Eighty percent of the world's population lives in low and middle income countries (LMIC) with few mental health resources, resulting in a substantial mental health treatment gap. Growing evidence indicates that evidence-based mental health treatments can be delivered in LMIC using a task-sharing approach, in which non-professionals deliver care under supervision. Very limited research, however, focuses on how to embed, support, and effectively deliver these treatments within existing, government-supported systems in which they could be scaled up to population-level. With LMIC governments typically spending <2% of their national budgets on mental health, innovative and low-cost options are needed for intervention delivery and for implementation support.
Building and Sustaining Interventions for Children (BASIC): Task-sharing mental health care in low-resource settings builds on our 15-year history of collaborations with research partners in Kenya, prior NIH-funded work that identified mental health needs of orphaned children in LMIC, and iterative and collaborative intervention adaptation and testing using a task-sharing approach, to address these needs. In BASIC, we test the implementation of Trauma-focused Cognitive Behavioral Therapy (TF-CBT), delivered via task-sharing, in two governmental sectors prioritized by our Kenyan partners as potential options for scale up - Education and Health Extension. The recent development of the Kenyan government (leading to more local decision-making), the launch of a National Mental Health Policy, and our Kenyan partners' empowerment work building enthusiasm for TF-CBT are converging to create a local climate in which BASIC could become part of the country plan, if evidence-based guidance for implementation, using mostly existing resources, existed.
Principal Investigator: Kathryn Whetten
CHPIR Staff: Andrew Weinhold, Leonard Ng'Eno, Christine Gray
Partners: Shannon Dorsey at University of Washington (co-PI), ACE Africa Kenya