Community-based psychological treatment for adolescents with anxiety and depression in India

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Anxiety and depression are common mental disorders and two leading causes of illness and disability among adolescents globally.In India, between 7 and 12% of adolescents have anxiety and depression, but very few have access to treatment because there are too few psychologists and psychiatrists, and poor access to mental health services. We know that psychological treatments can help reduce symptoms of anxiety and depression in adolescents. We also know that 'non-specialist' workers (i.e. those with no specialised mental health training) can provide effective psychological treatments in the community. However, we not know how to identify adolescents with anxiety and depression in the community, which specific treatment could be used by non-specialists in rural and urban slum Indian settings, where many vulnerable adolescents live, or how best to organise referrals for adolescents who do recover or have severe symptoms of anxiety and depression.In this project, we aim to understand how adolescents, their families, and local health providers think about anxiety and depression in adolescents, identify tools to screen adolescents for anxiety and depression in the community, adapt one of five existing psychological treatments in partnership with adolescents, their families and local non-specialist workers, and develop referral pathways. Finally, we will pilot this adapted psychological treatment - as well as the screening tool and referrals - with adolescents over a period of nine months to find out if providing treatment in this way is acceptable, feasible, and leads to a reduction in symptoms of anxiety and depression in adolescents. We will also collect data on the costs of the screening, psychological treatment and referrals.We will focus on adolescents with mild or moderate symptoms of anxiety and depression, and refer those with more severe symptoms or suicidal thoughts to mental health services.Through this project, we hope to greatly expand access for treatment to help adolescents with anxiety and depression in rural and urban India.