Task sharing in psychotherapy as a viable global mental health approach in resource-poor countries and also in high-resource settings

• 作者: Klaus W.Lange
• 来源期刊: 全球健康杂志（英文）
• 年，卷（期）: 2021,（3）
• 所属期刊栏目: SPECIAL ISSUE ON GLOBAL HEALTH AID FOR POVERTY ALLEVIATION
• 页码范围: 120-127
• 页数: 8页
• 语种: 英文

摘要

A global disparity exists between the burden of mental ill-health and the resources available to address this is-sue.Common mental disorders,such as mild-to-moderate depression,anxiety disorders and post-traumatic stress disorder,are associated with a significant decline in health and functioning and contribute significantly to the overall burden of disease.In view of a shortage of mental health professionals in most low-and middle-income countries,task sharing (task shifting) can make an important contribution to improving access to mental health services.Task sharing involves non-specialists in the delivery of health care.The use of lay health workers is premised on the assumption that the shorter training required for non professionals will allow an increase in the provision of required care without the need for an increase in resources and will strengthen and scale-up sustainable health systems.The need for low-tech support in the management of common mental disorders is widespread,and the core resource is humans trained to identify and treat those requiting mental health care.There is a strong evidence base for the effectiveness of task sharing in psychotherapy,and talk therapies,e.g.cognitive behavioral therapy,can easily be delegated to non-specialists,including non-specialist health work-ers,peer helpers and lay people.A (cost-) effective model of mental health care in low-resource settings as well as in high-income countries may include the medical school-based training of some psychiatrists and clinical psychologists in the treatment of referred patients with serious mental illness.These professional mental health specialists would also be trainers and supervisors of non-specialist health workers who would identify common mental health disorders and provide psychotherapy to people with these conditions in a community-based set-ring.Community-based generalism including task sharing rather than centralized specialism may be capable of preventing and treating many common mental disorders with minor financial expenditure.