Enabling mental health task-sharing : a collective case study of undergraduate clinical associate training programmes in South Africa
Loading...
Date
Authors
Moodley, Saiendhra Vasudevan
Wolvaardt, Jacqueline Elizabeth (Liz)
Grobler, Christoffel
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
BACKGROUND There is a shortage of the human resources needed to deliver mental health services which is
likely to be exacerbated by COVID-19. Due to mental health workforce shortages, task-shifting and task-sharing
approaches have been implemented in a number of countries. Clinical associates, a mid-level cadre working under
the supervision of medical practitioners, could play a role in delivering mental health services but it is not clear if they
are adequately prepared. This study explored the mental health curriculum content of the undergraduate clinical
associate training programmes in South Africa and the views of key informants of the adequacy of training in mental
health.
METHODS A qualitative collective case study approach was utilised for this multisite study at the three universities in
South Africa offering clinical associate degrees. The study consisted of in-depth interviews utilising videoconferencing
of individuals involved in each programme and a document review. Thematic analysis of the data was conducted.
RESULTS Nineteen interviews were conducted. Mental health formed part of the curriculum in all three programmes
with the bulk of the training taking place in the final year of the three-year degree. Facility-based training ranged from
two weeks to four weeks with one university only using hospitals with mental health units while two universities used
hospitals at which the students were based for the year regardless of potential mental health exposure they would
receive. The list of curricula inclusions extended to seldom-seen conditions. The quality of training and supervision
appeared site-dependant and only one university set minimum experiential targets.
CONCLUSION There is a basis on which to build the competencies and skills regarding mental health in this cadre. A
training model that integrates mental health early in the undergraduate curriculum, focuses on common conditions
and those with high disease burden, includes time in a mental health unit, provides facility-based trainers with
detailed guidance to improve standardisation, and includes specific experiential targets that are monitored will
enhance the potential utility of this cadre.
Description
Keywords
Clinical associates, Task-sharing, Mental health, Psychiatry, Curriculum, Training, Assessment
Sustainable Development Goals
Citation
Moodley, S.V., Wolvaardt, J., Grobler, C. 2022, 'Enabling mental health task-sharing : a collective case study of undergraduate clinical associate training programmes in South Africa', BMC Medical Education, vol. 22, art. 745, pp. 1-12, doi : 10.1186/s12909-022-03806-9.