Feasibility and acceptability of a novel community-based mental health intervention delivered by community volunteers in Maharashtra, India: the Atmiyata programme

Abstract

Background: Many community-based intervention models for mental health and wellbeing have undergone robust experimental evaluation; however, there are limited accounts of the implementation of these evidencebased interventions in practice. Atmiyata piloted the implementation of a community-led intervention to identify and understand the challenges of delivering such an intervention. The goal of the pilot evaluation is to identify factors important for larger-scale implementation across an entire district in India. This paper presents the results of a feasibility and acceptability study of the Atmiyata intervention piloted in Nashik district, Maharashtra, India between 2013 and 2015. Methods: A mixed methods approach was used to evaluate the Atmiyata intervention. First, a pre-post survey conducted with 215 cases identified with a GHQ cut-off 6 using a 3-month interval. Cases enrolled into the study in one randomly selected month (May-June 2015). Secondly, a quasi-experimental, pre-post design was used to conduct a population-based survey in the intervention and control areas. A randomly selected sample (panel) of 827 women and 843 men age between 18 to 65 years were interviewed to assess the impact of the Atmiyata intervention on common mental disorders. Finally, using qualitative methods, 16 Champions interviewed to understand an implementation processes, barriers and facilitators.

“Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study

“…They found the intervention worthy of their time and looked forward to the sessions. Their responses were similar to another lay-led community-based mental health intervention with qualitative findings that reported reduced depressive moods and improved social functioning in adults [50]. They also suggested changing the recruitment process to appeal to more potential participants and have more informative and mindfulness training sessions for better insight.…”

Scaling up community-delivered mental health support and care: A landscape analysis

“…Mitras receive one day of training, during which they are paired with Champions for support ( 50 ). A randomized, controlled trial of the Atmiyata program found that Champions were able to accurately identify people with emotional distress, and, after six counseling sessions, the proportion of participants with elevated symptoms dropped from 63.8 to 36.8% ( 52 ). While this program is based entirely within community settings, there is a mechanism through which lay health workers can refer individuals with more serious mental disorders to higher-level care ( 52 ).…”

“…A randomized, controlled trial of the Atmiyata program found that Champions were able to accurately identify people with emotional distress, and, after six counseling sessions, the proportion of participants with elevated symptoms dropped from 63.8 to 36.8% ( 52 ). While this program is based entirely within community settings, there is a mechanism through which lay health workers can refer individuals with more serious mental disorders to higher-level care ( 52 ). To ensure ongoing support and supervision of the Atmiyata Champions and Mitras, remote approaches utilizing mobile phones were combined with in-person supervision sessions ( 52 ).…”

“…While this program is based entirely within community settings, there is a mechanism through which lay health workers can refer individuals with more serious mental disorders to higher-level care ( 52 ). To ensure ongoing support and supervision of the Atmiyata Champions and Mitras, remote approaches utilizing mobile phones were combined with in-person supervision sessions ( 52 ). Leveraging technology to support supervision was essential for maintaining program fidelity and promoting successful scale up in a setting where supply of advanced clinical professionals is limited.…”

Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study

“…Community Mental Health Services (CMHS) is a common development in mental health services worldwide [14]. It positively affects reducing to utilize other services, reducing stigma, improving help-seeking attitudes, and promoting mental health [15][16][17]. Many Central and Eastern European countries have been working to develop CMHS [18].…”