Intervention-based mental health training for community level workers in India –A systematic review

Development & evaluation of a training programme to address complex post-COVID psychological needs

Background & objectives In India, mental health treatment gaps are significant, and related to shortage of trained personnel. Published literature has identified gaps in existing training programmes including - delivering psychological interventions for complex concerns such as intensified post-COVID grief, trauma, suicidality; ongoing mentoring; and culture-sensitive interventions. Despite government initiatives, gaps in treatment and training have been compounded by a surge in psychological distress following COVID-19. This study aimed to develop, implement and evaluate a training programme for psychologists to identify, assess, and treat complex post-COVID psychological concerns. Methods The study employed a sequential mixed exploratory research design with tailored programme development (Phase I) and programme delivery with pre-post evaluations of participation, satisfaction, learning and competence using Moore's framework (Phase II). Psychologists with postgraduate qualifications, engaged in direct client contact were invited through flyers to participate in the free online training programme. Results The final programme included ten modules; with knowledge, skills, and application components; comprising synchronous and asynchronous elements. Fifty-three participants enrolled in the programme and 70 per cent completed the course. Pre-post evaluations indicated high satisfaction (93.54% rated as met/exceeded expectations); improvements in competence (pre training mode = 3; post-training mode = 4); and average to above average learning scores (mean scores ≥3 on 7 out of 9 module quizzes). Participant feedback revealed that the focus on complex concerns, practical learning through interactive sessions and role play recordings, and case-based supervision were helpful. Interpretation & conclusions The programme focused on training gaps identified through a needs assessment survey. It was received well in terms of participation, satisfaction, content, accessibility and learning. The indigenous and skill-focused training has implications to contribute to future mental health preparedness and scope for large-scale deployment.

Perceptions of primary healthcare providers for screening and management of mental health disorders in India: a qualitative study

Introduction

Individuals experiencing mental health disorders encounter numerous challenges while accessing mental healthcare services. Despite the inclusion of mental health in the primary healthcare system, screening and managing mental health disorders remain significantly overlooked. Therefore, there is a need to understand the perceptions of healthcare providers in primary care settings, identify the challenges faced, and gather suggestions for effective mental healthcare delivery.

Methods

The present qualitative study was conducted in 13 primary healthcare facilities in the Jodhpur district of Rajasthan, India, from 2023 to 2024 among 25 primary healthcare providers. Semi-structured interview guides were developed for each category of primary healthcare provider, including Medical Officers, Community Health Officers, and General Nurse Midwives, Auxiliary Nurse Midwives and in-depth interviews were recorded, transcribed, and thematically analyzed using codes and sub-codes.

Results

Results are summarized under the themes: (i) Navigating Mental Healthcare in Primary Healthcare Facilities, (ii) Challenges and Barriers in Mental Healthcare Delivery, (iii) Recommendation for Enhancing Mental Healthcare Services, and (iv) Approaches for Comprehensive Capacity Building Training and Module and further findings of each theme are presented under various sub-themes.

Conclusion

The findings suggest that despite a perceived competence in providing mental health services, there were substantial levels of negative attitudes towards mental health disorders among participants and provide insights for policymakers and healthcare professionals to develop targeted interventions and improve mental healthcare delivery at primary care facilities.

Universal mental health training for frontline professionals: evaluation of pilot trial in Ukraine

Background

Increasing accessibility of mental health services and expanding universal health coverage is possible worldwide by using a task-shifting approach as partial delegation of some mental health support tasks to trained non-mental health service providers in order to use the available workforce more efficiently. The Universal Mental Health Training (UMHT), which is dedicated to this aim, was developed and piloted in Ukraine. The UMHT is an educational program for frontline professionals on high-quality and evidence-based responses to the mental health needs of the population they serve.

Methods

The pilot trial of UMHTs' effectiveness was conducted with 307 frontline professionals divided into 24 training groups. The control group included 211 persons with the same occupation background who participated in training later (waiting list). All the groups took part in eight-hour training, which includes one introductory module that introduces the mental health topic alongside a five-step model of UMHT, two disorders-focused modules with the steps adjusted to work with specific disorders, and the final module that considers possible difficulties frontline professionals might experience. Three effectiveness measurements were used in the outcome assessment: readiness to interact with people with mental health issues at work, mental health awareness and mental health proficiency.

Results

Analysis of the outcome data for the frontline professionals who underwent the UMHT revealed a moderate effect size related to the knowledge of mental health conditions, mental health awareness, and increasing the readiness to interact with people with mental health issues in comparison to the control group.

Conclusions

High-level utilisation of the UMHT at work by trained professionals confirms the effectiveness of the developed intervention. Obtained results favour the continuation of the development of the UMHT and future implementation research in this field in Ukraine and potentially in other low- and middle-income countries.

Secondary trauma, burnout and resilience among mental health professionals from India: A review of research

While globally there has been growing research interest in the negative psychological consequences faced by helping professionals, literature among Indian Mental Health Professionals (MHPs) is sparse, and predominantly focussed on health care workers. This systematic review aims to synthesize and summarize current Indian literature on burnout, secondary traumatic stress and resilience among Indian MHPs. The review explores 14 research studies published in peer-reviewed journals between January 2005 to January 2022. Studies in the areas of secondary traumatic stress, burnout, vicarious trauma, compassion fatigue, and resilience have been included in the review. The term resilience within this paper includes compassion satisfaction, vicarious post-traumatic growth, well-being, coping, and stress management. The mental health professionals considered were psychiatrists, psychiatric nurses, psychiatric social workers, clinical psychologists, psychotherapists and counsellors. Studies were reviewed for their methodological considerations, the mental health population being studied, and the primary outcomes. Data related to sociodemographic variables, psychological impacts, risk and protective factors that influence burnout, secondary trauma and resilience among mental health professionals in India have been reported. The review summarizes conceptual, methodological, and analytical gaps and generates recommendations that contribute to theoretical and practice-based improvements in this area of research and practice.