Most people with mental health conditions around the world do not receive effective care. For example, among people living with depression, just 3% living in low- and middle-income countries receive even minimally adequate treatment, in part due to an insufficient number of workers well-trained in mental health care.
In humanitarian crises, such as those ongoing in Afghanistan, Ethiopia, Yemen, and more recently Ukraine and neighbouring countries, the scale of the need, coupled with the severe shortage of mental health specialists, means that other means of providing mental health and psychosocial support are required.
Psychological interventions can be effectively delivered by non-specialists such as community workers, when they receive training and supervision. However, training and supervision may vary in quality, which can lead to less effective care.
Ensuring high quality and effective psychological support
To ensure quality in training and supervision, WHO, in partnership with UNICEF, developed the Ensuring Quality in Psychological Support (EQUIP) platform. EQUIP guides trainers and supervisors on how to change their existing programmes into competency-based approaches. A competency-based approach uses role plays and assessments of skills to ensure that helpers not only have the knowledge but also the skills needed to deliver quality support.
“Since 2019, the EQUIP project has collaborated with multiple organizations around the world to develop a competency-based approach that can be applied to training of psychological interventions, ” said Dr Mark van Ommeren, whose team is leading the EQUIP programme at WHO. “Through the EQUIP project, tools were developed that are needed by trainers and supervisors to ensure trainees are highly skilled and competent in helping people with depression and anxiety.”
Rozane El Masri, a research coordinator with War Child Lebanon, evaluated the use of EQUIP in training helpers of adolescents affected by armed conflict. She reported that the EQUIP approach significantly enhanced training outcomes. “EQUIP enables trainers to really zoom in on what our trainees need. We understand what areas we need to focus on during training and tailor our sessions accordingly,” she said. Use of EQUIP in Lebanon with non-specialist helpers supporting children and adolescents led to a 17% increase in skill levels compared to standard training approaches. Trainings in Peru and other countries have shown similarly meaningful results.
Launch of digital training for greater accessibility
Before the pandemic, EQUIP was largely delivered by in-person training. However, during the COVID-19 pandemic, the training increasingly moved online. Carla Mirea Sandoval Zapata, a community health worker in Lima, Peru, associated with Socios de Salud (Partners in Health), benefitted from the online resources during the pandemic. Carla said: “I was able to support my neighbour who lost her husband to COVID-19 and was dealing with profound grief. She has now started to slowly get back to her routine and engage with her family members. I’m grateful to have these skills that enable me to support my community, particularly at a time when the mental health of so many people has been impacted.”
Today, WHO and UNICEF are formally launching the digital version of EQUIP, making the platform freely available to support trainers and supervisors. This will considerably increase the accessibility and quality of psychological interventions. In so doing, training programmes around the world will be better positioned to deliver skilled helpers to improve mental health and reduce suffering.