Q&A with Daisy Singla on an approach that shows ‘great promise in addressing the growing need for mental health support’
By Daisy Singla
September 8, 2025
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“As a senior scientist, my research focuses on improving access to evidence-based talk therapies, such as interpersonal therapy and behavioural activation. These brief interventions are recommended in clinical guidelines worldwide, yet they remain largely inaccessible to most individuals who need them,” Daisy Singla says.
Editor’s note: the Canadian Nurse editorial board recently interviewed Daisy Singla about her work to expand access to mental health care by supporting more practitioners to deliver it.
Can you tell me about yourself?
I’m a clinical psychologist by training and a global mental health researcher. Throughout my career, I’ve had the privilege of working with non-governmental organizations (NGOs) in low- and middle-income countries, where I’ve focused on innovative ways to expand access to evidence-based mental health care. One of the key lessons from this work has been task sharing — training individuals who are not traditionally mental health professionals to deliver brief, evidence-based talk therapies for depression and anxiety. This approach has shown great promise in addressing the growing need for mental health support, particularly for pregnant and postpartum patients.
Currently, I am a womenmind senior scientist at the Centre for Addiction and Mental Health and an associate professor in the Department of Psychiatry at the Temerty Faculty of Medicine at the University of Toronto. My work now focuses on bringing these global insights to North America, exploring how we can scale and integrate task-sharing models within our health-care systems to improve access to mental health care.
Can you share more about your research?
As a senior scientist, my research focuses on improving access to evidence-based talk therapies, such as interpersonal therapy and behavioural activation. These brief interventions are recommended in clinical guidelines worldwide, yet they remain largely inaccessible to most individuals who need them.
My work aims to address this gap by exploring innovative, scalable solutions. A key area of my research is task sharing — training non-mental health specialist providers, such as nurses, midwives and doulas, to deliver high-quality talk therapies. This approach has strong evidence behind it, with more than 100 randomized controlled trials demonstrating its effectiveness globally. In 2018, we received funding from the Patient Centered Outcomes Research Institute to implement the Scaling Up Maternal Mental Health Care by Increasing Access to Treatment (SUMMIT) trial in Toronto; Chapel Hill, North Carolina; and Chicago, Illinois. SUMMIT investigated two key questions: Can non-specialists deliver psychotherapy as effectively as mental health professionals like psychologists and psychiatrists? And, can telemedicine-delivered psychotherapy be as effective as in-person care for perinatal depression and anxiety? Importantly, everyone received the same eight-session behavioural activation treatment. The manual is freely available on our study website.
Beyond SUMMIT, my research also focuses on ensuring that increased access to therapy is paired with high-quality care. Our PEERS projects, funded by Grand Challenges Canada, explores scalable methods for supervising non-specialist providers. In collaboration with Sangath (an award-winning NGO in India), Dimagi (technology partner) and Harvard Medical School, we are implementing a digital platform that facilitates peer supervision among community health-care workers in two states in India. Through this platform, trained community health-care workers can register their patients, rate their treatment sessions using a validated checklist, track their patients’ progress, schedule supervision sessions and receive feedback, creating a structured, measurement-based approach to maintaining high-quality care.
Ultimately, our goal is to ensure that brief, evidence-based psychotherapies are not only widely available, but also delivered effectively to those who need them most.
Can you describe more about the SUMMIT study, given its relevance to nursing?
The SUMMIT study was a multi-site, non-inferiority trial aimed at enhancing access to mental health care for pregnant women and new mothers. Recognizing that perinatal depression and anxiety are prevalent but untreated, our goal was to bridge this gap by exploring innovative delivery methods for effective talk therapies.
A central focus of the SUMMIT trial was task sharing, which involved training non-specialist providers — particularly nurses, midwives and doulas — to deliver brief, evidence-based psychotherapies. This approach leverages the unique position of nurses, who frequently interact with pregnant and postpartum patients and who are often trusted confidants in health-care settings. Their involvement is crucial, as they can identify and address perinatal mental health issues promptly, potentially reducing the need for specialist referrals that may lead to long wait times.
The study finished recently. Can you share the results?
What we found was really encouraging. When non-specialist providers, such as nurses and midwives, are trained to deliver brief, evidence-based talk therapies, they can do so just as effectively as mental health specialists with many years of training. We also looked at telemedicine as a delivery method and found that it was as effective as in-person psychotherapy. Many of the barriers that prevent women from getting treatment — such as scheduling conflicts, transportation challenges and childcare responsibilities — can be reduced when therapy is delivered remotely.
Ultimately, these findings reinforce what we’ve seen in global mental health: task sharing works, and patient-centred approaches such as telemedicine have the potential to improve access to quality mental health care. Importantly, client satisfaction was high, irrespective of modality and provider type, and almost half of our participants identified as Black, Indigenous or persons of colour.
Because SUMMIT is among the largest psychotherapy trials in the world, these results provide strong evidence of pragmatic solutions such as task sharing and telemedicine. The findings have been published in Nature Medicine.
Our goal now is to scale these approaches in ways that are sustainable and patient-centred.
What do you think are the implications of the SUMMIT study for nursing?
Nurses are in a unique position to deliver brief psychotherapies because they are often the first point of contact for pregnant and postpartum women. They are trusted by patients, have strong interpersonal skills, and regularly encounter perinatal depression in their practice. However, many nurses have expressed frustration that, while they can identify these concerns, their only option is to refer patients — often to long wait lists — without knowing if they will actually receive care.
Through the SUMMIT trial, we are training interested and available nurses to deliver brief, evidence-based psychotherapy. While there may be initial trepidation, we’ve found that with proper training and weekly guided supervision, nurses gain confidence and can deliver these treatments just as effectively as specialist providers. This approach not only enhances access to care but also empowers nurses to address a significant and growing issue in perinatal mental health.
How can nurses reading this article learn more, including how to be trained in delivering psychological interventions?
For more information, visit our study website for our implementation toolkit, which provides information for various stakeholders, including health-care providers, administrators and patients. Training is typically provided by a clinical expert.
Nurses can also have a look at their respective regulatory body for further guidance on the delivery of psychotherapy by nurses. For example, the College of Nurses of Ontario has a FAQ section on their website.
Dr. Daisy Singla, PhD, is a clinical psychologist, an associate professor in the Department of Psychiatry at the University of Toronto, and a senior scientist at the Centre for Addiction and Mental Health.
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