Table 4.
No | Author (year) | Location | Economic status | Outcome measure | Outcome type | Outcome method | Significance | Key findings |
1 | Abas et al (2016) | Zimbabwe | Low income | Satisfaction, attitude, clinical outcome |
Mixed | Interview/focus group | Training was positively received by patients, and was found rewarding for lay health workers to deliver. | |
2 | Abayomi et al (2012) | Nigeria | Lower middle income | Attitude | Quantitative | Questionnaire | Significant improvement | Training reduced perceived dangerousness and improved attitude towards persons with mental health problems. |
3 | Adebowale et al (2015) | Nigeria | Lower middle income | Clinical skills | Quantitative | Vignette | Significant improvement | Training improved knowledge and expected mental health practice with greater effect on case management than case recognition. |
4 | Alonso et al (2014) | Sierra Leone | Low income | Clinical outcome, clinical practice | Quantitative | Questionnaires, case record examination | Trained primary health workers could deliver safe and effective treatment for mental health disorders. | |
5 | Armstrong et al (2010) | Australia | High income | Confidence, clinical skills | Quantitative | Questionnaire, interview | Significant improvement | Training improved objective competence and subjective confidence in delivering cognitive behavioural therapy. |
6 | Armstrong et al (2011) | India | Lower middle income | Attitude, clinical skills | Quantitative | Vignette | Significant improvement | Training improved ability to recognise mental disorders, reduced faith in unhelpful interventions and reduced stigmatising attitudes. |
7 | Bowers and Burnett (2009) | UK | High income | Confidence and knowledge | Quantitative | Questionnaire | Training increased confidence regarding mental health disorder assessments and in making clinical diagnoses. | |
8 | Chew-Graham et al (2014) | UK | High income | Clinical practice, satisfaction | Qualitative | Interview/focus group | Training increased awareness, recognition and respect for the needs of patients from under-served communities. | |
9 | Chibanda et al (2016) | Zimbabwe | Low income | Clinical outcome | Quantitative | Questionnaire | Significant improvement | Lay health worker-administered, primary care-based problem-solving therapy with education and support improved patient symptoms. |
10 | Church et al (2010) | Canada | High income | Attitude, clinical practice, confidence, satisfaction |
Mixed | Questionnaire, written feedback, interview/focus group, facilitator’s notes | Significant improvement | Training heightened awareness of and improved confidence in mental health issues and interventions, while increasing interprofessional collaborations. |
11 | Cook et al (2017) | USA | High income | Attitude, clinical practice, knowledge |
Mixed | Questionnaire | Trainees’ professional diversity increased over time. Health professionals had higher scores on some outcome variables than non-health professionals. | |
12 | Ekers et al (2013) | UK | High income | Clinical outcome and satisfaction | Mixed | Questionnaire | Trainees found the training acceptable and useful. | |
13 | Ferraz and Wellman (2009) | UK | High income | Clinical practice, knowledge | Quantitative | Questionnaire | Significant improvement | Training increased participants’ knowledge and understanding of solution-focused brief therapy and their use of the techniques in routine clinical practice. |
14 | Hofmann-Braussard et al (2017) | India | Lower middle income | Attitude, confidence, knowledge |
Mixed | Questionnaire, vignette | Significant improvement | Training increased ability to recognise mental health disorders, decreased stigma and increased competence in working with people who have poor mental health. |
15 | Hossain et al (2010) | Australia | High income | Confidence, knowledge, satisfaction | Mixed | Interview/focus group | Training improved participants’ confidence in and knowledge of mental health issues and increased their empathy toward persons with mental health problems. | |
16 | Jenkins et al (2013) | Kenya | Lower middle income | Clinical outcome, clinical skills | Quantitative | Questionnaire, clinical notes | Significant improvement | Training showed no effect on recorded diagnostic rates of mental health disorders, but improved patient outcomes. |
17 | Jordans et al (2012) | Nepal | Low income | Knowledge | Quantitative | Questionnaire, vignette | Significant improvement | Training improved mental health literacy for complex emergencies. |
18 | Kauye et al (2014) | Malawi | Low income | Clinical skills | Quantitative | Questionnaire, clinical notes | Significant improvement | Training improved quality of detection and management of patients with mental health disorders. |
19 | Lam et al (2016) | Hong Kong (China) | High income | Attitude, confidence, clinical practice | Mixed | Questionnaire | Significant improvement | Training improved confidence in the recognition, diagnosis and management of mental health issues. |
20 | Li et al (2014) | China | Upper middle income | Attitude and knowledge | Quantitative | Questionnaire, vignette | Significant improvement | Training did not have an effect on knowledge, but improved attitude towards people with mental health problems. |
21 | MacCarthy et al (2013) | Canada | High income | Attitude, confidence, clinical outcome, clinical practice, satisfaction |
Quantitative | Questionnaire | Significant improvement | Training had a positive impact on patient outcomes and decreased stigmatising attitudes. |
22 | Morawska et al (2013) | Australia | High income | Attitude, clinical skills | Mixed | Questionnaire, vignette, interview/focus group | Significant improvement | Training increased recognition of mental illnesses, confidence in providing help and treatment and reduced stigmatising attitudes with positive long-term effects. |
23 | Paudel et al (2014) | India | Lower middle income | Attitude, knowledge, practice | Qualitative | Focus group | Training improved the identification of symptoms and ability to suggest management options and increased empathetic attitudes towards patients. | |
24 | Ravitz et al (2013) | Canada | High income | Attitude, clinical skills, confidence, knowledge | Mixed | Questionnaire, focus group | Significant improvement | Training heightened knowledge in mental health issues, improved confidence, morale, practice behaviour changes. |
25 | Ruud et al (2016) | Norway | High income | Attitude, clinical skills, practice, satisfaction | Qualitative | Questionnaire, interview | Training improved recruitment, satisfaction among participants and service managers, strengthened clinical competence, increased understanding and mutual respect between professional groups and service levels, and increased focus on user involvement and influence. | |
26 | Sadik et al (2011) | Iraq | Upper middle income | Attitude, clinical skills, clinical practice, knowledge, satisfaction |
Quantitative | Questionnaire, clinical notes, interview | Significant improvement | Training improved knowledge in mental health issues, and demonstration of practical skills in the workplace. |
27 | Siriwardhana et al (2016) | Sri Lanka | Lower middle income | Knowledge, satisfaction | Mixed | Questionnaire, interview | Training improved overall knowledge in mental illnesses and mental healthcare. | |
28 | Usher et al (2014) | Pacific Island Small States | Aggregates | Attitude, clinical skills, knowledge |
Quantitative | Questionnaire | Significant improvement | Training improved the knowledge, skills and attitudes of people who care for persons experiencing mental health problems. |
29 | Wright et al (2014) | Malawi | Low income | Confidence, clinical practice, clinical skills, knowledge | Mixed | Questionnaire, clinical notes | Significant improvement | Training had positive effect on knowledge and confidence in providing care, and increased mental health promotion activity. |