New Frontiers in Mental Health: Understanding Transdiagnostic Approaches in Lowand Middle-Income Countries

There have been significant gains in understanding both the effectiveness of mental health treatments and implementation methods that increase sustainability and build capacity (e.g., task-shifting) in low-and middle-income countries (LMIC). However, there continue to be barriers in providing and scaling up mental health services in low resourced settings. This chapter will examine how transdiagnostic approaches may help to bridge the mental health treatment gap in LMIC. We begin by defining and delineating different transdiagnostic approaches. Then we discuss the potential benefits of such approaches in LMIC. Next, we review treatments found to be effective in LMIC, taking a critical look at intervention outcomes across multiple common mental health problems. Collectively, mental health treatments utilizing lay community workers show promise, with flexible, multiproblem approaches showing the largest effects in treating a wide range of common mental health problems. We discuss implementation strategies for making transdiagnostic approaches accessible to lay providers as well as highlight a flexible, multiproblem approach, the Common Elements Treatment Approach (CETA), as an example of how such implementation strategies may be trained and implemented. Further development and investigation of transdiagnostic approaches that utilize lay community workers are needed to determine the best ways to implement, sustain, and scale-up such approaches.