Competency-based mental health supervision: evidence-based tool needs for the humanitarian context

[摘要] The mental health (MH) care needs in humanitarian crises often far outweigh the local workforce capacity, making task-sharing to non-specialist MH staff essential to provide care for people with severe and common mental disorders (Murray and Jordans, Reference Murray and Jordans2016; Singla et al., Reference Singla, Kohrt, Murray, Anand, Chorpita and Patel2017; Patel et al., Reference Patel, Saxena, Lund, Thornicroft, Baingana, Bolton, Chisholm, Collins, Cooper, Eaton, Herrman, Herzallah, Huang, Jordans, Kleinman, Medina-Mora, Morgan, Niaz, Omigbodun, Prince, Rahman, Saraceno, Sarkar, de Silva, Singh, Stein, Sunkel and UnÜtzer2018; Carreño et al., Reference Carreño, Keane, Echeverri, Goodfriend, Tijerino and Fagard2019). Yet, task-sharing strategies cannot (and should not) replace professional accreditation models involving years of training. Clinical supervision of MH staff in task-sharing contexts is widely accepted as a way to guarantee quality of care; however, these activities are not consistently prioritized by MH policy makers who may focus on quick fixes such as one-off trainings without follow-up strategies including supervision, or on the immediate needs of the health care system over the needs of frontline care providers (Kemp et al., Reference Kemp, Petersen, Bhana and Rao2019). In low-resource and humanitarian settings (LRHS), this means that practitioners with limited experience often care for high numbers of extremely vulnerable patients after time-limited training (Faregh et al., Reference Faregh, Lencucha, Ventevogel, Dubale and Kirmayer2019), with expert support only provided occasionally (Kemp et al., Reference Kemp, Petersen, Bhana and Rao2019). Typical capacity building approaches have focused on ensuring fidelity to intervention manuals. The emphasis must shift, however, to building practical clinical skills over time.

[学科分类] 化石学

[关键词] Clinical supervision;competency-based supervision;mhGAP;task-sharing;task-shifting