PROJECT SUMMARY/ABSTRACT
There has been an increase in availability of evidence-based approaches for interventions and mental health
service delivery in low-resource settings. In low- and middle-income countries this includes delivery of services
by people who are not mental health specialists in primary care and community settings. However, there
continues to be major gaps in delivery of evidence-based mental health services. In order to improve service
delivery, we propose a quality assessment tool that can be completed by people with lived experience of
mental health conditions who use services in primary care settings. When service users rate the quality of the
care they receive, this feedback can be provided to health system managers and policy makers to aid in their
decision making for improved mental health services. The quality assessment tool will be co-created by
patients and their caregivers using health services (demand side in the healthcare system) and managers and
policy makers (supply side in the healthcare system). Based on this co-creation process, service users will be
able to complete assessments to rate quality indicators such as communication skills of service providers, the
physical space for confidential clinical encounters, the availability of medication, referrals for psychological
services, and use of patient education materials. The tool will differ from standard patient satisfaction tools that
typically use subjective Likert scoring. Instead, the assessment tool will be based on a series of observations of
provider behaviors, treatment and educational resources, and facility infrastructure. The quality assessment
tool will be designed using the formatting of the World Health Organization Ensuring Quality in Psychological
Support and Mental Health Helping Skill (EQUIP) platform, with the intention that the tool could eventually be
made freely available on the platform alongside other care ratings resources. By completion of this research
study, there will be an EQUIP quality assessment tool that can be completed by service users. The tool will
have been piloted in two low-resource settings: Liberia and Nepal. There will also be adequate capacity
building and other formative work completed to conduct a larger scale multi-site evaluation of quality
improvement using this tool rated by health care service users.