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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 52
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 53
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 54
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 55
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 56
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 57
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 58
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 59
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 60
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 61
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 62
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 63
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 64
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 65
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 68
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 69
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 70
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 71
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 72
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 73
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 74
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Page 75
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 76
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 77
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
×
Page 78
Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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Suggested Citation:"Appendix A: Summary of Candidate Core Competencies." Institute of Medicine. 2013. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18348.
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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

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

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

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

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

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

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

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.

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

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

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

60 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.2 Identifies and Community/Lay ALL ALL ALL ALL assists Worker patients and families in overcoming Non-specialized, ALL ALL ALL ALL barriers to Non-prescribing successful treatment and recovery (e.g., Non-specialized, ALL ALL ALL ALL adherence, Prescribing stigma, finances, accessibility, access to Specialized ALL ALL ALL ALL social support) TC.3 Community/Lay ALL ALL ALL ALL Demonstrates Worker ability to Non-specialized, ALL ALL ALL ALL monitor Non-prescribing mental status Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.4 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge of Non-specialized, ALL ALL ALL ALL how to offer Non-prescribing emergency Non-specialized, first aid ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL

APPENDIX A 61 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.5 Community/Lay Initiates ALL ALL ALL ALL Worker and/or participates in Non-specialized, ALL ALL ALL ALL community- Non-prescribing based Non-specialized, treatment, ALL ALL ALL ALL Prescribing care, and/or prevention Specialized ALL ALL ALL ALL programs TC.6 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge of Non-specialized, ALL ALL ALL ALL treatment and Non-prescribing care resources Non-specialized, in the ALL ALL ALL ALL Prescribing community Specialized ALL ALL ALL ALL TC.7 Community/Lay ALL ALL ALL ALL Promotes Worker mental health Non-specialized, ALL ALL ALL ALL literacy (e.g., Non-prescribing to minimize Non-specialized, impact of ALL ALL ALL ALL Prescribing stigma and discrimi- Specialized ALL ALL ALL ALL nation) TC.8 Community/Lay ALL ALL ALL ALL Commu- Worker nicates to the Non-specialized, ALL ALL ALL ALL public about Non-prescribing MNS Non-specialized, disorders ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL

62 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.9 Community/Lay ALL ALL ALL ALL Monitors for Worker adherence to Non-specialized, ALL ALL ALL ALL and/or side Non-prescribing effects of Non-specialized, medication ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.10 Community/Lay Practices ALL ALL ALL ALL Worker good therapeutic Non-specialized, ALL ALL ALL ALL patient Non-prescribing interactions (e.g., com- Non-specialized, ALL ALL ALL ALL munication, Prescribing relationship, attitude) Specialized ALL ALL ALL ALL TC.11 Community/Lay ALL ALL ALL ALL Provides links Worker between Non-specialized, patients and ALL ALL ALL ALL Non-prescribing community Non-specialized, resources ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.12 Community/Lay ALL ALL ALL ALL Identifies Worker available Non-specialized, resources to ALL ALL ALL ALL Non-prescribing support patients (e.g., Non-specialized, ALL ALL ALL ALL rehabilitation, Prescribing medication supplies) Specialized ALL ALL ALL ALL

APPENDIX A 63 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.13 Community/Lay Promotes ALL ALL ALL ALL Worker activities that aim to raise Non-specialized, ALL ALL ALL ALL awareness Non-prescribing and improve the uptake of Non-specialized, ALL ALL ALL ALL interventions Prescribing and the use of services Specialized ALL ALL ALL ALL TC.14 Community/Lay ALL ALL ALL ALL Protects Worker patients and Non-specialized, identifies ALL ALL ALL ALL Non-prescribing vulnerabilities (e.g., human Non-specialized, ALL ALL ALL ALL rights) Prescribing Specialized ALL ALL ALL ALL TC.15 Community/Lay Demonstrates ALL ALL ALL ALL Worker respect, compassion, Non-specialized, ALL ALL ALL ALL and respon- Non-prescribing siveness to patient needs Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.16 Community/Lay ALL ALL ALL ALL Demonstrates Worker knowledge and skills to Non-specialized, ALL ALL ALL ALL use Non-prescribing information Non-specialized, technology to ALL ALL ALL ALL Prescribing improve treatment and Specialized ALL ALL ALL ALL care

