Description

One of the largest treatment gaps for mental, neurological, and substance use (MNS) disorders in the world can be seen in Sub-Saharan Africa (SSA). According to the World Health Organization (WHO), about 80% of people with serious MNS disorders living in low- and middle-income countries do not receive needed health services. A critical barrier to bridge this treatment gap is the ability to provide adequate human resources for the delivery of essential interventions for MNS disorders. An international workshop was convened in 2009, by the U.S. Institute of Medicine (IOM) Forum on Neuroscience and Nervous Systems Disorders and the Uganda National Academy of Sciences (UNAS) Forum on Health and Nutrition, to bring together stakeholders from across SSA and to foster discussions about improving care for people suffering from MNS disorders and what steps, with potential for the greatest impact, might be considered to bridge the treatment gap.

Due to the broad interest to further examine the treatment gap, the IOM forum organized a second workshop in Kampala, Uganda on September 4 and 5, 2012. The workshop's purpose was to discuss candidate core competencies that providers might need to help ensure the effective delivery of services for MNS disorders. The workshop focused specifically on depression, psychosis, epilepsy, and alcohol use disorders. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary outlines the presentations and discussions by expert panelists and participants of the plenary sessions of the workshop. This summary includes an overview of challenges faced by MNS providers in the SSA, perspectives on the next steps, the 2009 workshop, and more.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON STRENGTHENING HUMAN RESOURCES FOR MENTAL, NEUROLOGICAL, AND SUSBTANCE USE DISORDERS IN SUB-SAHARAN AFRICA
• INSTITUTE OF MEDICINE FORUM ON NEUROSCIENCE AND NERVOUS SYSTEM DISORDERS
• INSTITUTE OF MEDICINE BOARD ON AFRICAN SCIENCE ACADEMY DEVELOPMENT
• Reviewers
• INTRODUCTION
  • Organization of the Workshop and Report
• STRENGTHENING HUMAN RESOURCES
• WHY FOCUS ON DEPRESSION, PSYCHOSIS, EPILEPSY, AND ALCOHOL USE?
• OVERVIEW OF THE 2009 JOINT IOM AND UNAS WORKSHOP
• PROGRESS SINCE 2009
  • WHO mhGAP Intervention Guide
  • Grand Challenges in Global Mental Health
  • Provider Education
• STATUS OF MNS HUMAN RESOURCES IN SUB-SAHARAN AFRICA
  • Defining the Gap
  • Bridging Human Resources Gaps for MNS Disorders
• CHALLENGES FACING MNS CARE PROVIDERS IN SSA
  • Developing Candidate Core Competencies
• MNS DISORDER PROVIDERS
  • Traditional and Faith Health Practitioners
• CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS
  • Participant Comments from Breakout Group Discussions
  • Community/Lay Workers
  • Non-Specialized, Non-Prescribing Providers
  • Non-Specialized Prescribing Providers
  • Specialized Providers
• THE PROCESS OF UPDATING AND INTEGRATING CORE COMPETENCIES
  • Lessons Learned from Integrating Mental Health and HIV Care
  • Zimbabwe
  • Ethiopia
  • Uganda
  • Rwanda
  • Panel Overview
• PERSPECTIVES ON NEXT STEPS
  • Practical Considerations for Moving Forward
  • Closing Remarks
• APPENDIXES
  • A Summary of Candidate Core Competencies
  • B Candidate Core Competencies
  • C Provider Definitions and Relationship Roles
  • D References
  • E Workshop Agenda
  • F Working Groups
  • G Attendees

Rapporteurs: Diana E. Pankevich, Theresa M. Wizemann, Patricia A. Cuff, and Bruce M. Altevogt

This project was supported by contracts between the National Academy of Sciences and the Alzheimer's Association; CeNeRx Biopharma; the Department of Health and Human Services' National Institutes of Health (NIH, Contract No. N01-OD-4-2139) through the National Eye Institute, National Institute of Mental Health, National Institute of Neurological Disorders and Stroke, National Institute on Aging, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and NIH Blueprint for Neuroscience Research; Department of Veterans Affairs; Eli Lilly and Company; Fast Forward, LLC; Foundation for the National Institutes of Health; GE Healthcare, Inc.; GlaxoSmithKline, Inc.; Johnson & Johnson Pharmaceutical Research and Development, LLC; Lundbeck Research USA; Merck Research Laboratories; The Michael J. Fox Foundation for Parkinson's Research; the National Science Foundation (Contract No. OIA-0753701); One Mind for Research; Pfizer Inc.; the Society for Neuroscience; and Wellcome Trust. The views presented in this publication are those of the editors and attributing authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2013. Strengthening human resources through development of candidate core competencies for mental, neurological, and substance use disorders in sub-Saharan Africa: Workshop summary. Washington, DC: The National Academies Press.

NOTICE: The workshop that is the subject of this summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.