’s perspective J Rural Health 2011 27 4 425 432 21967387 source

      Not checked in the free run.

    • cites [54] Bulbrook KM Carey TA Lenthall S Byers L Behan KP Treating mental health in remote communities: what do remote health practitioners need? Rural Remote Health 2012 12 4 2346 23140573

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Televideo-delivered care is generally well accepted and produces outcomes equivalent to in-person care.

    “While delivering care via televideo conferencing is generally well accepted and offers equivalent outcomes to in-person care, additional considerations arose within the review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Some people may prefer long-distance care, including children with developmental disabilities and some First Nations community members who preferred an outside person.

    “Some individuals may prefer long-distance care such as children with developmental disabilities36 and some individuals in a First Nations community who preferred to talk to someone from outside the community.45”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [36] Szeftel R Mandelbaum S Sulman-Smith H Telepsychiatry for children with developmental disabilities: applications for patient care and medical education Child Adolesc Psychiatr Clin N Am 2011 20 95 111 21092915 source

      Not checked in the free run.

    • cites [45] Gibson K O’Donnell S Coulson H Kakepetum-Schultz T Mental health professionals’ perspectives of telemental health with remote and rural First Nations communities J Telemed Telecare 2011 17 263 267 21824967 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Other task-sharing challenges include turf issues and difficulties working across large distances and diverse communities.

    “Additional challenges related to task sharing include turf issues or challenges working across vast geographic distances and diverse communities.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    CHW turnover affects the sustainability of these care models and is understudied.

    “Staff turnover of CHWs impacts sustainability of these models of care and remains understudied.65”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [65] Nkonki L Cliff J Sanders D Lay health worker attrition: important but often ignored Bull World Health Organ 2011 89 919 923 22271950 PMC3260896 source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    Low-income countries have emphasized community health workers in community settings, whereas middle-income countries have successfully adopted collaborative care in primary care.

    “Overall, low income countries have focused more on utilizing CHWs in the community while middle income countries have successfully implemented collaborative care in primary care.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Rural counties account for two-thirds of US counties and roughly one-fifth of the population, yet under 10% of mental health workforce practices are located there.

    “Rural counties make up two-thirds of all counties and about 20% of the US population,1 but fewer than 10% of the mental health workforce practices are in these settings.2”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [1] U.S. Census Bureau Frequently asked questions Accessed August 25, 2015 Available from https://ask.census.gov

      Not checked in the free run.

    • cites [2] Ellis AR Konrad TR Thomas KC Morrissey JP County-level estimates of mental health professional supply in the United States Psychiatr Serv 2009 60 1315 1322 19797370 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Because many studies were descriptive, the authors did not assess study quality and could not synthesize outcomes.

    “As many studies were descriptive in nature, the quality of the studies was not evaluated by the authors and synthesis of study outcomes was not feasible for this review.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prior systematic reviews have found support for collaborative care in treating depression and anxiety.

    “Previous reviews have supported collaborative care for depression and anxiety,32,73”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [32] Archer J Bower P Gilbody S Collaborative care for depression and anxiety problems Cochrane Database Syst Rev 2012 10 Cd006525 PMC11627142 23076925

      Not checked in the free run.

    • cites [73] Coventry PA Hudson JL Kontopantelis E Characteristics of effective collaborative care for treatment of depression: a systematic review and meta-regression of 74 randomised controlled trials PLoS One 2014 9 e108114 25264616 PMC4180075 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Telepsychiatry interventions are promising in rural K-12 schools and rural universities.

    “Telepsychiatry interventions hold promise in both rural K – 12 schools41,42 and rural universities.42,43”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [41] Knopf A School-based telehealth brings psychiatry to rural Georgia Behav Healthc 2013 33 47 48 23479847

      Not checked in the free run.

    • cites [42] Saeed SA Diamond J Bloch RM Use of telepsychiatry to improve care for people with mental illness in rural North Carolina N C Med J 2011 72 219 222 21901921

      Not checked in the free run.

    • cites [43] Khasanshina EV Wolfe WL Emerson EN Stachura ME Counseling center-based tele-mental health for students at a rural university Telemed J E Health 2008 14 35 41 18328023 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Non-specialist providers especially need training, but mental health specialists also need training to work effectively in shared-care teams.

    “Training is especially needed for providers who are not mental health specialists (eg, emergency department staff, CHWs),29,51 but even mental health specialists need training to be effective team members when sharing mental health care tasks with other providers.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [29] BHA Behavioral Health Aide Program 2013 3 Anchorage, AK Alaska Native Tribal Health Consortium

      Not checked in the free run.

    • cites [51] Hills DJ Robinson T Kelly B Heathcote S Outcomes from the trial implementation of a multidisciplinary online learning program in rural mental health emergency care Educ Health (Abingdon) 2010 23 351 20589605 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    An on-site clinical navigator may help personalize televideo care, guide patients through encounters, and prevent undue emotional escalation.

    “an on-site clinical navigator may help make the experience more personal,47 help patients navigate clinical encounters,48 and safeguard against undue emotional escalations.49”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [47] Swinton JJ Robinson WD Bischoff RJ Telehealth and rural depression: physician and patient perspectives Fam Syst Health 2009 27 172 182 19630458 source

      Not checked in the free run.

    • cites [48] Pruthi S Stange KJ Malagrino GD Jr Chawla KS LaRusso NF Kaur JS Successful implementation of a telemedicine-based counseling program for high-risk patients with breast cancer Mayo Clin Proc 2013 88 68 73 23274020 source

      Not checked in the free run.

