Mental Health Care Support in Rural India

作者：Pallab K Maulik, Mercian Daniel, Siddhardha Devarapalli, Sudha Kallakuri, Amanpreet Kaur, Arpita Ghosh, Laurent Billot, Ankita Mukherjee, Rajesh Sagar, Sashi Kant, Susmita Chatterjee, Beverley M. Essue, Usha Raman, Devarsetty Praveen, Graham Thornicroft, Shekhar Saxena, Anushka Patel, David Peiris · 发表于：JAMA Psychiatry · 年份：2024 · DOI：10.1001/jamapsychiatry.2024.2305 · 被引用次数：15 · 研究领域：Mental Health Treatment and Access、Digital Mental Health Interventions、COVID-19 and Mental Health

Importance: More than 150 million people in India need mental health care but few have access to affordable care, especially in rural areas. Objective: To determine whether a multifaceted intervention involving a digital health care model along with a community-based antistigma campaign leads to reduced depression risk and lower mental health-related stigma among adults residing in rural India. Design, Setting, and Participants: This parallel, cluster randomized, usual care-controlled trial was conducted from September 2020 to December 2021 with blinded follow-up assessments at 3, 6, and 12 months at 44 rural primary health centers across 3 districts in Haryana and Andhra Pradesh states in India. Adults aged 18 years and older at high risk of depression or self-harm defined by either a Patient Health Questionnaire-9 item (PHQ-9) score of 10 or greater, a Generalized Anxiety Disorder-7 item (GAD-7) score of 10 or greater, or a score of 2 or greater on the self-harm/suicide risk question on the PHQ-9. A second cohort of adults not at high risk were selected randomly from the remaining screened population. Data were cleaned and analyzed from April 2022 to February 2023. Interventions: The 12-month intervention included a community-based antistigma campaign involving all participants and a digital mental health intervention involving only participants at high risk. Primary health care workers were trained to identify and manage participants at high risk using the Mental Health Ga...