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What is GMHAT?

The Global Mental Health Assessment Tool is a computer assisted clinical interview to be used in routine clinical practice to detect and manage mental disorders in most settings.

What is the purpose of GMHAT?

The main purpose of developing GMHAT is to help people in bringing relief from the sufferings of their mental disorders. This will be even more relevant to countries where there is, at present, no, or no adequate service due to shortages of trained staff.

Why is GMHAT necessary?

In many parts of the world thousands, perhaps millions of people with mental illness go untreated due to a lack of mental health nurses and psychiatrists. Locally trained nurses and psychiatrists often as not emigrate to the West, so that there are in Africa, for example, countries which have no or only one psychiatrist, and throughout the world even in many developed countries, psychiatrists tend to practice in cities, and rural populations are deprived. There is no clear solution to the tendency of health workers to emigrate and cluster in towns except an entirely new and innovative approach harnessing the power of computers to generate a psychiatric diagnosis (the rate limiting step, requiring a number of professional years of training to achieve) from interviews undertaken by trained interviewers. This is the gap which GMHAT has been designed to overcome. Already, many areas around the world have shown an interest in using it.

We recommend strongly that it is first translated into local languages and then validated if at all possible against psychiatric diagnosis locally. Ideally, GMHAT PC should be integrated into the local primary care polyclinic or other setting. GMHAT FULL can be employed by nurses with short training working, say 10 to a psychiatrist supervisor. It is recognised that there will be areas in the world where there is no psychiatric supervisor so that detailed treatment procedures have been provided within the context of the interview.

How was GMHAT developed?

Over some 30-40 years Dr. Sharma and Prof Copeland have been engaged in epidemiological research on large population samples, funded by the Wellcome Trust, the Medical Research Council UK; and the Department of Health. To undertake these studies it was necessary to be able to apply a diagnostic system to large populations of over 5000 subjects. Original studies had started by deploying psychiatrists to interview small populations samples. As the need for large samples grew in order to assess risk factors and incidence of disease other methods of diagnosis had to be devised. Interview schedules with computerised differential diagnostic programs were developed. Following the publication of the studies these computerised methods were adopted by many research centres around the world and proved successful in a variety of settings on all continents. Because there was a perceived clinical need for such diagnoses for both primary and secondary care it was decided to develop and adapt the research principles for clinical use. Hence the GMHAT PC and GMHAT FULL are based on many years of the development of standardised interviews with computer assisted diagnosis. Both have taken around 10 years to develop. GMHAT PC is now up and running in a usable form suitable for adaptation to local circumstances. GMHAT FULL is at present undergoing validation trials but should be ready for distribution by the end of 2010.