    • cites [49] Morland LA Greene CJ Rosen C Mauldin PD Frueh BC Issues in the design of a randomized noninferiority clinical trial of telemental health psychotherapy for rural combat veterans with PTSD Contemp Clin Trials 2009 30 513 522 19576299 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Partnership approaches shift power dynamics, which may matter especially for Indigenous communities with colonization histories.

    “This partnership approach creates a shift in the power dynamic that may be particularly important for indigenous communities that have faced a history of colonization.58”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Allan J Campbell M Improving access to hard-to-reach services: a soft entry approach to drug and alcohol services for rural Australian Aboriginal communities Soc Work Health Care 2011 50 443 465 21774586 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The review's search was restricted to PubMed and excluded PsychInfo, CINHAL, and Google Scholar.

    “One limitation of the review was its focus on the PubMed database. The authors did not include PsychInfo, CINHAL, and Google Scholar in the search.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Task sharing is highly relevant and promising for improving access to and meeting mental health care needs in rural and otherwise underserved US communities.

    “The concept of task sharing is highly relevant for improving access to mental health care in rural and otherwise underserved communities in the US”
    • Also stated in: § Conclusion · boosted
      “There is great promise for task sharing to meet mental health needs in rural and other low resources areas in the US.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review's search end date was August 31, 2013.

    “Another limitation is the end date for the review of August 31, 2013.”
    Quote in the paperNot a substantial claim
34 of 34

  • The paper relies on this without support.

    Rural areas in the US can be considered low-resource settings, and findings from this review will generalize to other low-resource US settings.

    “We view rural areas in the US as a low resource setting and feel findings from this review will generalize to other low resource settings in the US.”

  • The paper relies on this without support.

    Many rural and low-resource primary care settings in the US possess the financial resources to implement collaborative care, telemental health, and community health worker programs.

    “In comparison with areas where task sharing is occurring globally, many rural and low resource primary care settings in the US have financial resources to implement collaborative care, telemental health, and programs involving CHWs.”

  • The paper relies on this without support.

    There will never be a sufficient number of specialists, particularly in geriatric and child and adolescent psychiatry.

    “as there will never be enough specialists, especially in areas such as geriatric or child and adolescent psychiatry.”
3 of 3

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?

  • Training non-specialist mental health workers to deliver packages of mental health care under the supervision of mental health specialists in a collaborative, stepped-care, task sharing approach is an effective approach.

    “An effective approach is training non-specialist mental health workers to deliver packages of mental health care under the supervision of mental health specialists in a collaborative, stepped-care, task sharing approach [36].”

    From Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project (2022) · cites this paper as [36]

    The Results sections on education and specialist support describe training non-specialists, supervision, and effectiveness studies of collaborative care. But the stepped-care example is explicitly described as not focused on collaborative care, and the Discussion says evidence on community health workers in mental health care is sparse. The review therefore supports elements of the approach, not an unqualified effectiveness claim for the combined model. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • 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”

    From Digital Technology for Building Capacity of Nonspecialist Health Workers for Task Sharing and Scaling Up Mental Health Care Globally (2019) · cites this paper as [5]

  • 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”

    From Digital Technology for Building Capacity of Nonspecialist Health Workers for Task Sharing and Scaling Up Mental Health Care Globally (2019) · cites this paper as [5]

  • The use of information and communications technology allows mental health specialists to remotely assist primary care teams in underserved locations.

    “Although the uneven distribution of specialized mental health services may preclude adoption of these models in rural primary care practices, the use of information and communications technology (ICT) allows mental health specialists to remotely assist primary care teams in underserved locations [15].”

    From A remote collaborative care program for patients with depression living in rural areas: open-label trial (2018) · cites this paper as [15]

Cites

Flagged first, then by citations

Research works printed but not linked: 8

  1. WHO, 2008, Task Shifting: Global Recommendations and Guidelines
  2. WHO, 2007, The Optimal Mix of Services for Mental Health
  3. 2011, Community Health Workers Evidence‐Based Models Toolbox
  4. Hardeman R., 2012, Community Health Workers in the Midwest: Understanding and Developing the Workforce
  5. Viswanathan M, 2009, Outcomes of Community Health Worker Interventions
  6. Garcia B, 2006, Sisters of Color United for Education Newsletter, 1
  7. Rhett‐Mariscal W, 2008, Promotores in Mental Health in California and the Prevention and Early Intervention Component of the MHSA
  8. 2013, BHA ‐ Behavioral Health Aide Program

Cited by

Sorted by citations

Related

Authors
Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J.
Affiliations
  • University of Washington (US)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Hoeft, Theresa J.
ORCID
Venue
The Journal of Rural Health
Publisher
Wiley
Published
2017-01-13
Volume
34
Issue
1
Pages
48-62
ISSN
  • 0890-765X (ISSN-L)
  • 1748-0361
DOI
10.1111/jrh.12229
PMC
PMC5509535
OpenAlex
W2575377210
Semantic Scholar
666c19b27fcc69d1afa3fa436a47a4f8cede0de1
Cited by
619
References
70
Citations by year
2026: 73 · 2025: 77 · 2024: 102 · 2023: 76 · 2022: 75 · 2021: 113 · 2020: 56 · 2019: 27 · 2018: 18 · 2017: 2
FWCI
4.43
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • The Journal of Rural Health (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders
  • Office of Rural Mental Health Research at the National Institute of Mental Health (#HHSN271201300463P)
  • Geriatric Mental Health Services Research Fellowship through the National Institute of Mental Health (T32 MH073553)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
task shifting, task sharing, rural mental health services, resource-limited settings, community health workers, primary care providers, telemedicine, provider education, confidentiality, mental health workforce shortage, high-income countries
MeSH terms
Community Health Workers, Cooperative Behavior, Humans, Mental Health Services, Quality of Health Care

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