64 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.17 Community/Lay Demonstrates ALL ALL ALL ALL Worker ability in general Non-specialized, SW SW SW SW counseling Non-prescribing skills Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.18 Community/Lay ALL ALL Demonstrates Worker ability to Non-specialized, SW SW SW administer Non-prescribing brief Non-specialized, interventions ALL ALL ALL Prescribing Specialized ALL ALL ALL TC.19 Community/Lay Demonstrates Worker ability to select Non-specialized, appropriate Non-prescribing treatment based on an Non-specialized, ALL ALL ALL ALL understanding Prescribing of diagnosis Specialized ALL ALL ALL ALL TC.20 Community/Lay Initiates, ALL ALL ALL ALL Worker organizes, and/or Non-specialized, SW, OT SW, OT SW, OT SW, OT facilitates Non-prescribing self-help or Non-specialized, support ALL ALL ALL ALL Prescribing groups PRN, PRN, PRN, PRN, Specialized PY PY PY PY

APPENDIX A 65 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.21 Community/Lay CHW CHW CHW CHW Provides brief Worker advice on Non-specialized, symptom SW SW SW SW Non-prescribing management Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.22 Community/Lay Demonstrates CHW CHW Worker skills to provide Non-specialized, SW, OT SW, OT OT psychosocial Non-prescribing interventions Non-specialized, ALL ALL ALL Prescribing PRN, Specialized ALL ALL PY ALL TC.23 Community/Lay Conducts CHW CHW CHW Worker relapse prevention Non-specialized, SW SW SW programs Non-prescribing Non-specialized, CO, RN CO, RN CO, RN Prescribing Specialized PY PY PY TC.24 Community/Lay Demonstrates CHW CHW CHW CHW Worker skills in home visitation Non-specialized, SW, OT SW, OT SW, OT SW, OT Non-prescribing Non-specialized, CO CO CO CO Prescribing Specialized

66 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.25 Community/Lay ALL ALL ALL ALL Assists with Worker adjustments Non-specialized, following SW, OT SW, OT SW, OT SW, OT Non-prescribing discharge Non-specialized, CO, RN CO, RN CO, RN CO, RN Prescribing Specialized TC.26 Community/Lay CHW CHW CHW CHE Demonstrates Worker competence Non-specialized, in the SW SW SW Non-prescribing delivery of evidence- Non-specialized, CO CO CO, MD CO based Prescribing therapies PY, NE, Specialized PY, PS PY, PS PS PY, PS TC.27 Community/Lay Advises Worker patients and Non-specialized, families on PH, SW PH, SW PH, SW PH, SW Non-prescribing taking medications Non-specialized, ALL ALL ALL ALL properly Prescribing PRN, PRN, PRN, PRN, Specialized NE, PS NE, PS NE, PS NE, PS

APPENDIX A 67 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.28 Community/Lay Demonstrates Worker knowledge of Non-specialized, and ability to SW SW SW SW Non-prescribing apply relevant legislation Non-specialized, and policies ALL ALL ALL ALL Prescribing and access to appropriate Specialized ALL ALL ALL ALL services TC.29 Community/Lay Demonstrates Worker knowledge of Non-specialized, drug PH, SW PH, SW PH, SW PH, SW Non-prescribing interactions Non-specialized, ALL ALL ALL ALL Prescribing PRN, PRN, PRN, PRN, Specialized NE, PS NE, PS NE, PS NE, PS TC.30 Community/Lay CHW CHW CHW CHW Provides Worker appropriate Non-specialized, forms of SW SW SW SW Non-prescribing therapy (e.g., individual Non-specialized, CO CO CO CO group, family, Prescribing marital) Specialized PY PY PY PY TC.31 Community/Lay CHW CHW CHW CHW Demonstrates Worker knowledge of Non-specialized, community- SW, OT SW, OT SW, OT SW, OT Non-prescribing based rehabilitation Non-specialized, ALL ALL ALL ALL approaches Prescribing Specialized

