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Innovative Mental Health Initiatives in India

Updated: Oct 9, 2022

India, a country where mental illness soars at alarming levels, stakeholders have become ever then more vigilant and assiduous in order to improve the worsening conditions. And researchers especially have been re-thinking how mental health can be addressed in this country, with more focus on innovations that can sustain and be scaled. In India more than 100 million people live with a mental illness, and we have merely 9000 psychiatrists for them. How can we possibly ever get everyone the treatment they need? But there is hope, as researchers have been proposing and working towards alternative ways of capacity building, breaking stigma and closing the treatment gap. Today, with excitement and hope, I'll be sharing some groundbreaking research that is being conducted or has been recently published.

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1. Atmiyata by Centre for Mental health Law & Policy

Atmiyata is an innovative & evidence-based community-led intervention to reduce the mental health and social care gap in rural communities. It is a community volunteer service that identifies and supports people experiencing distress in rural communities of Gujarat state in western India. Volunteers have the following roles: to raise awareness in the community about mental health issues; to identify individuals experiencing distress and provide 4-6 sessions of counselling; to refer people who may have a severe mental health condition to the public mental health service; and to support people in need with access to social care benefits. Results showed that recovery rates for people experiencing distress were clinically and statistically higher in people receiving support from the Atmiyata service compared with the control. Improvements in depression, anxiety, and overall symptoms of mental distress were seen after three and eight months. Significant improvements in functioning, social participation and quality of life were reported at the end of eight months.

Credits: Centre for Mental Health Law & Policy, Mariwala Health Initiative

2. PRIDE (Premium for Adolescents) by Sangath

PRIDE is a Wellcome Trust-funded programme that aims to develop and test a suite of scalable, evidence-based interventions in India. The country is home to the largest concentration of adolescents in the world, comprising 20% of the total global population of 10-19-year-olds. Previous research has shown that a significant percentage of secondary school students experience mental health morbidity, and suicide is the leading cause of mortality in Indian adolescents.

It was designed initially for urban, low-income secondary schools in New Delhi and Goa, the PRIDE intervention model incorporates three design innovations.

1. They systematically identified evidence-based practices to common adolescent problems found in the local context. These building blocks are combined within a structured transdiagnostic protocol from which a ‘menu’ of behavioural modules are selected, titrated and sequenced

2. They employ lay counsellors as the primary delivery agents, in line with evidence for the cost-effectiveness of task-sharing for mental health care in diverse low-resourced settings. A low-cost digital training package was been developed to enable capacity building at scale.

3. A stepped care architecture allows for further resource efficiency. A broad-based problem-solving intervention is delivered as a brief first-line intervention, followed by a more tailored, higher-intensity second step for non-responders.

There has much evidence supporting the claim of the efficiency of this intervention, including stepped-wedge, cluster-randomised controlled trial of a classroom-based sensitisation intervention designed to generate demand for the Step 1 problem-solving intervention (Parikh et al., 2021). They are in midst of another trial that evaluates the learning outcomes of online training provided for prospective PRIDE counsellors without prior experience in psychological therapies.

POD Adventures is a smartphone based-game that teaches problem-solving skills through interactive animated stories, skill-based mini-games and quizzes. Personalized action plans are created by the user to help apply problem-solving skills to real-life problems and situations with support and encouragement from an in-game guide”(Sangath 2021c).

Credits: Sangath


(The National Institute of Mental Health and Neuro-Sciences)

The present study was conducted to ascertain the effectiveness of Project ECHO, a tele-mentoring model to bridge the urban-rural divide in mental health and addiction care in the context of a developing country like India. The Counsellors from 11 rural and underserved districts of Chhattisgarh were periodically connected to NIMHANS multidisciplinary specialists by smartphone app and underwent virtual mentoring to learn and translate "best practices" in Mental health and Addiction by using "patient-centric learning", a core component of NIMHANS ECHO model. The outcome evaluation was modelled on Moore's evaluation framework focusing on participant engagement, satisfaction, learning, competence and performance. Over the period of 6 months i.e. 12 tele-ECHO clinics, 41 patients case summaries were discussed by the Counsellors with NIMHANS Hub Specialists. Half of the counsellors could join >80% clinics and overall there were no drop-outs. There was a significant increase in learning and self-confidence after six months. The participants liked "relevance of the courses to clinical practices". "group based discussions" and "a reduction in professionals isolation". The results indicate promise of the NIMHANS ECHO tele-mentoring model as one with potential for capacity-building in mental health and addiction for remote and rural areas by leveraging technology.

4. SMART Health by The George Institute for Global Health

SMART mental health program is a pilot initiative by the George Institute for Global Health. Under this pilot initiative, digital technology was applied for the purpose of screening, management, referral and treatment of mental health issues such as depression, stress and suicidal risk. The Project was implemented across 12 villages in West Godavari district, Andhra Pradesh, India. Under the project, technology enabled electronic decision support system (EDSS) was used to facilitate delivery of mental health services by primary healthcare workers. The intervention was found to be effective in enhancing the participants understanding about Common Mental Disorders and promoting overall well-being.

5. Mann Mela by Sangath

Mann Mela is India’s first digital museum aimed at addressing mental health issues faced by the youth of India. It is an initiative by Sangath, a non-governmental organization working in various states across India. Mann Mela describes mental health stories from young people in the age group 18-35 years from across India. Mann Mela makesuse of art and technology to exhibit first person stories of mental trauma, breaking stigma and recovery. Personal stories act as one of the powerful tool to link with people facing similar kind of mental health issues and thus aid in their recovery.

"Telling one’s personal story has a long tradition of being a powerful tool for enabling people to understand and empathize with the other, with humanity, and ultimately with oneself."

- Vikram Patel, Mann Mela Advisor‍

6. Muskurayega India by NSS

Muskurayega India (India will smile) is a tele-counselling initiative by NSS10, Uttar Pradesh in collaboration with UNICEF, Uttar Pradesh and Public Health Foundation of India (PHFI)(UNICEF 2020). Under this initiative, mental health counsellors provide tele-counselling support to students and general public. UNICEF, Uttar Pradesh supported this initiative by providing subject matter experts and digital platforms necessary for conducting the training sessions. PHFI planned the technical sessions and provided the backend support. In April 2020, 300 programme officers from each district were nominated as mental health Counsellors by the NSS Cell of Uttar Pradesh. In May 2020, a mobile application called “NSS-UP” was launched for the counsellors. As on September 30, 2020, 286 mental health counsellors registered on the NSS- UP app and provided tele-counselling support to 2,207 callers. In such a short span, the initiative has shown an encouraging response and provides motivation for more such initiatives in future.


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