A systematic review protocol of educational and training interventions aimed at healthcare workers in the detection and management of people with mental health conditions in South and South-East Asia

2021 
South and South-East Asian countries have significant mental health treatment gaps. To bridge this, it is essential the healthcare workforce is able to detect and manage mental health conditions. We aim to synthesize evidence of effective educational and training interventions aimed at healthcare workers to increase their ability to detect and manage mental health conditions in South and South-East Asia. Methods: Systematic review of six electronic academic databases from January 2000 to August 2020 was performed. All quantitative, qualitative and mixed-method studies were eligible for inclusion if conducted among healthcare workers in South and South-East Asia and reported education and training interventions to improve detection and management of mental health conditions. Quality of studies were assessed using Modified Cochrane Collaboration tool, ROBINS-I tool and MMAT tool and data synthesized by narrative synthesis. Results are reported according to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A review protocol was registered with the PROSPERO database (CRD42020203955). Findings: Of 3654 articles screened, 48 met inclusion criteria. 39 studies evaluated an intervention while nine described the training alone. Out of 39 studies, 38 demonstrated improvements in mental health services provided by healthcare providers, case identification, referral support and patient’s mental health improvement and 36 studies investigated healthcare worker’s knowledge, changing attitude towards mental health, improving skills and reducing stigma against mentally ill patients. We also discovered that training facilitated improvements in detection and treatment of common mental disorders and severe mental illness, increased consultancies, referrals and appropriate medical intervention. Nine studies assessed training outcomes by identifying common mental disorder symptoms reduction, better daily functioning, treatment consistency, disability and risk reduction of severe mental illness. Interpretation: In low resource country settings, upskilling and capacity building of primary care healthcare workers can lead to better detection and management of mental health disorders.
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