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Table 1 The mhGAP-IG in pre-service training: introduction, implementation, and outcomes

From: WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG): the first pre-service training study

Institution

Preparation phase

Teaching process

mhGAP-IG introduction

Reasons for using mhGAP-IG

Alternatives considered to mhGAP-IG

Language

mhGAP-IG translated

Approaches taken to integrate mhGAP-IG into existing curriculum

Funding

mhGAP-IG modules used in teaching

Teaching–Instructors

Teaching –format

Duration of mhGAP-IG training

Number of students

trained

Universidad Nacional Autónoma de México, Mexico City, Mexico

Revision of the existing curriculum

mhGAP-IG content; huge treatment gap

None

Spanish

Noa

Allocated time for mhGAP-IG in lectures and removed other elements from the curriculum

None

All 10 modules

Assistant professor of psychiatry

Didactic teaching settings (in lecture hall) and in small group settings

20 h

50 medical doctors

University of Ibadan, Ibadan, Nigeria

Revision of the existing curriculum

Evidence-based; freely available; decision informed by local survey/research on competencies and training needs; mhGAP-IG content; and huge treatment gap

None

English

No

Allocated time for mhGAP-IG in lectures; removed other elements from the curriculum; and utilized mhGAP-IG as a clinical tool during placements

None

Psychosis; depression; drug and alcohol use disorders; behavioral disorders; and developmental disorders

Professor of psychiatry

Didactic teaching and role-play

Six hours for medical students and 5 days for master’s students

455 medical students and 95 master’s students

Phebe Paramedical Training Program and School of Nursing, Suakako, Bong, Liberia

Revision of the existing curriculum

Evidence-based; decision informed by stakeholder consultation and mhGAP-IG content

None

English

No

Allocated time for mhGAP-IG in lectures; removed other elements from the curriculum; and utilized mhGAP-IG as a clinical tool during placements

Carter Center Mental Health Program and the Government of Liberia

Behavioral disorder management

Clinical instructors

Didactic teaching, small group teaching, and as a clinical placement tool

4 months

200 nurses

University of Hargeisa, Hargeisa, Somaliland

New training program

Evidence-based; freely available; decision informed by stakeholder consultation; mhGAP-IG content; and huge treatment gap

Traditional psychiatric curriculum

English

No

N/A

None

All mhGAP-IG modules except module on alcohol and substance use disorders

Professor of psychiatry; clinical Instructors

Didactic teaching; role-play and small group teaching, along with real clinical contacts

11 days for medical students and 10 days for nursing students

320 medical students and 30 nurses

Sierra Leone Medical School, Freetown, Sierra Leone

New training program

Evidence-based; freely available; decision informed by stakeholder consultation; mhGAP-IG content; and huge treatment gap

Traditional psychiatric curriculum

English

No

N/A

None

All 10 modules

Professor of psychiatry; clinical Instructors; tutors;

Didactic teaching; role-play and small group teaching along with real clinical contacts

1 week

40 medical students

University of Amoud, Borama, Somaliland

New training program

Evidence-based; freely available; decision informed by stakeholder consultation; mhGAP-IG content; and huge treatment gap

Traditional psychiatric curriculum

English

No

N/A

None

All mhGAP-IG modules except module on alcohol and substance use disorders

Professor of psychiatry; clinical Instructors

Didactic teaching; role-play and small group teaching, along with real clinical contacts

11 days

160 medical students

P.L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Revision of the existing curriculum

Evidence-based; freely available; and mhGAP-IG content

None

Russian

Yes

Allocated time for mhGAP-IG in lectures and removed other elements from the curriculum

None

Depression module

Lecturer in psychiatry

Didactic teaching

2 days

30 doctors in training

Kyiv Medical University, Kyiv, Ukraine

Revision of the existing curriculum

Evidence-based and freely available

None

Ukrainian and English (for international students)

Yes

Allocated time for mhGAP-IG in lectures; removed other elements from the curriculum; utilized mhGAP-IG as a clinical tool during placements; and small group learning activity

