Improving detection of mental health problems in community settings in Nepal: development and pilot testing of the community informant detection tool

Subba, Prasansa; Luitel, Nagendra P.; Kohrt, Brandon A.; Jordans, Mark J. D.

doi:10.1186/s13031-017-0132-y

Cited by 33 publications

(52 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 A number of studies and programmes in Nepal and in other countries have demonstrated the effectiveness of Aryal et al: Adolescents left behind by migrant workers in Nepal a community-based approach to address mental health challenges. For example, use of the community informant detection tool is not only effective for detection of mental health cases in the community, 15 but has also been shown to have increased utilization of mental health services in Nepal. 16 Another good example of community mental health activities is the "community mental health and psychosocial support programme" carried out by the Centre for Mental Health and Counselling-Nepal, which has trained more than 2000 health workers, 8000 female community health volunteers and 250 doctors, and these trained workers have subsequently provided mental health services to more than 50 000 individuals, from government health facilities.…”

Section: Mental Health Governance In Nepal and The Role Of Communitymentioning

confidence: 99%

Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal

Aryal

Regmi

Teijlingen

et al. 2019

WHO South-East Asia J Public Health

View full text Add to dashboard Cite

Over the past two decades, the unique health needs associated with the second decade of life have been recognized, not least the mental health of adolescents. In parallel, the negative health impacts of parental migration on the children and adolescents who are "left behind" in low-and middle-income countries (LMICs) is beginning to be acknowledged. Nepal is a growing supplier of labour migrantsan estimated 3.5 million Nepali individuals are working abroad -resulting in families being separated and thousands of adolescents being left behind. This can increase psychological and emotional stress and feelings of loneliness and abandonment, and reduce self-esteem among left-behind adolescents, which in turn may have a negative impact on their psychosocial health. Globally, mental health and neurodevelopmental disorders are one of the top three causes of disability-adjusted life-years lost among adolescents. The devastating earthquake in Nepal in 2015 brought into sharp focus the lack of prioritization of mental health services and spurred development of the Community mental health care package Nepal, 2074 in 2017. This package, together with the upcoming revised National Mental Health Policy, emphasizes the need to (i) ensure the availability and accessibility of basic mental health and psychosocial support services for all; and (ii) facilitate integration of mental health services into the primary health-care system. Recognizing that mental health and psychosocial support services have been predominantly focused on the adult population only, the package includes a component on childhood and adolescent mental and behavioural disorders. It will be essential for policy-makers to ensure that strategies are in place to ensure that left-behind adolescents, especially those who are not in school, have access to these community-based services. Given the paucity of research on mental health interventions among adolescents in LMICs in general, monitoring and assessment of what works for this special group of young people in Nepal may have broader implications for implementation in other countries where migration has resulted in significant populations of left-behind adolescents.

show abstract

Section: Mental Health Governance In Nepal and The Role Of Communitymentioning

confidence: 99%

Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal

Aryal

Regmi

Teijlingen

et al. 2019

WHO South-East Asia J Public Health

View full text Add to dashboard Cite

show abstract

“…The CIDT is a pro-active case detection approach aimed to increase helpseeking using a vignette-based tool designed for the ease of use by lay people. It has been developed and tested in Nepal [35], with positive results on the positive predictive value (0.68) and increasing the utilization of mental health services [36]. A general distress CIDT version had been adapted for this trial (cite 16), which includes gender-matched vignettes for the "gender" of the wards.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises Nepal: study protocol for a cluster randomised controlled trial (c-RCT)

