Task Shifting in Health Service

I developed a task-shifting intervention to address the mental health inequities among the indigenous population of Pima county. Essentially, instead of siloing indigenous mental health services for a few thousand people and a wide geographical area in only one or two locations, task shifting trains lay and paraprofessional individuals as community mental workers to bring those services back to their communities. With proper training and professional support, task-shifting is an effective, lower-cost method of expanding health services in underserved and low-resource communities.

The Centers for Disease Control and Prevention (CDC, 2015) offers a six-step framework for evaluating public health programs, involving stakeholder engagement, describing the program, focusing the evaluation design, gathering credible evidence, justifying one’s conclusions, and ensuring use and sharing what was learned from the evaluation. After involving key community stakeholders, one must define what the program does/addresses as well as the context and environment in which it was implemented; then, one must determine what quality or outcome measures will be considered for evaluation and which benchmarks must be met in order to be considered successful. Next, one must gather evidence relevant to these measures. The task shifting program will be considered successful based on quantitatively measurable reduction in reported days of severe psychological distress, a reduction in binge drinking and substance use, and reduction in suicide deaths, as well as qualitative measures of perceived improved access to mental health services and acceptability of task-shifting such services to lay and paraprofessional community mental health workers.

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This data will help to justify any conclusions made on whether or not the intervention was successful. If unsuccessful, improvements can be made and a re-evaluation performed. If the intervention is considered successful, however, the results of the evaluation should be published and communicated in order to increase awareness of effective strategies for reducing mental health disparities. Thus, similar interventions may be implemented or adapted in other communities across the nation and the globe.