“Helping myself empowered me to help young people better”: A stepped care model, with non-specialist workers (NSWs) addressing mental health of young people in urban vulnerable communities across the Mumbai metropolitan region in India

Shyam, Rama and Mitra, Arati and Sharma, Seema and Ajgaonkar, Vinita and Balasubramanyam, Anu and Jayaraman, Anuja and Karandikar, Neeta and Shaikh, Nikhat and Rajan, Sheetal and Das, Tanushree and Raj, Tanya (2024) “Helping myself empowered me to help young people better”: A stepped care model, with non-specialist workers (NSWs) addressing mental health of young people in urban vulnerable communities across the Mumbai metropolitan region in India. Cambridge Prisms: Global Mental Health, 11. ISSN 2054-4251

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Abstract

Research on adolescent mental health in low and middle-income countries cites the paucity of human resources and emphasises non-specialist worker (NSW)-led counselling intervention within school and health-system platforms. This pilot study aimed to evaluate the feasibility and acceptability of a transdiagnostic stepped care model, for delivering preventive psychological treatment to adolescents through NSWs in urban vulnerable community settings. Conducted in three such settlements in Mumbai and Thane districts of Maharashtra in India, this mixed-methods study engaged 500 young people, their parents and 52 NSWs. Quantitative data, obtained through monitoring indicators, fidelity checklists and the Strengths and Difficulties Questionnaire (SDQ), revealed key stressors for adolescents, including poverty, structural inequity, cultural conformity pressures, academic anxieties and communication gap within families. Post-intervention, adolescents exhibited an enhanced capacity for positive emotions and agency. The qualitative component, incorporating observations, focus group discussions (FGDs) and in-depth interviews (IDIs) with various stakeholders, highlighted reduced stigma around mental health, yet identified barriers like time commitment, lack of incentivisation for NSWs, lack of privacy in densely populated communities and societal stigma. This implementation research underscores that adolescent mental health stressors often originate from social determinants, exacerbated by insufficient awareness and stigma. Such stepped care models offer a pathway for communities to establish enduring support networks.

Item Type:	Article
Authors:	Shyam, Rama and Mitra, Arati and Sharma, Seema and Ajgaonkar, Vinita and Balasubramanyam, Anu and Jayaraman, Anuja and Karandikar, Neeta and Shaikh, Nikhat and Rajan, Sheetal and Das, Tanushree and Raj, Tanya
Document Language:	Language English
Uncontrolled Keywords:	adolescent health; non-specialist worker; social determinants; stigma; urban community-based mental health
Subjects:	Public Health
Divisions:	Azim Premji University - Bhopal > Public Health
Full Text Status:	None
URI:	http://publications.azimpremjiuniversity.edu.in/id/eprint/6515
Publisher URL:	https://www.cambridge.org/

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