This study provides preliminary evidence for a stepped care programme aimed at common adolescent mental health problems.
Authors
Kanika Malik, Associate Professor, Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, India; PRIDE Project, Sangath, New Delhi, India.
Maliha Ibrahim, Assistant Professor, Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, India; PRIDE Project, Sangath, New Delhi, India.
Sonal Mathur, PRIDE Project, Sangath, New Delhi, India.
James E. Jose, PRIDE Project, Sangath, New Delhi, India.
Pooja Nair, PRIDE Project, Sangath, New Delhi, India.
Rooplata Sahu, PRIDE Project, Sangath, New Delhi, India.
Madhuri Krishna, Communication for Development, United Nations Children’s Fund, New Delhi, India.
Deepak Jangra, PRIDE Project, Sangath, New Delhi, India.
Rhea Mathews, PRIDE Project, Sangath, New Delhi, India.
Pim Cuijpers, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
Bruce Chorpita, Department of Psychology, University of California, Los Angeles, CA, USA.
Christopher G. Fairburn, Department of Psychiatry, University of Oxford, Oxford, UK.
Vikram Patel, PRIDE Project, Sangath, New Delhi, India; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
Daniel Michelson, School of Psychology, University of Sussex, Brighton, UK.
Summary
The ‘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.
Methods
A 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.
Results
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. 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.
Conclusions
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.
Published in: Global Mental Health
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