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International Federation of Red Cross and Red Crescent Societies (2009) Community Based PSS Trainer’s Guide
Category: Specific Tools & Materials, Key Tools
Audience: Implementing agencies
Training Other MHPSS Providers working within PHC or linked to Outreach Health Services
Use this trainer's kit to support non-specialist MHPSS providers in the provision of community-based psychosocial support.
Theoretical basis: Foundations of case management, person centered approach, problem solving techniques, and aspects of cognitive behavior therapy
For use by: MHPSS providers including social workers, community health workers, and volunteers.
Target: Persons with MHPSS problems. -
International Rescue Committee (draft) Social Support Groups. Shared Problem Solving for Communities with Tension or Division: A Pocket Facilitator’s Guide
Category: Specific Tools & Materials, Key Tools
Audience: Implementing agencies
Training Other MHPSS Providers working within PHC or linked to Outreach Health Services
Use this pocket guide that describes a process for social support groups within the community, that can be led by supervised non-professionals.
Theoretical basis: WHO Community Healing Dialogues, shared problem solving, and Socio-therapy
For use by: Supervised active and influential community members, including youth, religious leaders, elders, and other volunteers
Target: Affected community members and their family members -
Center for Victims of Torture (2005) Helping Refugee Trauma Survivors in the Primary Care Setting
Category: Specific Tools & Materials, Key Tools
Audience: Implementing agencies
Training for Primary Health Staff (doctors and nurses) working with survivors of torture
Use this manual for training primary care physicians and other providers in identifying and supporting survivors of war trauma and torture.
(A supplementary training resource to mhGAP listed under MH intervention Guidelines)
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Clinical Support and Supervision Tools
Category: Specific Tools & Materials, Clinical Support & Supervision
Audience: Implementing agencies, Governments, Donors
IMC Lebanon (2015) Support and Supervision Guidance Document for Integration of Mental Health
Clinical Support and Supervision Training Resources: Various Level Staff within Primary Healthcare
Clinical Support and Supervision Training CMs and CHWs Material -
Knowledge & Competency Measures
Category: Specific Tools & Materials, Knowledge & Competency
Audience: Implementing agencies
WHO (2017) mhGAP 2.0. PrePost Knowledge test
Field Adaptations
IMC Afghanistan (sample) MH knowledge and attitudes questionnaire
IMC Lebanon (sample) pre/post nurses training with answer key
IMC Lebanon (sample) pre/post GP refresher training with answer key
IMC Lebanon (sample) pre/post nurses refresher training with answer key -
Save the Children (2015) Stress Management for Staff Training
Category: Specific Tools & Materials, Staff and Self Care
Audience: Implementing agencies
Access this resource if you are planning a training on stress recognition and exploration of ways to reduce stress.
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International Federation of Red Cross and Red Crescent Societies (2009) Caring for Volunteers: A Psychosocial Support Toolkit
Category: Specific Tools & Materials, Staff and Self Care
Audience: Implementing agencies
Use this staff care toolkit as a resource for helping volunteers before, during, and after disasters. Different aspects of psychosocial well-being are discussed and can be adapted to fit particular needs.
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Antares Foundation (2012) Managing Stress in Humanitarian Workers
Category: Specific Tools & Materials, Staff and Self Care
Audience: Implementing agencies
Use these guidelines for guidance on good practice in managing stress of humanitarian workers and assistance in developing programs that reduce risk of stress and burnout.
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WHO & Antares Foundation (2017) Staff Care Policy and Development Workshop Products
Category: Specific Tools & Materials, Staff and Self Care
Audience: Implementing agencies
Access these products from a staff care policy and development workshop in Gaziantep, Turkey. Products include a staff care and well-being policy, staff well-being advocacy materials, questionnaire survey results, organizational assessment and action plan, and staff care approaches.
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Interhealth Worldwide (2015) Staff Care Guidelines
Category: Specific Tools & Materials, Staff and Self Care
Audience: Implementing agencies
View these guidelines with recommendations on staff care that have emerged on how staff health, wellbeing & safety, at all levels of an organization, significantly impacts on the effectiveness of humanitarian, development and mission work where it matters most - in the field.

Step 2. Build Capacity of General Healthcare Workers
Capacity building includes theoretical and practical training, as well as ongoing technical support and supervision for general health workers such as doctors and nurses as well as community health workers. Additional MHPSS workers to be trained is dependent on the context and can include social workers, counsellors, psychosocial workers and volunteers.

WHY is this step needed?
Treatment coverage for people with mental disorders is increased significantly by offering accessible and affordable mental health services as part of general health care.
- Building the knowledge and skills of facility and community level general health care providers and non-specialist MHPSS providers through training, supervision and mentorship over time helps ensure that trainees are confident and able to apply their skills to provide quality services.
- Raising Awareness among health care providers and other trainees about mental health and their roles in mental health integration (e.g. access, combating stigma, affordability, etc.) makes such services more accessible and acceptable.

