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
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
dc.contributor.author | Daniel, Mercian | |
dc.contributor.author | Maulik, Pallab K. | |
dc.contributor.author | Kallakuri, Sudha | |
dc.contributor.author | Kaur, Amanpreet | |
dc.contributor.author | Devarapalli, Siddhardha | |
dc.contributor.author | Mukherjee, Ankita | |
dc.contributor.author | Bhattacharya, Amritendu | |
dc.contributor.author | Billot, Laurent | |
dc.contributor.author | Thornicroft, Graham | |
dc.contributor.author | Praveen, Devarsetty | |
dc.contributor.author | Raman, Usha | |
dc.contributor.author | Sagar, Rajesh | |
dc.contributor.author | Kant, Shashi | |
dc.contributor.author | Essue, Beverley | |
dc.contributor.author | Chatterjee, Susmita | |
dc.contributor.author | Saxena, Shekhar | |
dc.contributor.author | Patel, Anushka | |
dc.contributor.author | Peiris, David | |
dc.date.accessioned | 2022-03-27T01:47:14Z | |
dc.date.available | 2022-03-27T01:47:14Z | |
dc.date.issued | 2021-12-01 | |
dc.description.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. Trial registration: Clinical Trial Registry India CTRI/2018/08/015355. Registered on 16 August 2018. | |
dc.identifier.citation | Trials. v.22(1) | |
dc.identifier.uri | 10.1186/s13063-021-05136-5 | |
dc.identifier.uri | https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05136-5 | |
dc.identifier.uri | https://dspace.uohyd.ac.in/handle/1/4135 | |
dc.subject | Anti-stigma campaign | |
dc.subject | Cluster randomised controlled trial | |
dc.subject | Common mental disorders | |
dc.subject | Electronic decision support systems | |
dc.subject | Implementation | |
dc.subject | India | |
dc.subject | Primary healthcare worker | |
dc.subject | SMART Mental Health | |
dc.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 | |
dc.type | Journal. Article | |
dspace.entity.type |
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