The proportion of people with depression who sought care increased six-fold from 4.3 to 27.2 per cent in 30 villages in the Amravati district of Vidarbha. The proportion of people who accessed mental healthcare was the same across sex (53 per cent males and 47 per cent females), education, income and religion. As a result, the prevalence of depression among nearly 1,900 participants dropped from 14·6 to 11·3 per cent during this period. The results were published on January 5 in the journal The Lancet Psychiatry.
The prevalence of suicidal thoughts reduced by about 50 per cent — from 5.2 to 2.5 per cent. The actual reduction in the prevalence of suicidal thoughts was only small and was not the primary objective of the intervention, says Prof. Vikram Patel from the Public Health Foundation of India (PHFI), Delhi and the senior author of the paper.
The Vidarbha region has witnessed a large number of suicides in recent years. While other benefits have been extended to people in the region, access to mental care has not been provided. The intervention was carried out by VISHRAM (the Vidarbha Stress and Health ProgRAM), a grass-root community mental health program that has been designed to address the mental health risk factors for suicide (depression and alcohol use disorders).
There were just eight counsellors providing advanced psychosocial care and 39 community workers who helped increase awareness about mental health in the 30 villages. A baseline survey was conducted on nearly 1,500 participants who were randomly selected and another survey was carried out on nearly 1,900 randomly chosen people at the end of 18 months.
“The pilot study has shown that the programme can be expanded to cover the entire State,” says Dr. Rahul Shidhaye rom PHFI and the first author of the paper. “A similar approach pilot tested in one district in Madhya Pradesh under PRIME (programme for improving mental health care) was scaled up last year to cover the entire State.”
In India, 2-3 per cent (13 million people) adults suffer from depression. Yet, only about 4.3 per cent access mental care and nearly 90 per cent do not.