Testing the Effectiveness of Implementing a Model of Mental Healthcare Involving Trained Lay Health Workers in Treating Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part II Results.

TitleTesting the Effectiveness of Implementing a Model of Mental Healthcare Involving Trained Lay Health Workers in Treating Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part II Results.
Publication TypeJournal Article
Year of Publication2019
AuthorsMalla A, Margoob M, Iyer S, Majid A, Lal S, Joober R, Mansouri BIssaoui
JournalCan J Psychiatry
Pagination706743719839314
Date Published2019 Apr 01
ISSN1497-0015
Abstract

OBJECTIVES: To report the outcomes of young people (aged 14-30 years) treated for major mental disorders in a lay health worker (LHW) intervention model in a rural district of conflict-ridden Kashmir, India.METHODS: Over a 12-month follow-up, LHWs collected data on symptoms, functioning, quality of life and disability, and patients' and families' service engagement and satisfaction.RESULTS: Forty trained LHWs (18 males and 22 females) identified 262 individuals who met the criteria for a diagnosis of a major mental disorder, connected them with specialists for treatment initiation (within 14 days), and provided follow-up and support to patients and families. Significantly more patients (14-30 years) were identified during the 14 months of the project than those in all age groups in the preceding 2 years. At 12 months, 205 patients (78%) remained engaged with the service and perceived it as very helpful. Repeated measures ANOVA showed significant improvements in scores on the global assessment of functioning (GAF) scale (F[df, 3.449] = 104.729, p < 0.001) and all 4 domains of the World Health Organization quality of life (WHOQOL) brief version (WHOQOL-BREF) of the survey-Physical F(df, 1.861) = 40.82; Psychological F(df, 1.845) = 55.490; Social F(df, 1.583) = 25.189; Environment F(df, 1.791) = 40.902, all ps < 0.001-and a decrease in disability (F[df, 1.806] = 4.364, p = 0.016). An interaction effect between time and sex was observed for the physical health domain of the WHOQOL-BREF.DISCUSSION AND CONCLUSIONS: Our results show that an LHW-based service model, implemented in a rural setting of a low-to-middle income region plagued by long-term conflict, benefits young people with major mental disorders. We discuss the implications of our findings in the context of similar environments and the challenges encountered.

DOI10.1177/0706743719839314
Alternate JournalCan J Psychiatry
PubMed ID30935214

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