Abstract
AbstractBackgroundThe ‘PRemIum for aDolEscents’ (PRIDE) project has developed a school-based, transdiagnostic stepped care programme for common adolescent mental health problems in India. The programme comprises a brief problem-solving intervention (‘Step 1’) followed by a personalised cognitive-behavioural intervention (‘Step 2’) for participants who do not respond to the first step.MethodsA mixed-method design was used to evaluate the acceptability and feasibility of the stepped care programme in five schools in New Delhi. Participants were N = 80 adolescents (mean age = 15.3 years, females = 55%) with elevated mental symptoms and associated distress/impairment.Results61 (76%) of the enrolled sample were assessed following Step 1, from which 33 (54%) met non-remission criteria. Among these 33 non-remitted cases, 12 (36%) opted for Step 2 and five (42%) completed the full programme. The remaining non-remitted cases (n = 21, 64%) opted out of further treatment. Perceived resolution of the primary problem (n = 9, 43%) was the most common reason for opting out. The median time to complete each step was 22 and 70 days respectively, with a gap of 31 days between steps. Qualitative feedback from adolescents and counsellors indicated requirements for a shorter delivery schedule, greater continuity across steps and more collaborative decision-making.ConclusionsThis study provides preliminary evidence for a stepped care programme aimed at common adolescent mental health problems. Modifications are recommended to enhance the acceptability and feasibility of the programme in low-resource settings.
Highlights
IntroductionA core set of practice elements have been systematically identified by matching evidence-based practices to common adolescent problems in the local context (Boustani et al, 2020)
The ‘PRemIum for aDolEscents’ (PRIDE) project was initiated in 2016 to address the large burden of adolescent mental health problems in India, home to 20% of the global population of adolescents (United Nations, Department of Economic and Social Affairs, Population Division, 2019)
Sixty-one (76%) study participants were assessed at T1, of which 33 (54%) met non-remission criteria and were eligible for Step 2
Summary
A core set of practice elements have been systematically identified by matching evidence-based practices to common adolescent problems in the local context (Boustani et al, 2020). PRIDE employs lay counsellors as the primary delivery agents, in line with evidence for the cost-effectiveness of tasksharing in mental health care in diverse low-resource settings (Raviola et al, 2019). The ‘PRemIum for aDolEscents’ (PRIDE) project has developed a school-based, transdiagnostic stepped care programme for common adolescent mental health problems in India. 61 (76%) of the enrolled sample were assessed following Step 1, from which 33 (54%) met non-remission criteria Among these 33 non-remitted cases, 12 (36%) opted for Step 2 and five (42%) completed the full programme. This study provides preliminary evidence for a stepped care programme aimed at common adolescent mental health problems. Modifications are recommended to enhance the acceptability and feasibility of the programme in low-resource settings
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