Browsing by Author "Vikram Patel"

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    A qualitative analysis of collaborative efforts to build a school-based intervention for multiple common adolescent mental health difficulties in India
    (Front. Psychiatry, 2022) Resham Gellatly; Kendra Knudsen; Maya M. Boustani; Daniel Michelson; Kanika Malik; Sonal Mathur; Pooja Nair; Vikram Patel; Bruce F. Chorpita
    IntroductionIn low- and middle-income countries (LMICs), the gap between need for mental health (MH) treatment and access to services is stark, particularly among children and adolescents. In service of addressing this treatment gap, the current study provides an in-depth illustration of later-stage collaborative design of a school-based, transdiagnostic MH intervention in New Delhi and Goa, India, using a combination of contextual insights from local stakeholders and knowledge derived from the global evidence base. MethodsUsing an inductive-deductive approach to qualitative thematic analysis, we examined coded data from qualitative sources related to experiences of developing and implementing an intervention prototype. These sources included notes from meetings attended by treatment development team members and providers, written feedback on protocol materials (e.g., provider manual, student handouts), field notes reflecting researcher observations, and minutes from weekly clinical supervision meetings. ResultsResults revealed that codes involving cultural/contextual considerations, protocol material and content, and intervention complexity arose consistently throughout treatment development and across document types, illustrating their central role in finalizing protocol design. DiscussionThese findings have implications for the future of mental health treatment development and implementation globally.
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    Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda
    (Soc. Sci. Med., 2014) Emily Mendenhall; Mary J. De Silva; Charlotte Hanlon; Inge Petersen; Rahul Shidhaye; Mark Jordans; Nagendra Luitel; Joshua Ssebunnya; Abebaw Fekadu; Vikram Patel; Mark Tomlinson
    Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs. (C) 2014 The Authors. Published by Elsevier Ltd.
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    Realizing universal health coverage in India
    (Frontiers in Public Health, 2023) Nerges Mistry; Sandhya Venkateswaran; Rama Baru; Vikram Patel
    While the goals of UHC are largely common, the pathways leading to goal realization may vary across countries.