None

Depression; dementia; epilepsy; behavioral disorders

Professor of neurology; professor of psychiatry; and tutors

Didactic teaching in lecture group learning; and as a clinical placement tool

2 weeks

30 medical students

Tbilisi State Medical University, Tbilisi, Georgia

Revision of the existing curriculum

Evidence-based; freely available; and huge treatment gap

None

Georgian

Yes

Allocated time for mhGAP-IG in lectures and removed other elements from the curriculum; utilized mhGAP-IG as a clinical tool during placements; and small group learning activity

None

Depression; dementia; bipolar disorder; suicide; self-harm; anxiety disorder

Professor of psychiatry

Introduced as a clinical tool during placements

1 week

16 medical studentsb

Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia

Revision of the existing curriculum

mhGAP-IG content; huge treatment gap

None

Armenian

Yes

Allocated time for mhGAP-IG in lectures and removed other elements from the curriculum; utilized mhGAP-IG as a clinical tool during placements; and small group learning activity

None

Depression; ADHD; suicide

Associate professors of clinical psychology

Didactic teaching in lecture format and small group learning

8 h

480 medical students

Kyrgyz-Russian Slavic University named after B.N. Yeltsin, Bishkek, Kyrgyzstan

Revision of the existing curriculum

Evidence-based; freely available; mhGAP-IG content; and huge treatment gap

None

Russian/Kyrgyz

Yes

Allocated time for mhGAP-IG in lectures and removed other elements from the curriculum; utilized mhGAP-IG as a clinical tool during placements

Not received

Depression; dementia; suicide; substance abuse; and child and adolescent mental and behavioral disorders

Professors/researchers in psychiatry

Didactic teaching and small group learning

6 months

12 medical students

Institution

Outcomes

Knowledge testing

Students’ response to mhGAP-IG

Teaching instructors’ response to mhGAP-IG

Clinical administrators’ response to mhGAP-IG

Recommendations made by respondents

Universidad Nacional Autónoma de México, Mexico City, Mexico

Post-exams

Highly satisfied (HS)

HS

HS

Use small groups and short courses; include students in the training work

University of Ibadan, Ibadan, Nigeria

Pre- and post-tests; exams

HS

HS

Satisfied (S)

Increase duration of training and use outcome assessment

Phebe Paramedical Training Program and School of Nursing, Suakako, Bong, Liberia

Pre- and post-tests; students’ presentations

HS

S

HS

Have two-way communication between students and instructors about training modules

University of Hargeisa, Hargeisa, Somaliland

Pre- and post-tests; clinical OSCE (objective clinical structured exam)and observed role-plays

HS

S

S

Ensure that psychiatrists accept mhGAP-IG; ensure support at the policy level; and provide training to local educators

Sierra Leone Medical School, Freetown, Sierra Leone

Pre- and post-tests; clinical OSCEs; and observed role-plays

HS

S

S

Ensure psychiatrists’ buy-in and adopt public health approach; ensure support from ministry level; and more local champions

University of Amoud, Borama, Somaliland

Pre- and post-tests; clinical OSCEs; and observed role-plays

HS

S

S

Ensure that psychiatrists move from traditional teaching to use of mhGAP-IG; ensure support at the policy level; and provide training to local educators

P.L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Pre- and post-tests

HS

HS

More emphasis on feedback from students and assessment of their knowledge

Kyiv Medical University, Kyiv, Ukraine

Pre- and post-tests

HS

S

S

Tbilisi State Medical University, Tbilisi, Georgia

Case discussion and multiple choice questions (MCQs)

Satisfied (S)

S

HS

Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia

Exam and practical session

HS

HS

HS

Kyrgyz-Russian Slavic University named after B.N. Yeltsin, Bishkek, Kyrgyzstan

MCQs; pre- and post-training assessment

HS

S

S

Conduct informational trainings and meetings with representatives of the Ministry of Education in the presence of the WHO Country Office

  1. aUNAM used WHO’s translated Spanish version of the mhGAP-IG
  2. bTSMU trained four students in each psychiatric clerkship program