68 CANDIDATE CORE COMPETENCIES FOR MNS DISORDERS IN SSA Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.32 Community/Lay Educates Worker patients about Non-specialized, side effects, PH PH PH PH Non-prescribing contra- indications, Non-specialized, ALL ALL ALL ALL etc. Prescribing PRN, PRN, PRN, PRN, Specialized NE, PS NE, PS NE, PS NE, PS TC.33 Community/Lay Demonstrates Worker skills to provide long- Non-specialized, OT OT OT OT term Non-prescribing support/care Non-specialized, ALL ALL ALL ALL Prescribing PRN, PRN, Specialized PY, PS PRN, PS PRN, PS PY, PS TC.34 Community/Lay Reports Worker information Non-specialized, to relevant SW, OT SW, OT SW, OT SW, OT Non-prescribing health management Non-specialized, ALL ALL ALL ALL systems Prescribing Specialized ALL ALL ALL ALL TC.35 Community/Lay Demonstrates Worker knowledge Non-specialized, and skills to PH PH PH PH Non-prescribing dispense medications Non-specialized, MD MD MD MD Prescribing Specialized NE, PS NE, PS NE, PS NE, PS

APPENDIX A 69 Candidate Condition Core Provider Types Alcohol Depression Psychosis Epilepsy Competency Use TC.36 Community/Lay CHW CHW CHW CHW Assists Worker patients with Non-specialized, access to SW SW SW SW Non-prescribing other providers and Non-specialized, ALL ALL ALL ALL helps Prescribing coordinate efforts Specialized ALL ALL ALL ALL TC.37 Community/Lay CHW CHW CHW CHW Provides Worker advice on Non-specialized, symptom SW SW SW SW Non-prescribing management Non-specialized, ALL ALL ALL ALL Prescribing PRN, PRN, PRN, Specialized PY, PS PY, PS ALL PY, PS TC.38 Community/Lay Documents Worker medical records Non-specialized, Non-prescribing Non-specialized, ALL ALL ALL ALL Prescribing Specialized ALL ALL ALL ALL TC.39 Community/Lay Demonstrates Worker knowledge and skills to Non-specialized, consult with Non-prescribing other providers in Non-specialized, ALL ALL ALL ALL the Prescribing treatment/care team Specialized ALL ALL ALL ALL

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

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

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

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

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

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.

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

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)

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

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

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

Next: Appendix B: Candidate Core Competencies »
Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary Get This Book
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One of the largest treatment gaps for mental, neurological, and substance use (MNS) disorders in the world can be seen in Sub-Saharan Africa (SSA). According to the World Health Organization (WHO), about 80% of people with serious MNS disorders living in low- and middle-income countries do not receive needed health services. A critical barrier to bridge this treatment gap is the ability to provide adequate human resources for the delivery of essential interventions for MNS disorders. An international workshop was convened in 2009, by the .S. Institute of Medicine (IOM) Forum on Neuroscience and Nervous Systems Disorders and the Uganda National Academy of Sciences (UNAS) Forum on Health and Nutrition, to bring together stakeholders from across SSA and to foster discussions about improving care for people suffering from MNS disorders and what steps, with potential for the greatest impact, might be considered to bridge the treatment gap.

Due to the broad interest to further examine the treatment gap, the IOM forum organized a second workshop in Kampala, Uganda on September 4 and 5, 2012. The workshop's purpose was to discuss candidate core competencies that providers might need to help ensure the effective delivery of services for MNS disorders. The workshop focused specifically on depression, psychosis, epilepsy, and alcohol use disorders. Strengthening Human Resources Through Development of Candidate Core Competencies for Mental, Neurological, and Substance Use Disorders in Sub-Saharan Africa: Workshop Summary outlines the presentations and discussions by expert panelists and participants of the plenary sessions of the workshop. This summary includes an overview of challenges faced by MNS providers in the SSA, perspectives on the next steps, the 2009 workshop, and more.

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