A

Summary of Candidate Core Competencies
1

NOTE: ALL signifies every provider in a particular category. See Table 1 in the main report (page 19) for definitions of acronyms.

Candidate Core Competency Provider Types Condition
Depression Psychosis Epilepsy Alcohol Use
Screening/Identification (SI)
SI.1 Demonstrates awareness of common signs and symptoms Community/Lay Worker ALL ALL ALL ALL
Non-specialized, Non-prescribing ALL ALL ALL ALL
Non-specialized, Prescribing ALL ALL ALL ALL
Specialized ALL ALL ALL ALL
SI.2 Recognizes the potential for risk to self and others Community/Lay Worker ALL ALL ALL ALL
Non-specialized, Non-prescribing ALL ALL ALL ALL
Non-specialized, Prescribing ALL ALL ALL ALL
Specialized ALL ALL ALL ALL

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1 This table presents candidate core competencies discussed by one or more workshop participants. During the workshop, all participants engaged in active discussions of candidate competencies. In some cases, participants expressed differing opinions about whether a particular competency could be useful and included in the list. However, because this is a summary of workshop comments and not meant to provide consensus recommendations, workshop rapporteurs endeavored to include all candidate core competencies discussed by workshop participants across providers and disorders. This table and its content should be attributed to the rapporteurs of this summary as informed by the workshop.



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A Summary of Candidate Core Competencies1 NOTE: ALL signifies every provider in a particular category. See Table 1 in the main report (page 19) for definitions of acronyms. Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use Screening/Identification (SI) SI.1 Community/Lay ALL ALL ALL ALL Demonstrates Worker awareness of Non-specialized, ALL ALL ALL ALL common Non-prescribing signs and Non-specialized, symptoms ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.2 Community/Lay ALL ALL ALL ALL Recognizes Worker the potential Non-specialized, ALL ALL ALL ALL for risk to self Non-prescribing and others Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL 1 This table presents candidate core competencies discussed by one or more workshop participants. During the workshop, all participants engaged in active discussions of candidate competencies. In some cases, participants expressed differing opinions about whether a particular competency could be useful and included in the list. However, because this is a summary of workshop comments and not meant to provide consensus recommendations, workshop rapporteurs endeavored to include all candidate core competencies discussed by workshop participants across providers and disorders. This table and its content should be attributed to the rapporteurs of this summary as informed by the workshop. 49

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50 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use SI.3 Community/Lay ALL ALL ALL ALL Demonstrates Worker basic Non-specialized, knowledge of ALL ALL ALL ALL Non-prescribing causes Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.4 Community/Lay ALL ALL ALL ALL Provides the Worker patient and Non-specialized, community ALL ALL ALL ALL Non-prescribing with awareness Non-specialized, ALL ALL ALL ALL and/or Prescribing education Specialized ALL ALL ALL ALL SI.5 Community/Lay ALL ALL ALL ALL Demonstrates Worker cultural Non-specialized, competence ALL ALL ALL ALL Non-prescribing Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.6 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge of Non-specialized, other mental, ALL ALL ALL ALL Non-prescribing neurological, and substance Non-specialized, ALL ALL ALL ALL use (MNS) Prescribing disorders Specialized ALL ALL ALL ALL

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APPENDIX A 51 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use SI.7 Community/Lay ALL CHW CHW CHW Demonstrates Worker the ability to Non-specialized, screen for and SW, OT SW, OT SW, OT Non-prescribing use screening Non-specialized, tools ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.8 Community/Lay CHW CHW CHW CHW Demonstrates Worker knowledge Non-specialized, and skills in SW, OT SW, OT SW, OT SW, OT Non-prescribing taking patient history Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.9 Community/Lay CHW CHW CHW CHW Demonstrates Worker the ability to Non-specialized, conduct a SW, OT OT SW Non-prescribing mental status exam Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL SI.10 Community/Lay CHW Recognizes Worker patients who Non-specialized, are relapsing SW SW, OT Non-prescribing and require inpatient care Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL

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52 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use SI.11 Community/Lay Demonstrates Worker knowledge Non-specialized, SW, OT SW, OT SW, OT SW, OT and skills to Non-prescribing assess Non-specialized, patients and ALL ALL ALL ALL Prescribing determine level of care PRN, Specialized ALL ALL NE, PS ALL needed SI.12 Community/Lay ALL ALL ALL ALL Identifies Worker cases during Non-specialized, SW SW SW SW home visits Non-prescribing Non-specialized, Prescribing Specialized SI.13 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, identify high- Non-prescribing risk patients or treatment Non-specialized, ALL ALL ALL ALL complications Prescribing (e.g., children, PRN, PRN, PRN, PRN, breastfeeding Specialized NE, PS NE, PS NE, PS NE, PS women) SI.14 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing assess Non-specialized, patients at CO, MD CO, MD CO, MD CO, MD Prescribing risk of relapse PRN, Specialized PS PS NE, PS PY, PS

