C

Provider Definitions and Relationship Roles

COMMUNITY/LAY WORKERS

Peer/service user (PR): A peer/service user can be a family member, friend, or other patient who is either being treated for a similar condition or has a relationship with the primary patient. Patients who use health care services in the community can provide support to others, share personal experiences, and participate in self-help and mutual aid activities. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment.

Community health care worker/health extension worker (CHW): Community health workers and health extension workers provide health education, referral and follow-up, case management, and basic preventive health care and home visiting services to specific communities. They provide support and assistance to individuals and caregivers in navigating the health and social services system. They foster a foundation for sharing information, providing mutual support and a sense of belonging for patients, families, and providers. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. They reduce caregiver burden and can encourage the involvement of caregivers in treatment plans. They can both refer and receive patients.

NON-SPECIALIZED, NON-PRESCRIBING PRACTITIONERS

Pharmacist (PH): Pharmacists store, preserve, compound, and dispense medicines. They advise patients and family members on the proper use and adverse effects of drugs and medicines. Pharmacists dispense prescription medications according to the direction of medical doctors and other health professionals. They contribute to researching, testing, preparing, prescribing, and monitoring medicinal therapies for optimizing human health. They communicate about drug procurement or shortage issues. They may educate other providers about new drugs. They may provide assistance in accessing and coordinating with other health care providers.

Social worker (SW): A social worker is a professional who plans and provides counseling, skills development, crisis intervention, and mediation services in individual, family, or group settings to assist clients’ function within the limitations of their environment, improve their relationships, and solve personal and family problems. They may serve as counselors for a large array of issues and in a variety of settings. They may also serve as case managers. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. They may consult and/or liaise with general practitioners to deliver primary interventions (e.g., drug supply, organization of community health services) and with other providers (e.g., psychiatric nurses, occupational therapists, psychologists).

Psychosocial care provider (subcategory): Through good communication and assessment skills, psychosocial care providers support patients on psychological, social, and spiritual levels. They play a unique role in supporting patients through dialogue in order to understand how patients view themselves as individuals, what is important to them, and how their relationship with others may affect their treatment. Psychosocial care providers build a rapport with patients and help other providers develop a clinical relationship with patients and their families.

Occupational therapist (OT): An occupational therapist is a professional who works with patients to help them achieve a fulfilled and satis-

fied state in life. An occupational therapist utilizes purposeful activity or interventions designed to achieve functional outcomes that promote health, prevent injury or disability, and develop, improve, sustain, or restore the highest possible level of independence. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. They may work exclusively with individuals in a particular age group or with particular disabilities. Specific therapies may include facilitating the use of the hands, promoting skills for listening and following directions, fostering social skills, or teaching dressing and grooming skills. Occupational therapists may also serve as case managers. They can consult and/or liaise with other providers (e.g., general practitioners, psychiatric nurses, psychologists). They may provide assistance in accessing and coordinating with other health care providers.

NON-SPECIALIZED PRESCRIBING PRACTITIONERS

Clinical officer (CO): A clinical officer is a paramedical practitioner who provides advisory, diagnostic, curative, and preventive medical services. A clinical officer performs duties that are more limited in scope and complexity than those carried out by medical doctors. They work autonomously or with limited supervision from medical doctors, and perform clinical, therapeutic, and surgical procedures for treating and preventing diseases, injuries, and other physical or mental impairments common to specific communities. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. Clinical officers can serve as liaisons with other providers and may provide assistance in accessing and coordinating with other health care providers. They may also work with other health care professionals to provide health education for patients, caregivers, and families. They may collaborate with health professional groups and other important partners involved in program implementation to ensure that all health workers receive appropriate education and training, including management of mental, neurological, and substance use (MNS) disorders.

