Improving Help-seeking for Depression Care in Nepal

Transcultural Psychosocial Organization Nepal

Status: Active, not recruiting

Conditions: Help-Seeking Behavior; Depression

Treatments: Behavioral: Gain-Life (Give informAtIoN to transform Life)

Study type: Interventional

Funder types: Other

Identifiers

NCT06574074

WTMOST

Details and patient eligibility

About

Depression is a serious public health concern worldwide due to its high prevalence rate and significant emotional and financial burden on individuals, their families, and society. There is a substantial gap between the number of people in need of treatment for depression and those who actually receive it. The recent World Health Organization (WHO) World Mental Health Survey revealed that 86.3% of people with anxiety, mood, or substance disorders in lower-middle-income countries did not receive any treatment in the past 12 months. This study aims to evaluate a community-based intervention to address demand-side barriers by improving mental health literacy, dispelling myths and misconceptions about depression, changing negative attitudes towards depression care, and promoting help-seeking behavior.

Full description

It is estimated that more than 300 million people worldwide are experiencing depression, which is about 4.4% of the world's population. Despite the availability of evidence-based treatment, it is reported that 86.3% of people with anxiety, mood, or substance disorders in lower-middle-income countries received no treatment in the past 12 months. Among people who receive treatment for depression, only one out of 27 persons receive minimally adequate treatment in low- and middle-income countries (LMICs). Despite being the major contributor to the overall global burden of disease, depression receives less or no health priority in many LMICs, where more than 80% of people with depression reside.

This study will take place in two municipalities in Morang district, eastern Nepal. Female Community Health Volunteers will administer the intervention to individuals identified with depression using the locally developed and validated Community Informant Detection Tool (CIDT). Participants who receive the intervention will be followed up after one month to evaluate their help-seeking behavior (primary outcome) and after three months to assess treatment adherence, a secondary objective of the study. The study will assess the effects and interactions of four intervention components (information on depression, available treatments, stigma and myths, and life transformation experiences) on the primary outcome of help-seeking behavior and secondary outcomes such as treatment adherence. The severity of depression symptoms will be assessed using the validated PHQ-9, and knowledge and attitudes toward depression will be evaluated to assess mediation effects.

Enrollment: 286 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• being an adult aged 18 or older residing in Kanepokhari Rural Municipality or Patharisanischare Municipality,
• those detected through the CIDT
• providing consent for participation
• being proficient in speaking and understanding Nepali

Exclusion criteria

• people with already receiving mental health services
• having severe mental illness]
• participants below the age of 18 years,
• participants outside of Kanepokhari and Pathari-sanischare Municipality

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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286 participants in 8 patient groups

Factor-1

Other group

Description:

Participants allocated to this will receive full version of the Gain Life intervention

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-2

Other group

Description:

Participants allocated to this will receive a few components of the Gain Life intervention that include information on depression, available treatments, and stigma reduction

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-3

Other group

Description:

Participants allocated to this will receive only a few components of Gain Life intervention including information on depression, available treatments, and life transformation experiences

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-4

Other group

Description:

Participants allocated to this will receive only information on depression, and available treatments components of the Gain Life intervention

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-5

Other group

Description:

Participants allocated to this will receive three components of the Gain Life intervention that include information on depression, stigma reduction and life transformation experiences

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-6

Other group

Description:

Participants allocated to this will receive information on depression and stigma reduction components of the Gain Life intervention

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-7

Other group

Description:

Participants allocated to this will receive a selected components of the Gain Life intervention such as information on depression, available treatments and life transformation experiences

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)

Factor-8

Other group

Description:

Participants allocated to this will receive only the information on depression component of the Gain Life intervention

Treatment:

Behavioral: Gain-Life (Give informAtIoN to transform Life)