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Abstract：
BACKGROUND: Clinical associates are a health professional cadre that could be utilised in mental health task sharing in South Africa but this is training dependent. The objectives of the study were to identify the potential curricula content, training sites, and teaching modalities for undergraduate and potential postgraduate clinical associate mental health training and to identify the tasks that they should perform based on these curricula.
METHODS: We utilised the Delphi method to reach consensus on items with the panel comprising psychiatrists and family physicians. The first round questionnaire of the Delphi survey was developed based on a literature review and the results from earlier phases of the overall study. The survey was administered electronically and consisted of three rounds. Following both the first and second rounds, an updated questionnaire was constructed omitting the items on which consensus was reached. The questionnaire consisted primarily of nine-point scales with consensus based on 70% of participants rating 1,2,3 or 7,8,9.
RESULTS: There were 26 participants in the first round with this number falling to 23 in later rounds. There was strong consensus on a training attachment to a mental health clinic at a community health centre (CHC) at undergraduate (96.2%) and postgraduate level (100%). Consensus was reached on the importance of training on the management of six categories of disorders at the undergraduate level and nine categories of disorders at the postgraduate level. Clerking patients as a teaching modality reached 100% consensus at both undergraduate and postgraduate levels. PHC clinics, CHCs and district hospitals reached consensus as appropriate settings for clinical associates to provide mental health services. In addition, GP practices and secondary hospitals reached consensus for those with postgraduate training. Consensus was reached on ten of the 21 listed tasks that could be performed based on undergraduate training and 20 of the 21 tasks based on a postgraduate qualification in mental health.
CONCLUSIONS: The Delphi panel\'s recommendations provide a clear roadmap for enhancing mental health curricula for clinical associates, enabling their utilisation in mental health service provision. A future postgraduate mental health qualification for clinical associates would allow for expanded task sharing.
METHODS: We utilised the Delphi method to reach consensus on items with the panel comprising psychiatrists and family physicians. The first round questionnaire of the Delphi survey was developed based on a literature review and the results from earlier phases of the overall study. The survey was administered electronically and consisted of three rounds. Following both the first and second rounds, an updated questionnaire was constructed omitting the items on which consensus was reached. The questionnaire consisted primarily of nine-point scales with consensus based on 70% of participants rating 1,2,3 or 7,8,9.
RESULTS: There were 26 participants in the first round with this number falling to 23 in later rounds. There was strong consensus on a training attachment to a mental health clinic at a community health centre (CHC) at undergraduate (96.2%) and postgraduate level (100%). Consensus was reached on the importance of training on the management of six categories of disorders at the undergraduate level and nine categories of disorders at the postgraduate level. Clerking patients as a teaching modality reached 100% consensus at both undergraduate and postgraduate levels. PHC clinics, CHCs and district hospitals reached consensus as appropriate settings for clinical associates to provide mental health services. In addition, GP practices and secondary hospitals reached consensus for those with postgraduate training. Consensus was reached on ten of the 21 listed tasks that could be performed based on undergraduate training and 20 of the 21 tasks based on a postgraduate qualification in mental health.
CONCLUSIONS: The Delphi panel\'s recommendations provide a clear roadmap for enhancing mental health curricula for clinical associates, enabling their utilisation in mental health service provision. A future postgraduate mental health qualification for clinical associates would allow for expanded task sharing.
摘要：
背景：临床助理是健康专业干部，可用于南非的心理健康任务共享，但这取决于培训。这项研究的目的是确定潜在的课程内容，培训网站,和本科生和潜在研究生临床助理心理健康培训的教学模式，并确定他们应该根据这些课程执行的任务。
方法：我们利用Delphi方法与由精神科医生和家庭医生组成的小组就项目达成共识。Delphi调查的第一轮问卷是根据文献综述和整个研究早期阶段的结果制定的。调查以电子方式进行，分为三轮。在第一轮和第二轮之后，我们构建了一份更新的问卷，省略了达成共识的项目。问卷主要由九分量表组成，基于70％的参与者的评分为1,2,3或7,8,9。
结果：第一轮有26名参与者，在后面的几轮中这一数字下降到23名。在本科（96.2％）和研究生水平（100％）的社区卫生中心（CHC）对心理健康诊所的培训附件达成了强烈共识。就本科六类疾病和研究生九类疾病管理培训的重要性达成共识。在本科生和研究生阶段，将患者作为一种教学方式达到了100％的共识。PHC诊所,CHC和地区医院达成共识，作为临床助理提供心理健康服务的适当设置。此外,GP实践和二级医院与接受研究生培训的人达成了共识。在列出的21项任务中，有10项可以根据本科培训执行，而在21项任务中，有20项可以根据心理健康研究生资格执行。
结论：Delphi小组的建议为加强临床员工的心理健康课程提供了明确的路线图，使他们能够利用精神卫生服务提供。未来的临床助理研究生心理健康资格将允许扩大任务共享。
方法：我们利用Delphi方法与由精神科医生和家庭医生组成的小组就项目达成共识。Delphi调查的第一轮问卷是根据文献综述和整个研究早期阶段的结果制定的。调查以电子方式进行，分为三轮。在第一轮和第二轮之后，我们构建了一份更新的问卷，省略了达成共识的项目。问卷主要由九分量表组成，基于70％的参与者的评分为1,2,3或7,8,9。
结果：第一轮有26名参与者，在后面的几轮中这一数字下降到23名。在本科（96.2％）和研究生水平（100％）的社区卫生中心（CHC）对心理健康诊所的培训附件达成了强烈共识。就本科六类疾病和研究生九类疾病管理培训的重要性达成共识。在本科生和研究生阶段，将患者作为一种教学方式达到了100％的共识。PHC诊所,CHC和地区医院达成共识，作为临床助理提供心理健康服务的适当设置。此外,GP实践和二级医院与接受研究生培训的人达成了共识。在列出的21项任务中，有10项可以根据本科培训执行，而在21项任务中，有20项可以根据心理健康研究生资格执行。
结论：Delphi小组的建议为加强临床员工的心理健康课程提供了明确的路线图，使他们能够利用精神卫生服务提供。未来的临床助理研究生心理健康资格将允许扩大任务共享。
