Wellcome Trust Clinical PhD Programme in International Health at the LSHTM: 'The roles of non-specialist health workers in mental health care provision in developing countries'. (360G-Wellcome-090352_Z_09_Z)

With the significant burden of mental illness in developing countries, the large treatment gap due principally to scarcity of skilled mental health personnel and inequities in their distribution, non-specialist health workers (professionals and non-professionals) (NSHW) are important for task-shifting within mental health care. Growing evidence for NSHWs? use in mental health care highlights the need to systematically examine their roles. India has pioneered decentralised mental health services since the 1970s but so far has had limited success in increasing coverage. Describing programmatic achievements and failures and understanding roles of NSHWs within mental health care are essential for informing policy makers and for building recommendations on effective implementation and sustainability of scaling up community mental health services in India and other low income countries (LICs). This project systematically reviews LIC mental health initiatives, which has not been done before. It explores the history and development of NSHWs? roles in mental health care provision in India through oral and written historical primary source analysis, describes NSHWs current roles through ethnographic observation and interviews and uses Delphi and workshop methods with key international and Indian stakeholders to examine the acceptability and feasibility of non-specialists? roles to inform the development of policies in LICs.