Philip Sharad, Chander K Rakesh, Varshney Prateek, Patley Rahul, Pandey Praveen, Suhas Satish, Nirisha P Lakshmi, Vinay B, Manjunatha Narayana, Kumar C Naveen, Math Suresh Bada
Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
Telemedicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
Indian J Psychol Med. 2022 Nov;44(6):537-543. doi: 10.1177/02537176221074253. Epub 2022 May 3.
The burden of mental health conditions and consequent disability impacts are felt most in low- and middle-income settings. These settings are constrained by the limited availability of resources to provide even essential aspects of mental health care (MHC). Task shifting and sharing interventions have shown promise in delivering community-based MHC across such low-resource settings. Some counseling tasks such as friendship bench interventions have been successfully shifted to laypersons. However, ethical and legal concerns regarding laypersons' incorporation in MHC delivery systems have not been examined.
To examine the ethical and legal concerns surrounding the certification of laypersons as community-based mental health counselors.
We undertook an academic review of various legislations pertinent to MHC service delivery and the certification of allied health care professionals to inform on acceptable and tenable strategies toward incorporating such a task-shifted intervention.
Scaling up the training of human resources to address access problems can be the first step in addressing the MHC access and treatment gaps. The certification of laypersons as community-based mental health counselors, although legally tenuous, can be pioneered by tertiary-level MHC institutions. This certification has sound ethical justification and is a progressive step toward realizing universal mental health coverage.
心理健康问题的负担以及随之而来的残疾影响在低收入和中等收入环境中最为明显。这些环境受到资源有限的限制，甚至无法提供心理健康护理（MHC）的基本方面。任务转移和共享干预措施在这种资源匮乏的环境中提供基于社区的MHC方面显示出了前景。一些咨询任务，如友谊长椅干预措施，已成功转移给非专业人员。然而，关于非专业人员纳入MHC提供系统的伦理和法律问题尚未得到研究。
研究围绕非专业人员认证为社区心理健康顾问的伦理和法律问题。
我们对与MHC服务提供以及相关医疗保健专业人员认证有关的各种立法进行了学术审查，以了解纳入这种任务转移干预措施的可接受和可行策略。
扩大人力资源培训以解决可及性问题可能是解决MHC可及性和治疗差距的第一步。非专业人员认证为社区心理健康顾问，虽然在法律上站不住脚，但可以由三级MHC机构率先开展。这种认证有合理的伦理依据，是朝着实现全民心理健康覆盖迈出的进步一步。
