Testing the Effectiveness of Implementing a Model of Mental Healthcare Involving Trained Lay Health Workers in Treating Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part II Results

被引：6

作者：

Malla, Ashok ^{[1
,2
]}

Margoob, Mushtaq ^{[3
,4
,5
]}

Iyer, Srividya ^{[1
,2
,6
]}

Majid, Abdul ^{[7
]}

Lal, Shalini ^{[8
,9
,10
]}

Joober, Ridha ^{[1
,6
,11
,12
]}

Mansouri, Bilal Issaoui ^{[6
]}

机构：

[1] McGill Univ, Dept Psychiat, Douglas Hosp, Res Ctr, Montreal, PQ, Canada

[2] ACCESS Open Minds Network, Douglas Hosp, Res Ctr, Montreal, PQ, Canada

[3] Islamic Univ Sci & Technol, Cognit & Behav Sci Studies Res Ctr, Awantipore, Kashmir, India

[4] Adv Inst Management Stress & Lifestyle Related Pr, Srinagar, Kashmir, India

[5] Supporting Always Wholeheartedly All Broken Heart, Kashmir, India

[6] Douglas Mental Hlth Univ Inst, Douglas Hosp, Res Ctr, Montreal, PQ, Canada

[7] Sherikashmir Inst Med Sci, Med Coll, Dept Psychiat, Srinagar, Kashmir, India

[8] Univ Montreal, Sch Rehabil, CHUM Res Ctr, Fac Med, Montreal, PQ, Canada

[9] Univ Montreal, CHUM Res Ctr, Hosp Res Ctr CRCHUM, Montreal, PQ, Canada

[10] Douglas Mental Hlth Univ Inst, CHUM Res Ctr, Montreal, PQ, Canada

[11] Prevent & Early Intervent Program Psychosis, Montreal, PQ, Canada

[12] Douglas Mental Hlth Univ Inst, Res Program Psychot & Neurodev Disorders, Montreal, PQ, Canada

来源：

CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE | 2019年 / 64卷 / 09期

关键词：

global mental health; low; and middle-income countries; lay health worker; youth mental health; technology in low; kashmir; india; case identification; stakeholder engagement; early intervention; ANXIETY DISORDERS; SCHIZOPHRENIA; INTERVENTION; INDIA; PREDICTORS; IMPACT; COMORBIDITY; DEPRESSION; ADHERENCE; FAMILIES;

D O I：

10.1177/0706743719839314

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Objectives: To report the outcomes of young people (aged 14-30 years) treated for major mental disorders in a lay health worker (LHW) intervention model in a rural district of conflict-ridden Kashmir, India. Methods: Over a 12-month follow-up, LHWs collected data on symptoms, functioning, quality of life and disability, and patients' and families' service engagement and satisfaction. Results: Forty trained LHWs (18 males and 22 females) identified 262 individuals who met the criteria for a diagnosis of a major mental disorder, connected them with specialists for treatment initiation (within 14 days), and provided follow-up and support to patients and families. Significantly more patients (14-30 years) were identified during the 14 months of the project than those in all age groups in the preceding 2 years. At 12 months, 205 patients (78%) remained engaged with the service and perceived it as very helpful. Repeated measures ANOVA showed significant improvements in scores on the global assessment of functioning (GAF) scale (F[df, 3.449] = 104.729, p < 0.001) and all 4 domains of the World Health Organization quality of life (WHOQOL) brief version (WHOQOL-BREF) of the survey-Physical F(df, 1.861) = 40.82; Psychological F(df, 1.845) = 55.490; Social F(df, 1.583) = 25.189; Environment F(df, 1.791) = 40.902, all ps < 0.001-and a decrease in disability (F[df, 1.806] = 4.364, p = 0.016). An interaction effect between time and sex was observed for the physical health domain of the WHOQOL-BREF. Discussion and Conclusions: Our results show that an LHW-based service model, implemented in a rural setting of a low-to-middle income region plagued by long-term conflict, benefits young people with major mental disorders. We discuss the implications of our findings in the context of similar environments and the challenges encountered.

引用

页码：630 / 637

页数：8

共 32 条

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