Expanding mental health services in low- and middle-income countries: A task-shifting framework for delivery of comprehensive, collaborative, and community-based care

This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommo...

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Bibliographic Details
Published in:	Global mental health Vol. 10; p. e16
Main Authors:	Bolton, Paul, West, Joyce, Whitney, Claire, Jordans, Mark J.D., Bass, Judith, Thornicroft, Graham, Murray, Laura, Snider, Leslie, Eaton, Julian, Collins, Pamela Y., Ventevogel, Peter, Smith, Stephanie, Stein, Dan J., Petersen, Inge, Silove, Derrick, Ugo, Victor, Mahoney, John, el Chammay, Rabih, Contreras, Carmen, Eustache, Eddy, Koyiet, Phiona, Wondimu, Esubalew Haile, Upadhaya, Nawaraj, Raviola, Giuseppe
Format:	Journal Article
Language:	English
Published:	Cambridge, UK Cambridge University Press 2023
Subjects:	community-based initiatives global mental health global mental health delivery healthcare system mental health community-based initiatives global mental health delivery healthcare system global mental health mental health
Online Access:	Get full text
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Summary:	This paper proposes a framework for comprehensive, collaborative, and community-based care (C4) for accessible mental health services in low-resource settings. Because mental health conditions have many causes, this framework includes social, public health, wellness and clinical services. It accommodates integration of stand-alone mental health programs with health and non-health community-based services. It addresses gaps in previous models including lack of community-based psychotherapeutic and social services, difficulty in addressing comorbidity of mental and physical conditions, and how workers interact with respect to referral and coordination of care. The framework is based on task-shifting of services to non-specialized workers. While the framework draws on the World Health Organization’s Mental Health Gap Action Program and other global mental health models, there are important differences. The C4 Framework delineates types of workers based on their skills. Separate workers focus on: basic psychoeducation and information sharing; community-level, evidence-based psychotherapeutic counseling; and primary medical care and more advanced, specialized mental health services for more severe or complex cases. This paper is intended for individuals, organizations and governments interested in implementing mental health services. The primary aim is to provide a framework for the provision of widely accessible mental health care and services.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2054-4251 2054-4251
DOI:	10.1017/gmh.2023.5