Educational and Training Interventions Aimed at Healthcare Workers in the Detection and Management of People With Mental Health Conditions in South and South-East Asia: A Systematic Review

Abstract

Background: To bridge significant mental health treatment gaps, it is essential that the healthcare workforce is able to detect and manage mental health conditions. We aim to synthesise evidence of effective educational and training interventions aimed at healthcare workers to increase their ability to detect and manage mental health conditions in South and South-East Asia.Methods: Systematic review of six electronic academic databases from January 2000 to August 2020 was performed. All primary research studies were eligible if conducted among healthcare workers in South and South-East Asia and reported education and training interventions to improve detection and management of mental health conditions. Quality of studies were assessed using Modified Cochrane Collaboration, ROBINS-I, and Mixed Methods Appraisal Tools and data synthesised by narrative synthesis. Results are reported according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A review protocol was registered with the PROSPERO database (CRD42020203955).Findings: We included 48 of 3,654 screened articles. Thirty-six reported improvements in knowledge and skills in the detection and management of mental health conditions. Training was predominantly delivered to community and primary care health workers to identify and manage common mental health disorders. Commonly used training included the World Health Organization's mhGAP guidelines (n = 9) and Cognitive Behavioural Therapy (n = 8) and were successfully tailored and delivered to healthcare workers. Digitally delivered training was found to be acceptable and effective. Only one study analysed cost effectiveness. Few targeted severe mental illnesses and upskilling mental health specialists or offered long-term follow-up or supervision. We found 21 studies were appraised as low/moderate and 19 as high/critical risk of bias.Interpretation: In low resource country settings, upskilling and capacity building of primary care and community healthcare workers can lead to better detection and management of people with mental health disorders and help reduce the treatment gap.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42020203955.

Assessment of Organizational Capacity in Implementation of the Kenya Mental Health Policy [2015-2030] in Kisumu County

“…Investing in continuous education is essential for improving mental healthcare quality and patient outcomes, as it ensures healthcare professionals stay updated on best practices and advancements in the field. This is supported by previous studies as a key to reducing treatment gap and achieving universal health coverage (Koly et al, 2021) (Kakuma et al, 2011).…”

Empowering health workers and leveraging digital technology to improve access to mental health and epilepsy care: A longitudinal quasi-experimental study in Hlaing Thar Yar Township

“…Nevertheless, and in line with other intervention projects, 24 , 25 , 28 our study suggests that developing skills and competencies of frontline health workers led to patients with mental disorders being identified, diagnosed and managed, and that raising awareness in the township might have helped change attitudes and practices within the community.…”

“…A key step to reducing the treatment gap would be to provide mental health training to frontline non-specialist healthcare workers in order to integrate mental health services into primary care. 22 , 23 , 24 , 25 …”

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

“…Increasing the availability of psychiatric medications and conducting large-scale training to increase the peer responder workforce were also suggested. Many countries have relied on people without MH training to deliver effective psychological interventions [ 34 , 89 ]. Government-level advocacy is also important to increase funding for the sustainability of community-based MH services [ 90 ].…”