Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility
Abstract Background 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-b...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425122000073/type/journal_article |
| _version_ | 1797782526383620096 |
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| author | Kanika Malik Maliha Ibrahim Sonal Mathur James E. Jose Pooja Nair Rooplata Sahu Madhuri Krishna Deepak Jangra Rhea Mathews Pim Cuijpers Bruce Chorpita Christopher G. Fairburn Vikram Patel Daniel Michelson |
| author_facet | Kanika Malik Maliha Ibrahim Sonal Mathur James E. Jose Pooja Nair Rooplata Sahu Madhuri Krishna Deepak Jangra Rhea Mathews Pim Cuijpers Bruce Chorpita Christopher G. Fairburn Vikram Patel Daniel Michelson |
| author_sort | Kanika Malik |
| collection | DOAJ |
| description | Abstract
Background
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.
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| first_indexed | 2024-03-13T00:12:11Z |
| format | Article |
| id | doaj.art-02496660fa594b929c700caa42a8a3f5 |
| institution | Directory Open Access Journal |
| issn | 2054-4251 |
| language | English |
| last_indexed | 2024-03-13T00:12:11Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj.art-02496660fa594b929c700caa42a8a3f52023-07-12T08:58:17ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512022-01-01952152510.1017/gmh.2022.7Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibilityKanika Malik0https://orcid.org/0000-0003-2869-9055Maliha Ibrahim1Sonal Mathur2James E. Jose3Pooja Nair4Rooplata Sahu5Madhuri Krishna6Deepak Jangra7Rhea Mathews8Pim Cuijpers9Bruce Chorpita10Christopher G. Fairburn11Vikram Patel12Daniel Michelson13https://orcid.org/0000-0001-7370-8788PRIDE Project, Sangath, New Delhi, India Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, IndiaPRIDE Project, Sangath, New Delhi, India Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, IndiaPRIDE Project, Sangath, New Delhi, IndiaPRIDE Project, Sangath, New Delhi, IndiaPRIDE Project, Sangath, New Delhi, IndiaPRIDE Project, Sangath, New Delhi, IndiaCommunication for Development, United Nations Children's Fund, New Delhi, IndiaPRIDE Project, Sangath, New Delhi, IndiaPRIDE Project, Sangath, New Delhi, IndiaDepartment of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Psychology, University of California, Los Angeles, CA, USADepartment of Psychiatry, University of Oxford, Oxford, UKPRIDE 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, USASchool of Psychology, University of Sussex, Brighton, UKAbstract Background 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. https://www.cambridge.org/core/product/identifier/S2054425122000073/type/journal_articleadolescent mental healthIndiaschoolsstepped caretransdiagnostic interventions |
| spellingShingle | Kanika Malik Maliha Ibrahim Sonal Mathur James E. Jose Pooja Nair Rooplata Sahu Madhuri Krishna Deepak Jangra Rhea Mathews Pim Cuijpers Bruce Chorpita Christopher G. Fairburn Vikram Patel Daniel Michelson Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility Cambridge Prisms: Global Mental Health adolescent mental health India schools stepped care transdiagnostic interventions |
| title | Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility |
| title_full | Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility |
| title_fullStr | Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility |
| title_full_unstemmed | Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility |
| title_short | Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility |
| title_sort | development of a transdiagnostic stepped care programme for common adolescent mental health problems in indian secondary schools lessons from a pilot study examining acceptability and feasibility |
| topic | adolescent mental health India schools stepped care transdiagnostic interventions |
| url | https://www.cambridge.org/core/product/identifier/S2054425122000073/type/journal_article |
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