An integrated community and primary healthcare worker intervention to reduce stigma and improve management of common mental disorders in rural India: protocol for the SMART Mental Health programme
| Author | Mercian Daniel | |
| Author | Pallab K. Maulik | |
| Author | Sudha Kallakuri | |
| Author | Amanpreet Kaur | |
| Author | Siddhardha Devarapalli | |
| Author | Ankita Mukherjee | |
| Author | Amritendu Bhattacharya | |
| Author | Laurent Billot | |
| Author | Graham Thornicroft | |
| Author | Devarsetty Praveen | |
| Author | Usha Raman | |
| Date Accessioned | 2024-12-07T05:04:47Z | |
| Date Available | 2024-12-07T05:04:47Z | |
| Date of Publication | 2021 | |
| Abstract | Background: Around 1 in 7 people in India are impacted by mental illness. The treatment gap for people with mental disorders is as high as 75-95%. Health care systems, especially in rural regions in India, face substantial challenges to address these gaps in care, and innovative strategies are needed. Methods: We hypothesise that an intervention involving an anti-stigma campaign and a mobile-technology-based electronic decision support system will result in reduced stigma and improved mental health for adults at high risk of common mental disorders. It will be implemented as a parallel-group cluster randomised, controlled trial in 44 primary health centre clusters servicing 133 villages in rural Andhra Pradesh and Haryana. Adults aged >= 18 years will be screened for depression, anxiety and suicide based on Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorders (GAD-7) scores. Two evaluation cohorts will be derived-a high-risk cohort with elevated PHQ-9, GAD-7 or suicide risk and a non-high-risk cohort comprising an equal number of people not at elevated risk based on these scores. Outcome analyses will be conducted blinded to intervention allocation. Expected outcomes: The primary study outcome is the difference in mean behaviour scores at 12 months in the combined 'high-risk' and 'non-high-risk' cohort and the mean difference in PHQ-9 scores at 12 months in the 'high-risk' cohort. Secondary outcomes include depression and anxiety remission rates in the high-risk cohort at 6 and 12 months, the proportion of high-risk individuals who have visited a doctor at least once in the previous 12 months, and change from baseline in mean stigma, mental health knowledge and attitude scores in the combined non-high-risk and high-risk cohort. Trial outcomes will be accompanied by detailed economic and process evaluations. Significance: The findings are likely to inform policy on a low-cost scalable solution to destigmatise common mental disorders and reduce the treatment gap for under-served populations in low-and middle-income country settings. | |
| Identifier URI | https://resourcerepository.azimpremjiuniversity.edu.in/handle/apurr/1003 | |
| Publisher | Trials | |
| Source URI/URL | http://dx.doi.org/10.1186/s13063-021-05136-5 | |
| Keyword | Vaccination perceptions | |
| Keyword | Vaccine acceptance | |
| Keyword | Community health workers | |
| Title | An integrated community and primary healthcare worker intervention to reduce stigma and improve management of common mental disorders in rural India: protocol for the SMART Mental Health programme | |
| Item Type | Article |