Innovative provision of primary mental health care in rural India - SMART Mental Health Programme

The global burden of mental disorders and treatment gap is large, especially in countries like India due to poor awareness about mental health and few available resources for providing care. A potential strategy to narrow this gap is by enabling the available primary-care workforce through provision of affordable, accessible and high-quality electronic clinical decision support.

Aims

To develop and evaluate the feasibility, acceptability and preliminary effectiveness of a multifaceted primary healthcare worker intervention utilising a mobile device based electronic decision support system to improve the identification and management of individuals greater than or equal to 18 years with common mental disorders (CMD).

Methods

The study will be conducted in two different sites – 12 villages near Bhimavaram town in West Godavari district of Andhra Pradesh, and 30 villages in a scheduled tribe area which is further away. Two key phases are:

1. Development of the intervention that will enable suitably trained ASHAs and primary-care doctors to identify and manage CMD in the community
2. Conduct of a large pilot study to evaluate this intervention utilising quantitative and qualitative methods

Current Status

The study in the 30 scheduled tribe villages has ended and results have been published. Data collection in the other 12 villages has ended and is being analysed.

Conclusion

This study will result in the development of a highly innovative intervention to improve mental health outcomes in a community with great need. It is anticipated that it will lead to development of a robust intervention for subsequent large-scale implementation and rigorous evaluation.