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Bundled Intervention Integrating Mental Health Services in Nepal

NCT ID: NCT02376062

Last Updated: 2017-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-06

Study Completion Date

2019-07-30

Brief Summary

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Globally, access to mental healthcare is often non-existent in rural, resource-deprived communities despite the pervasive need for services, particularly in post-conflict and post-disaster settings. We are developing and piloting will develop and pilot a culturally appropriate training model for non-specialist providers (NSPs) to deliver high-quality mental health care over a period of 24 months in a primary care hospital in a rural district in Nepal. We will employ a mixed methods framework to evaluate change in skills, knowledge, and attitude in NSP's, identify key mechanisms for continuum of mental healthcare delivery, and efficacy and cost-effectiveness in care delivery through a government hospital, clinics, and a network of community health workers. This integrated approach will introduce a bundled intervention that includes: both an on-site care coordinator and off-site psychiatric supervisors based in Nepal's capital, Kathmandu, weekly case conferences, and surveys of NSP's and clinical supervisors every six months during the study period. To learn about the acceptability, feasibility and challenges in the program we will also conduct Focus Group Discussions among the PCPs. In the last one year of the research in Achham District we have seen increase in knowledge efficacy and skills among the NSPs and also improved mental health care services at Bayalpata Hospital. Our experience in Achham motivated us to develop a similar program for Charikot Primary Health Center in Dolakha District. Outcomes of this study will focus on efficacy of this model to appropriately identify, counsel, and treat patients with depression, psychosis, and post-traumatic stress disorder (PTSD) through an integrated rural mental healthcare delivery intervention as a model for rural healthcare delivery.

Detailed Description

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Conditions

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Mental Health

Keywords

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Continuing Medical Education Chronic Diseases Nepal Implementation Research

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Bundled Intervention

* On-site care coordinator and off-site psychiatric supervisors based in Nepal's capital, Kathmandu
* Weekly case conferences
* Surveys of clinicians and clinical supervisors in accordance with CME curriculum

Group Type EXPERIMENTAL

Bundled Intervention

Intervention Type OTHER

The authors have designed continuing medical education curriculum to improve clinical capacity and competency about mental health for Nepali Primary Care Providers. Specifically:

* On-site care coordinator and off-site psychiatric supervisors based in Nepal's capital, Kathmandu
* Weekly case conferences
* Surveys of clinicians and clinical supervisors in accordance with CME curriculum

Interventions

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Bundled Intervention

The authors have designed continuing medical education curriculum to improve clinical capacity and competency about mental health for Nepali Primary Care Providers. Specifically:

* On-site care coordinator and off-site psychiatric supervisors based in Nepal's capital, Kathmandu
* Weekly case conferences
* Surveys of clinicians and clinical supervisors in accordance with CME curriculum

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Primary Care Provider (MBBS-level physician or Health Assistant)
* Current staff at healthcare facility in Achham, Bajura, or Doti Districts.

Exclusion Criteria

* N/A
Minimum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, San Francisco

OTHER

Sponsor Role collaborator

Harvard Medical School Center for Global Health Delivery-Dubai

UNKNOWN

Sponsor Role collaborator

National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role collaborator

Possible

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Citrin, PhD, MPH

Role: STUDY_DIRECTOR

Possible

Locations

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Bayalpata Hospital

Sanfebagar, Achham, Nepal

Site Status

Charikot Primary Health Center

Bhimeshwor, Dolakha, Nepal

Site Status

Countries

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Nepal

Related Links

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http://possiblehealth.org

Possible

http://hsdg.partners.org/

Healthcare Systems Design Group

Other Identifiers

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MHCMEnyaya

Identifier Type: -

Identifier Source: org_study_id