HOW is this step done?
- Select up to 51 priority mental health priority conditions to focus on (based on situational analysis/national guidelines), in addition to covering general principles of care.
- Identify targeted geographical regions and health facilities and select the number and types of trainees to include.
- Develop the training curriculum content (based on WHO mhGAP materials and guidelines), and adapt it to the context (local, social, and cultural considerations) and to the capacity and roles of trainees.
- Prioritize topics to emphasize better quality training on a smaller number of conditions vs training on all conditions. Training on additional conditions can be rolled out over phases as needed.
- Develop a training and supervision schedule which allocates the needed time and resources for on the job supervision sessions, with follow up sessions and refresher trainings as needed, avoiding a one-off training with no supervision.
- Engage local mental health professionals (where possible) in conducting training and providing longer term support, consultation and supervision (e.g. as co-trainers, to receive a training of trainers (TOT)) to ensure sustainable and quality mental health care.
- Engage mental health care providers (e.g. international psychiatrist, national psychiatrist, psychiatric nurse) to provide training as well as ongoing supervision (e.g. on the job mentorship, case discussions).
- Monitor and evaluate baseline and improvement in knowledge and skills to determine follow up and refresher training focus and content.
1 More than 5 mental health priority conditions may be chosen if in line and in accordance with national level discussions, policy and planning.

MINIMUM elements of capacity building
- Provide training and supervision sessions to local health professionals over a minimum of 4 months to recognize and treat and refer persons with mental disorders.
- Ideally, train on one mhGAP topic per day (2 maximum topics depending on assessment of foundational knowledge). If fewer training hours are restricted and few due to budget or logistical constraints or political/institutional considerations, consider reducing the number of priority conditions covered and include more supervision hours.
- Provide supervision (e.g. on the job supervision, group and/or individual supervision sessions) following completion of foundation training for a minimum of 3 months (e.g. 3 sessions per trainee, 1 session per month).
- Train community level non-specialists (e.g. community health workers, volunteers, psychosocial workers) to assist with case identification, follow up, community awareness raising and provide basic psychosocial support (e.g. Psychological First Aid (PFA)).
- Use M&E tools to track knowledge (pre-post test), and skills (on the job supervision checklist) among trainees.

COMPREHENSIVE additional elements of capacity building
- Carry out periodic evaluations (FGDs, interviews, questionnaires, supervision visits etc.) to assess remaining training gaps in knowledge and competencies, and develop follow up and refresher trainings.
- Set up peer level supervision between PHC staff.
- Develop additional supplemental materials (e.g. job aids).
- Support national stakeholders and health facilities in developing resources and strategies to promote staff well-being.
- Develop longer term strategy with national stakeholders to leverage role of national mental health professionals to provide training and ongoing supervision and support to general health workers and non-specialist MHPSS providers, and to to provide consultation or manage complex cases.
- Collaborate with academic institutions and professional associations to integrate mental health into pre-service training and continuing education for health professionals.
- Develop capacity of local non-specialist MHPSS providers (e.g. community health workers, social workers, psychosocial workers) in mental health case management, and evidence based scalable psychological interventions2 (e.g. cognitive behavior therapy, Problem Solving Plus (PM+) or interpersonal therapy (including group IPT)).
2 Use the manuals in the Psychological Interventions category resource below if you are developing an integration program with a component that teaches local non-specialist MHPSS providers to deliver evidence-based scalable psychological interventions for common mental disorders

WHEN is this step done?
After conducting the initial needs assessment and planning which would inform the selection of target facilities, trainees, geographical locations and training content as well as the identification of resources, partnerships, and local capacities to support in the short, medium, and longer term.

KEY CONSIDERATIONS
- Do establish links and communication between trained healthcare providers and specialized mental health services (e.g. psychiatrist) for ongoing technical support and referral/back-referral of persons with severe and complex mental health problems.
- Do identify supervisors before the training is conducted and define a timetable for supervision.
- Do ensure careful consideration and assessment of training needs, existing structures and resources.
- Do ensure training is within implementing agency’s capacity and based on current best practices and standards.
- Do use results of pre/post training tests to inform key aspects of supervision sessions.
- Do coordinate with the state health office or ministry of health on planning, implementing and longer term support, training, and supervision.
- Do pay attention to staff well-being (e.g. work load, schedules, breaks, stress management sessions).
- Do not decide on topics for training without consulting national guidelines and other relevant aspects of the needs assessment.
- Do not set up stand-alone training without proper follow up, support and supervision.
- Do not forget to monitor progress in knowledge and skills during training and supervision.
- Do not overwhelm the health staff (e.g. training on too many modules at the same time, asking them to do much more than what they usually do on a day to day basis).