Hof

Sangraula²,

Luitel³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background Globally, the lack of availability of psychological services for people exposed to adversities has led to the development of a range of scalable psychological interventions with features that enable better scale-up. Problem Management Plus (PM+) is a brief intervention of 5 sessions that can be delivered by non-specialists. It is designed for people in communities in low- and middle-income countries (LMIC) affected by any kind of adversity. Two recent randomized controlled trials in Pakistan and Kenya demonstrated the effectiveness of individually delivered PM+. A group version of PM+ has been developed to make the intervention more scalable and acceptable. This paper describes the protocol for a cluster randomized controlled trial (c-RCT) on locally adapted Group PM+ in Nepal. Methods: This c-RCT will compare Group PM+ to enhanced usual care (EUC) in participants with high levels of psychological distress recruited from the community. The study is designed as a two-arm, single-blind c-RCT that will be conducted in a community-based setting in Morang, a flood affected district in Eastern Nepal. Randomization will occur at ward level, the smallest administrative level in Nepal, with 72 enrolled wards allocated to Group PM+ or to EUC (ratio 1:1). Group PM+ consists of five approximately 2.5 hour sessions, in which participants are taught techniques to manage their stressors and problems, and is delivered by trained and supervised community psychosocial workers (CPSWs). EUC consist of a meeting with (a) basic information on adversity and mental health, (b) benefits of getting support, (c) information on seeking services from local health facilities with mhGAP-trained staff. The primary outcome measure is levels of individual psychological distress 20 weeks after baseline, measured by the General Health Questionnaire (GHQ-12). Secondary outcome measures include levels of functioning, depressive symptoms, post-traumatic stress disorder symptoms, levels of social support, somatic symptoms and ways of coping. We hypothesize that skills acquired will mediate any impact of the intervention. Discussion: This c-RCT will contribute to the growing evidence-base for transdiagnostic psychological interventions delivered by non-specialists for people in communities affected by adversity. If Group PM+ is proven effective the intervention manual will be released for use giving the opportunity to further adaptation and implementation of the intervention in diverse settings with communities that require better access to psychological interventions.

show abstract

“…The CIDT is a pro-active case detection approach aimed to increase helpseeking using a vignette-based tool designed for the ease of use by lay people. It has been developed and tested in Nepal [35], with positive results on the positive predictive value (0.68) and increasing the utilization of mental health services [36]. A general distress CIDT version had been adapted for this trial (28), which includes gender-matched vignettes for the "gender" of the wards.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises Nepal: study protocol for a cluster randomised controlled trial (c-RCT)

Hof

Sangraula²,

Luitel³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background Globally, the lack of availability of psychological services for people exposed to adversities has led to the development of a range of scalable psychological interventions with features that enable better scale-up. Problem Management Plus (PM+) is a brief intervention of 5 sessions that can be delivered by non-specialists. It is designed for people in communities in low- and middle-income countries (LMIC) affected by any kind of adversity. Two recent randomized controlled trials in Pakistan and Kenya demonstrated the effectiveness of individually delivered PM+. A group version of PM+ has been developed to make the intervention more scalable and acceptable. This paper describes the protocol for a cluster randomized controlled trial (c-RCT) on locally adapted Group PM+ in Nepal. Methods: This c-RCT will compare Group PM+ to enhanced usual care (EUC) in participants with high levels of psychological distress recruited from the community. The study is designed as a two-arm, single-blind c-RCT that will be conducted in a community-based setting in Morang, a flood affected district in Eastern Nepal. Randomization will occur at ward level, the smallest administrative level in Nepal, with 72 enrolled wards allocated to Group PM+ or to EUC (ratio 1:1). Group PM+ consists of five approximately 2.5 hour sessions, in which participants are taught techniques to manage their stressors and problems, and is delivered by trained and supervised community psychosocial workers (CPSWs). EUC consists of a family meeting with (a) basic information on adversity and mental health, (b) benefits of getting support, (c) information on seeking services from local health facilities with mhGAP-trained staff. The primary outcome measure is levels of individual psychological distress at endline (equivalent to 20±1 weeks after baseline), measured by the General Health Questionnaire (GHQ-12). Secondary outcome measures include levels of functioning, depressive symptoms, post-traumatic stress disorder symptoms, levels of social support, somatic symptoms and ways of coping. We hypothesize that skills acquired will mediate any impact of the intervention. Discussion: This c-RCT will contribute to the growing evidence-base for transdiagnostic psychological interventions delivered by non-specialists for people in communities affected by adversity. If Group PM+ is proven effective the intervention manual will be released for use giving the opportunity to further adaptation and implementation of the intervention in diverse settings with communities that require better access to psychological interventions.

show abstract

Improving detection of mental health problems in community settings in Nepal: development and pilot testing of the community informant detection tool

Cited by 33 publications

References 35 publications

Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal

Adolescents left behind by migrant workers: a call for community-based mental health interventions in Nepal

Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises Nepal: study protocol for a cluster randomised controlled trial (c-RCT)

Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises Nepal: study protocol for a cluster randomised controlled trial (c-RCT)

Contact Info

Product

Resources

About