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APPENDIX A 53 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use SI.15 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing conduct a Non-specialized, physical ALL ALL ALL ALL Prescribing exam PRN, PRN, PRN, PRN, Specialized NE, PS NE, PS NE, PS NE, PS SI.16 Community/Lay Recognizes Worker primary manifest- Non-specialized, tations of Non-prescribing other disorders Non-specialized, (e.g., Prescribing conversion disorder, Specialized NE, PS NE, PS NE, PS NE, PS anxiety) SI.17 Community/Lay Recognizes Worker comorbidities Non-specialized, that cause Non-prescribing secondary Non-specialized, epilepsy ALL Prescribing PRN, Specialized NE, PS

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54 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use SI.18 Community/Lay Recognizes Worker physical features that Non-specialized, might Non-prescribing indicate an underlying condition Non-specialized, CO, MD other than Prescribing epilepsy (e.g., skin lesions, Specialized NE deformities) SI.19 Community/Lay Recognizes Worker serious neurological Non-specialized, disorders that Non-prescribing may be present with seizures or Non-specialized, epilepsy (e.g., CO, MD Prescribing central nervous system infection, Specialized NE, PS stroke, tumor) Formal Diagnosis/Referral (DR) DR.1 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge of Non-specialized, when to refer ALL ALL ALL ALL Non-prescribing to next level Non-specialized, of care/other ALL ALL ALL ALL Prescribing provider/ specialist Specialized ALL ALL ALL ALL

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APPENDIX A 55 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use DR.2 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge of Non-specialized, ALL ALL ALL ALL potential Non-prescribing providers for Non-specialized, specialized ALL ALL ALL ALL Prescribing care within the Specialized ALL ALL ALL ALL community DR.3 Community/Lay CHW CHW CHW CHW Demonstrates Worker skills in Non-specialized, SW, OT SW, OT SW, OT SW, OT assessment of Non-prescribing relative levels Non-specialized, of social, ALL ALL ALL ALL Prescribing cognitive, and physical Specialized ALL ALL ALL ALL functioning DR.4 Community/Lay CHW CHW CHW CHW Demonstrates Worker knowledge of Non-specialized, required Non-prescribing information Non-specialized, for effective ALL ALL ALL ALL Prescribing referral Specialized ALL ALL ALL ALL DR.5 Community/Lay CHW Demonstrates Worker skills in using Non-specialized, OT OT various Non-prescribing assessment Non-specialized, tools ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL

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56 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use DR.6 Community/Lay Demonstrates Worker knowledge Non-specialized, SW, OT SW, OT SW, OT SW, OT and skills in Non-prescribing diagnosis of Non-specialized, psychosocial ALL ALL ALL ALL Prescribing factors related PRN, PRN, PRN, to condition Specialized PY, PS PY, PS ALL PY, PS DR.7 Community/Lay Demonstrates Worker an understanding Non-specialized, of and ability Non-prescribing to apply contextually Non-specialized, appropriate ALL ALL ALL ALL Prescribing diagnostic systems (e.g., Specialized ALL ALL ALL ALL DSM, ICD)2 DR.8 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, make a Non-prescribing formal Non-specialized, ALL ALL ALL ALL diagnosis and Prescribing formulation of differential Specialized ALL ALL ALL ALL diagnosis 2 DSM: Diagnostic and Statistical Manual of Mental Disorders; ICD: International Statistical Classification of Diseases and Related Health Problems.

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APPENDIX A 57 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use DR.9 Community/Lay Demonstrates Worker ability to Non-specialized, determine Non-prescribing severity level Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL DR.10 Community/Lay Demonstrates Worker ability to make a Non-specialized, diagnosis Non-prescribing according to an algorithm Non-specialized, ALL ALL ALL ALL (not Prescribing considered a clinical Specialized ALL ALL ALL ALL diagnosis) DR.11 Community/Lay Demonstrates Worker ability to Non-specialized, interpret Non-prescribing laboratory results Non-specialized, MD MD MD MD Prescribing Specialized NE, PS NE, PS NE, PS NE, PS

