Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study
Abstract Background Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healt...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Child and Adolescent Psychiatry and Mental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13034-024-00704-4 |
| _version_ | 1797350160280322048 |
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| author | Ankita Mukherjee Sandhya Kanaka Yatirajula Sudha Kallakuri Srilatha Paslawar Heidi Lempp Usha Raman Beverley M. Essue Rajesh Sagar Renu Singh David Peiris Robyn Norton Graham Thornicroft Pallab K. Maulik |
| author_facet | Ankita Mukherjee Sandhya Kanaka Yatirajula Sudha Kallakuri Srilatha Paslawar Heidi Lempp Usha Raman Beverley M. Essue Rajesh Sagar Renu Singh David Peiris Robyn Norton Graham Thornicroft Pallab K. Maulik |
| author_sort | Ankita Mukherjee |
| collection | DOAJ |
| description | Abstract Background Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents’ Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints. Methods In the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed. Results The anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO’s mhGAP algorithm, built into the digital health application. Conclusion The formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups. Trial Registration The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022. |
| first_indexed | 2024-03-08T12:40:47Z |
| format | Article |
| id | doaj.art-d3c17ba472324e98ae7652aeba93714c |
| institution | Directory Open Access Journal |
| issn | 1753-2000 |
| language | English |
| last_indexed | 2024-03-08T12:40:47Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Child and Adolescent Psychiatry and Mental Health |
| spelling | doaj.art-d3c17ba472324e98ae7652aeba93714c2024-01-21T12:10:50ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002024-01-0118111410.1186/s13034-024-00704-4Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS studyAnkita Mukherjee0Sandhya Kanaka Yatirajula1Sudha Kallakuri2Srilatha Paslawar3Heidi Lempp4Usha Raman5Beverley M. Essue6Rajesh Sagar7Renu Singh8David Peiris9Robyn Norton10Graham Thornicroft11Pallab K. Maulik12The George Institute for Global HealthThe George Institute for Global HealthThe George Institute for Global HealthThe George Institute for Global HealthCentre for Rheumatic Diseases, Faculty of Life Sciences & Medicine, King’s College LondonDepartment of Communication, University of HyderabadInstitute for Health Policy, Management and Evaluation, University of TorontoDepartment of Psychiatry, All India Institute of Medical Sciences, New DelhiYoung Lives IndiaThe George Institute for Global Health, UNSW SydneyThe George Institute for Global Health, UNSW SydneyCentre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonThe George Institute for Global HealthAbstract Background Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents’ Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints. Methods In the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed. Results The anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO’s mhGAP algorithm, built into the digital health application. Conclusion The formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups. Trial Registration The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022.https://doi.org/10.1186/s13034-024-00704-4Child and adolescent mental health (CAMH)DepressionFormative researchLMICSelf-harmSlums |
| spellingShingle | Ankita Mukherjee Sandhya Kanaka Yatirajula Sudha Kallakuri Srilatha Paslawar Heidi Lempp Usha Raman Beverley M. Essue Rajesh Sagar Renu Singh David Peiris Robyn Norton Graham Thornicroft Pallab K. Maulik Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study Child and Adolescent Psychiatry and Mental Health Child and adolescent mental health (CAMH) Depression Formative research LMIC Self-harm Slums |
| title | Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study |
| title_full | Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study |
| title_fullStr | Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study |
| title_full_unstemmed | Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study |
| title_short | Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study |
| title_sort | using formative research to inform a mental health intervention for adolescents living in indian slums the artemis study |
| topic | Child and adolescent mental health (CAMH) Depression Formative research LMIC Self-harm Slums |
| url | https://doi.org/10.1186/s13034-024-00704-4 |
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