June 2018 Dubai Workshop

Dubai meeting


Meeting Proceedings document can be found here.

The Harvard Medical School Center for Global Health Delivery-Dubai hosted a three-day workshop in Dubai, UAE, bringing together academic, non-governmental, community,  and  government  experts  to  catalyze  consensus  and  ongoing  collaboration  on  implementation  and  benchmarking  of  community-health  worker-delivered  service  delivery  packages  for  common  mental  disorders  (CMDs)  in  low-  and  middle-income  countries  (LMICs). 

The need for this meeting was clear – mental disorders are currently  the  leading  cause  of  disability  worldwide,  and  they  most  frequently  remain  unaddressed  and  untreated  due  to  a  lack  of  access  to  mental  health  care.  It is estimated that  up  to  90%  of  persons  with  common  mental  disorders  in  LMICs  receive  no  treatment  for  their  mental  health  conditions.  Research has now shown  the  effectiveness  and  feasibility  of  community  health  worker-delivered  psychosocial  and  mental  health  support  in  LMICs, however, bottlenecks  in  health  service  delivery  prevent  these  interventions  from  reaching  those  people  who  need  them  the  most  in  low-resource  settings.  Grassroots and community-based  organizations  have  increasingly  been  leveraging  health  care  delivery  platforms  to  deliver  mental  health  services  in  sustained  ways  in  these  settings.  This workshop seized the opportunity to  accelerate  progress  by  supporting  the  development  of  shared  platforms  and  practices  for  delivery  of  innovative  and  sustainable  community-based  mental  health  care  for  common  mental  disorders, in  particular  through  task-sharing  by  community  and  non-specialist  providers. 

The workshop aimed to generate recommendations on scaling up such interventions by: 1) Defining the specific tasks and related competencies for CHWs to increase contact and effective coverage for empirically supported interventions for CMDs; 2) Elaborating the training and supervision protocols and procedures for the delivery of such interventions; 3) Describing the system level strategies for enabling, sustaining and enhancing the effectiveness of such interventions; 4) Defining the role of stakeholder and community engagement for enabling, sustaining and enhancing the effectiveness of such interventions; and 4) Describing the metrics for impact assessment and evaluation designs for such programs. The first day of the workshop focused on synthesizing the evidence across these five objectives through a series of short plenary style lectures and panels. Over the second and third days, participants broke out into small groups to elaborate the best practices, barriers to delivery, and potential strategies for addressing barriers for each of the five areas.

The workshop concluded with participants building consensus around recommendations and knowledge gaps for scaling up CHW-delivered interventions for CMDs. Conversations were energetic and fruitful, and while time was too short to reach complete consensus at the end of the three days, participants committed to continuing these discussions and collaborations in pursuit of much-needed guidance on this issue. All those in attendance will provide iterative feedback on a consensus statement, which will inform a journal article and policy paper to be published in the next year.

Participants in the Scaling Up Community Health Worker-Delivered Interventions for Common Mental Disorders workshop represented a broad community of academics, researchers, policymakers and on-the-ground implementers – including community mental health workers themselves. The workshop was hosted in  collaboration  with  the  new  Harvard  initiative  GlobalMentalHealth@Harvard, a cross-Harvard initiative which aims to transform global mental health through education, research, innovation and engagement, as well as the  nongovernmental  organizations  Partners  In  Health  and  Sangath.

Number of Participants: 61

Number of Countries: 24

Countries Represented: Australia, Bangladesh, Canada, Ethiopia, Haiti, India, Indonesia, Lebanon, Lesotho, Liberia, Malawi, Mexico, Pakistan, Peru, Rwanda, Sierra Leone, South Africa, The Netherlands, UAE, Uganda, Ukraine, United Kingdom, USA, Zimbabwe