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58 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use DR.12 Community/Lay CHW Demonstrates Worker knowledge Non-specialized, about status OT Non-prescribing epilepticus and other Non-specialized, ALL types of Prescribing seizures Specialized ALL DR.13 Community/Lay Demonstrates Worker ability to Non-specialized, SW diagnose Non-prescribing alcohol use Non-specialized, disorders and ALL Prescribing related problems Specialized ALL DR.14 Community/Lay Demonstrates Worker psychological Non-specialized, interview Non-prescribing skills Non-specialized, Prescribing PRN, PRN, PRN, Specialized PY, PS PY, PS ALL PY, PS DR.15 Community/Lay Demonstrates Worker ability to Non-specialized, conduct a Non-prescribing neuro- Non-specialized, psychiatric Prescribing evaluation PY, NE, Specialized PY, PS PY, PS PS PY, PS

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APPENDIX A 59 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use DR.16 Community/Lay Demonstrates Worker knowledge of indications Non-specialized, when electro- Non-prescribing encephalogram (EEG) and/or Non-specialized, MD neuroimaging Prescribing is needed for epilepsy Specialized NE, PS DR.17 Community/Lay Demonstrates Worker ability to Non-specialized, interpret EEG Non-prescribing and Non-specialized, MD neuroimaging Prescribing reports Specialized NE, PS Treatment/Care (TC) TC.1 Community/Lay ALL ALL ALL ALL Provides Worker support for Non-specialized, ALL ALL ALL ALL patients and Non-prescribing families while Non-specialized, in treatment ALL ALL ALL ALL Prescribing and care Specialized ALL ALL ALL ALL

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70 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.40 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing provide proactive Non-specialized, follow-up and ALL ALL ALL ALL Prescribing monitors outcomes of Specialized ALL ALL ALL ALL care TC.41 Community/Lay Demonstrates Worker knowledge of Non-specialized, standard drug Non-prescribing regimens Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.42 Community/Lay Provides Worker mentoring and support to Non-specialized, other health Non-prescribing care providers Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL

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APPENDIX A 71 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.43 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, prescribe, Non-prescribing monitor, and adjust Non-specialized, ALL ALL ALL ALL medication Prescribing per patient response and in PRN, PRN, PRN, consultation Specialized NE, PS NE, PS NE, PS NE, PS with other providers TC.44 Community/Lay Demonstrates ALL ALL ALL ALL Worker ability to offer work, Non-specialized, social, and SW, OT SW, OT SW, OT SW, OT Non-prescribing recreational activities in a Non-specialized, welcoming Prescribing atmosphere Specialized TC.45 Community/Lay Demonstrates Worker skills to provide structured Non-specialized, clinical Non-prescribing interventions Non-specialized, ALL ALL ALL Prescribing Specialized PRN, PS PRN, PS PRN, PS

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72 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.46 Community/Lay Manages Worker acute hospital- ization of Non-specialized, patients with Non-prescribing severe conditions pending Non-specialized, CO, MD CO, MD CO, MD CO, MD review/ Prescribing transfer to mental health specialist Specialized ALL ALL NE, PS ALL TC.47 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing treat comorbidities Non-specialized, ALL ALL ALL ALL according to Prescribing level of PRN, PRN, PRN, PRN, training Specialized NE, PS NE, PS NE, PS NE, PS TC.48 Community/Lay Provides team Worker members with Non-specialized, skills in Non-prescribing assessment, treatment, and Non-specialized, CO, MD CO, MD CO, MD CO, MD follow-up Prescribing PY, NE, Specialized PY, PS PY, PS PS PY, PS

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APPENDIX A 73 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.49 Community/Lay Screens for Worker adverse Non-specialized, events and PH PH PH PH Non-prescribing allergies Non-specialized, ALL ALL ALL ALL Prescribing Specialized NE, PS TC.50 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing supervise treatment and Non-specialized, care/follow- CO, MD CO, MD CO, MD CO, MD Prescribing up care by other PY, NE, PY, NE, PY, NE, PY, NE, Specialized PS PS PS PS providers TC.51 Community/Lay Manages Worker inpatient Non-specialized, treatment and Non-prescribing care Non-specialized, CO, MD CO, MD CO, MD CO, MD Prescribing Specialized ALL ALL ALL ALL TC.52 Community/Lay ALL Provides Worker follow-up and referral for Non-specialized, SW, OT patients with Non-prescribing active Non-specialized, CO, MD epilepsy; Prescribing recognizes status epilepticus Specialized NE, PS and referral as an emergency