Nurse (RN): Nurses provide treatment, support, and care services for people experiencing the effects of illness, injury, aging, or other physical or mental impairments. They assume responsibility for the planning and

management of the care of patients, including the supervision of other health care providers, working autonomously or in teams with medical doctors and other providers in the practical application of preventative and curative measurers in clinical and community settings. They may make referrals to other providers for patient follow-up (e.g., social workers, occupational therapists). They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. Nurses may be involved in the development and dissemination of interventions to foster community mobilization and participation. They can consult and/or liaise with other providers (e.g., general practitioners, psychiatric nurses, occupational therapists, psychologists) and may provide assistance in accessing and coordinating with other providers. The distinction between nursing and midwifery professionals and associate professionals should be made on the basis of the nature of the work performed in relation to this definition.

Medical doctor/general practitioner (MD): Medical doctors/general practitioners are professionals who diagnose, treat, and prevent illness, disease, injury, and other physical and mental impairments. Their key role is to maintain the general health of patients through application of the principles and procedures of modern medicine. Medical doctors plan, supervise, and evaluate the implementation of care and treatment plans by other health care providers. They do not limit their practice to certain disease categories or methods of treatment, and may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities. They may lead multidisciplinary teams and supervise other providers, such as nurses and social workers. They may consult and/or liaise with other providers (e.g., psychiatric nurses, occupational therapists, psychologists) and may provide assistance in accessing and coordinating with other providers. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. They may collaborate with health professional groups and other important partners involved in program implementation to ensure that all health workers receive appropriate education and training, including management of MNS disorders.

SPECIALIZED PRACTITIONERS

Psychiatric nurse (PRN): A psychiatric nurse practices a specialty that cares for people of all ages with mental illness or mental distress, such as schizophrenia, bipolar disorder, psychosis, depression, or dementia. Nurses in this area receive more training in psychological therapies, building of alliances, dealing with challenging behavior, and the administration of psychiatric medication. They may supervise other providers (e.g., nurses, community health workers, peer/service users) and may provide assistance in accessing and coordinating with other providers. Psychiatric nurses may be involved in training non-specialized nurses. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment.

Psychologist (PY): Psychologists are professionals who work with patients in a variety of therapeutic contexts. There are different types of psychologists, including clinical, organizational, and academic. They may serve as part of a specialist ambulatory team providing training, support, and supervision of non-specialists. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. They may supervise other providers (e.g., nurses, community health workers, peer/service users) and may provide assistance in accessing and coordinating with other providers. They will work and/or liaise with other providers (e.g., general practitioners, psychiatric nurses, occupational therapists). They may collaborate with health professional groups and other important partners involved in program implementation to ensure that all health workers receive appropriate education and training, including management of MNS disorders. Psychologists may conduct research or apply their knowledge as practitioners. This latter category includes clinical or counseling psychologists.

Neurologist (NE): A neurologist is a physician who specializes in neurology and is trained to investigate, diagnose, and treat disorders of the nervous system. Neurologists diagnose and treat all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle. They may receive referrals from psychiatrists if patients have a condition

comorbid with a neurological condition or if a neurological condition needs to be ruled out. They may consult providers (e.g., psychiatrists, medical doctors), supervise providers (e.g., nurses, community health workers, peer/service users), and/or train providers (e.g., psychiatrists, medical doctors), and may provide assistance in accessing and coordinating with other providers. They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. The corresponding surgical specialty is neurosurgery. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research.

Psychiatrist (PS): A psychiatrist is a physician who focuses on the study and treatment of mental illness and behavioral disorders. Psychiatrists are trained in diagnostic evaluation and in psychopharmacological treatment. As part of their evaluation of patients, psychiatrists can prescribe psychiatric medications, conduct physical examinations, order and interpret laboratory tests and electroencephalograms, and may order brain imaging studies. They will receive referrals from other providers. They may lead multidisciplinary teams and supervise task shifting to medical doctors, nurses, psychologists, and social workers. They will provide ongoing assessment of treatment, education, and support services in addition to monitoring and evaluating community mental health services. They will engage in training of other providers and interact with a wide range of providers (e.g., psychiatric or general nurses, clinical psychologists, social workers, occupational therapists). They can form collaborative relationships and communicate with other community members and/or health care providers to address patient needs, including prevention and treatment. If resources are available, they may provide a consultancyliaison service to outpatient and primary health center settings for complex cases.