Promoting Effective Mental Healthcare through Peer Supervision
An ongoing project (2019-2026).
The Aim of the Study:
PEERS aims to test a peer-supervision mobile application and evaluate its impact on the quality of therapy delivered by non-specialist community health workers, and ultimately on patient outcomes for depression. The project is led by Sangath in partnership with Sinai Health Center (Calgary, Canada), Harvard Medical School, and Dimagi.
The Background:
Supervision is particularly important for treatments delivered by non-specialist health workers. However, relying on mental health specialists to supervise them in person is not scalable in low-resource settings, as specialists are rarely available and existing in-person supervision methods are costly, time-intensive, and lack generalizable quality metrics. PEERS addresses this gap by developing a digital peer-supervision platform that enables remote, structured quality assurance for depression care delivery.
The Project Plan:
The PEERS smartphone application was designed to capture patient session data and audio recordings, enabling specialists to rate the quality of therapy sessions remotely. HAP counselors (lay providers who have been trained to deliver care for depression using the Behavioral Activation model) in Goa and Bhopal were trained to use the application to document sessions and receive feedback. The project assessed the impact of this supervision model on counselor competence and patient outcomes.
Findings:
PEERS has trained over 90 HAP (Healthy Activity Program) counselors thus far to use the smartphone application for quality monitoring and supervision. A formative study was published in Cambridge Prisms: Global Mental Health (2024), demonstrating the feasibility and potential of digital peer supervision for scaling up task-shared psychological therapies. These findings are informing the design of supervision models within ongoing programs, such as OptimizeD.