Task-Shifting Psychosocial Counselling to Lay Providers and Detection of Common Mental Disorders in Ugandan Community Health Centres: A Multilevel Analysis of Training-Intensity Exposure

Task-shifting psychosocial counselling to lay providers is central to closing the mental health treatment gap in Uganda, yet the relationship between the intensity of training exposure and the detection of common mental disorders in community health centres remains poorly specified. Drawing on implementation science, medical sociology and community mental health services research, the framework distinguishes training intensity along three dimensions—didactic hours, supervised practice and refresher exposure—and specifies facility-level and provider-level mechanisms through which these dimensions operate. Detection is not a simple function of training volume but depends on the alignment between training intensity and the organisational conditions of the community health centre, including supervision density, caseload and referral pathways. A multilevel estimation strategy is proposed to separate within-facility and between-facility variation in detection, and boundary conditions for causal interpretation are identified. The contribution is a testable specification of training-intensity exposure that can guide the design of task-shifting programmes and the evaluation of their effects on detection of common mental disorders in Ugandan community health centres.