Development of a community intervention to increase help-seeking and adherence to depression care in India: mixed-methods study.

Authors

Miriam Sequeira, Yashi Gandhi, Richard Velleman, Daisy Radha Singla, Kedar Mirchandani, Luanna Fernandes, Helen A Weiss, Bijayalaxmi Biswal, Urvita Bhatia, Lalan Karapurkar, Lalan Madkaikar, Nikita Nalawade, Chunling Lu, Vikram Patel, Abhijit Nadkarni

Published in

BJPsych open. Volume 12. Issue 5. Pages e241. Oct 15, 2026. Epub Oct 15, 2026.

Abstract

Access to depression care can be improved by overcoming a combination of supply-side barriers and demand-side factors.
To describe the systematic development of a community-based intervention to improve uptake of, and adherence to, a psychosocial treatment for depression delivered by trained primary healthcare staff in Goa, India.
This mixed-methods study included five steps: Step 1, Synthesis of existing evidence by conducting relevant systematic reviews and a review of public health programmes in India; Step 2, In-depth interviews with community stakeholders (n = 35); Step 3, Consultation workshops with community stakeholders (n = 19) and primary healthcare staff (n = 34); Step 4, Triangulation of findings from the preceding steps; and Step 5, Content development for the intervention (e-course for training and the community intervention toolkit for delivery).
Overall, 20 strategies to enhance help-seeking and 5 strategies to improve adherence were identified to constitute the intervention. The community-based intervention is organised into four domains (Learn, Inform, Engage and Follow-up), with self-care integrated throughout the intervention. This intervention is designed to be delivered by a community volunteer who is motivated to cater to the communities' needs. The community volunteer is trained to deliver the intervention via a blended approach, an e-course and in-person one-on-one learning support by a coach, who later acts as a facilitator during the intervention delivery phase.
The systematic method enabled the development of a comprehensive intervention with contextually appropriate delivery strategies. The effectiveness of the intervention is presently being tested as part of a Hybrid Type II Implementation-Effectiveness randomised controlled trial. If found effective, the intervention has the potential to be a low-cost and sustainable opportunity to improve demand and adherence to depression treatment while also providing essential social, emotional and logistical support during the recovery process.

PMID:
42877953
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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