What is already known on this topic?

There is a critical global shortage of specialist human resources for mental health, particularly in low-income and middle-income countries (LMICs). In settings with inadequate numbers of mental health professionals, evidence suggests that task shifting is an effective human resources strategy and that minimally trained community health workers can increase access to mental health services while maintaining or improving the quality of clinical and social outcomes.1

What does this paper add?

• While previous studies have focused on community health treatments for people with common mental disorders, this trial focuses on the public health problem of services for people with schizophrenia in low-resource settings.

• The study demonstrates the impact of the intervention, particularly on disability, and assesses the additional cost of community-based care.

• Significant outcomes from the intervention occurred only in the site with the most limited resources, with no significant additional benefit in the better-resourced sites.

Limitations

• The findings are limited to a …