Adolescents' Resilience and Treatment nEeds for Mental health in Indian Slums (ARTEMIS)
Medical Research Council
The George Inst for Global Health India
The proposed trial will be a hybrid effectiveness-implementation cluster randomised trial with wards/blocks (only urban slums will be included) being the unit of allocation. The trial will implement a mobile-technology enabled mental health services delivery model for adolescents living in slums in two Indian cities - New Delhi and Hyderabad. Duration of the trial will be for 36 months. It will train primary healthcare workers and doctors to screen, diagnose, and manage adolescents suffering from depression and increased suicide risk, and also inquire and manage those identified at high risk of intimate partner violence leading to stress/depression. Besides task sharing, the complex intervention will also include an anti-stigma campaign. We hypothesise that: (1) a community-based anti-stigma campaign will lead to significant improvements in community's behaviours toward adolescents with mental disorders; (2) a mobile device-based decision support system for primary health care staff will significantly lower depression and suicide risk in adolescents. Forty wards (only slums will be included) will be randomized to intervention or control group and we aim to recruit 2560 adolescents into the study, in total. Standardized tools will be used to screen for depression and suicide risk and management will be done using evidence-based WHO guidelines. The primary outcomes will be assessed at the end of 12 months of intervention. Process evaluation will be done throughout the intervention, but the detailed evaluation will follow the intervention. Economic evaluation will use statistical modelling to ascertain cost-effectiveness. If successful, the trial could be scaled up across other areas of India or even other low and middle income countries with the help of the government and other key stakeholders.
6.6 Psychological and behavioural / Research Grant