As readers of Gede blogs will know, one of the key objectives of the ‘mental health movement’ is to see the screening, treatment and referral of common mental disorders (mainly depression and alcohol abuse) integrated into health service delivery platforms 9including through HIV-AIDS Adherence Counsellors). Although the strategy tends to give relatively little consideration to the reasons why a mental health ‘treatment gap’ exists (and almost totally ignores options related to capacity building Facility based health workers through, for example, ICT and qualified members of the diaspora), the core focus tends to be on developing ways in which to ‘task shift’ in health systems (even though this language seems to have become the slightly more politically acceptable ‘task sharing’) – essentially looking at ways in which mental health can be integrated into the busy daily lives of health workers. This utterly admirable aim runs the risk, however, of being practically difficult to implement or even ‘sell’ to those health workers whose waiting rooms and spaces are already bulging with people who need purely biomedical treatment and care. And what is the implication on ‘time management’ when patients (‘clients’ in our modern parlance) show more problematic mental health symptoms? We all know that long marches have to start with a small step, but one of the key issues in terms of ‘task sharing’ is that the health workers themselves seem rarely to be engaged in these initiatives…