TY - JOUR T1 - Supervision of Task-Shared Mental Health Care in Low-Resource Settings: A Commentary on Programmatic Experience JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 150 LP - 159 DO - 10.9745/GHSP-D-18-00337 VL - 7 IS - 2 AU - Christopher G. Kemp AU - Inge Petersen AU - Arvin Bhana AU - Deepa Rao Y1 - 2019/06/24 UR - http://www.ghspjournal.org/content/7/2/150.abstract N2 - Task-shared mental health care programs in low-resource settings often incorporate supervisory structures that would be difficult to implement at scale, and many rely on foreign specialist experts as supervisors. Future programs could leverage peer supervision, technology, competency assessments/fidelity checklists, and other tools. Mental health care specialists will require training, support, and incentives to supervise generalist care providers.Mental disorders are the leading cause of years lived with disability globally.1 Yet in low- and middle-income countries (LMICs) and other low-resource settings, 75% of people in need of treatment for mental disorders never receive care.2,3 Effective services that are feasible, scalable, and sustainable in the context of critical shortages of financial and human resources are needed to bridge this treatment gap.4–6 Few health systems in LMICs can rely exclusively on specialists to deliver mental health interventions, nor can they afford to develop mental health programs in parallel to other services.7 Instead, they have to rely on existing cadres of health care workers and constrained financial resources to expand access for mental health services.One promising approach has been to deliver psychosocial or pharmacological services via task sharing. Task sharing is an arrangement in which generalists—nonspecialist health professionals, lay workers, affected individuals, or informal caregivers—receive training and appropriate supervision by mental health specialists and screen for or diagnose mental disorders and treat or monitor people affected by them.8 Systematic reviews of task-shared mental health services in low-resource settings have demonstrated that the approach can be acceptable and feasible and can lead to substantial improvements in patient health outcomes, even in settings with few available specialists.9,10To ensure generalist providers adopt evidence-based mental health services and deliver them with fidelity, task-sharing programs must incorporate effective systems for ongoing training, supervision, and mentorship. … ER -