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74 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.53 Community/Lay CHW Demonstrates Worker mental health Non-specialized, promotion Non-prescribing skills to Non-specialized, prevent ALL Prescribing depression Specialized ALL TC.54 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, provide Non-prescribing medication management for complex Non-specialized, MD cases, Prescribing including second- and PRN, third-line Specialized NE, PS PS NE, PS PS medications TC.55 Community/Lay Supervises Worker complex Non-specialized, regimens Non-prescribing requiring more than one Non-specialized, MD drug Prescribing Specialized NE, PS NE, PS NE, PS NE, PS TC.56 Community/Lay Administers Worker long-term Non-specialized, interventions Non-prescribing Non-specialized, Prescribing Specialized PY, PS PY, PS NE PY, PS

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APPENDIX A 75 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.57 Demonstrates Community/Lay knowledge Worker and skills to provide Non-specialized, structured Non-prescribing psychosocial interventions, individual Non-specialized, and group Prescribing (e.g., interpersonal psycho- Specialized PY, PS PY, PS PY, PS therapy, CBT, PST)3 TC.58 Community/Lay Defines and Worker initiates a Non-specialized, treatment Non-prescribing plan Non-specialized, CO, MD Prescribing PY, NE, PY, NE, PY, NE, Specialized PS PS NE, PS PS 3 CBT = cognitive behavioral therapy; PST = problem solving therapy.

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76 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.59 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, apply various Non-prescribing modalities of psycho- Non-specialized, therapy to Prescribing treat patients Specialized PY, PS PY, PS PY, PS PY, PS TC.60 Community/Lay Recognizes Worker when to consult Non-specialized, PH PH PH PH prescriber Non-prescribing about appropriate- Non-specialized, ness of Prescribing prescription (e.g., wrong dose, critical drug Specialized interaction) TC.61 Community/Lay Develops and Worker administers a Non-specialized, rehabilitation OT OT OT OT Non-prescribing plan in consultation Non-specialized, with primary Prescribing care provider Specialized

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APPENDIX A 77 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.62 Community/Lay Demonstrates Worker skills to Non-specialized, OT OT OT OT monitor and Non-prescribing assist in Non-specialized, rehabilitation Prescribing Specialized TC.63 Community/Lay Provides Worker supervision of Non-specialized, complex Non-prescribing cases, Non-specialized, including Prescribing those with neurological Specialized NE, PS NE, PS NE, PS NE, PS comorbidities TC.64 Community/Lay Manages Worker status Non-specialized, epilepticus Non-prescribing Non-specialized, ALL Prescribing Specialized NE, PS TC.65 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, treat serious Non-prescribing neurological disorders that may present Non-specialized, MD with seizures Prescribing or epilepsy (e.g., CNS infection, Specialized NE, PS stroke, tumor)

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78 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.66 Community/Lay Administers Worker modified Non-specialized, electro- Non-prescribing convulsive Non-specialized, therapy Prescribing (ECT) PRN, Specialized NE, PS TC.67 Community/Lay Demonstrates Worker knowledge of drug dosing Non-specialized, PH for children Non-prescribing and adults, titration (both Non-specialized, ALL first-line Prescribing drugs and adjuncts) Specialized NE, PS TC.68 Community/Lay Demonstrates Worker knowledge and skills in Non-specialized, treatment of Non-prescribing cases complicated by infectious Non-specialized, and non- Prescribing communicable diseases (e.g., HIV/AIDS) Specialized NE, PS NE, PS NE, PS NE, PS

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APPENDIX A 79 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.69 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing provide a full range of Non-specialized, psychological Prescribing therapies Specialized PY PY PY TC.70 Community/Lay Demonstrates Worker knowledge of Non-specialized, when to Non-prescribing initiate treatment if a Non-specialized, CO, comorbid Prescribing MD neurological condition Specialized NE NE NE exists TC.71 Community/Lay Demonstrates Worker knowledge and skills for Non-specialized, the selection Non-prescribing of patients for surgical Non-specialized, management Prescribing Specialized NE

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80 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.72 Community/Lay Demonstrates Worker skills to Non-specialized, provide social SW Non-prescribing intervention —addressing Non-specialized, social Prescribing problems that led to/are maintaining Specialized depression TC.73 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to Non-prescribing manage Non-specialized, refractory Prescribing epilepsy Specialized NE TC.74 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills in Non-prescribing management Non-specialized, of psychiatric Prescribing comorbidities Specialized PS, NE TC.75 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills in Non-prescribing management Non-specialized, of pseudo- MD Prescribing seizures Specialized PS, NE