Development of a transdiagnostic stepped care programme for common adolescent mental health problems in Indian secondary schools: lessons from a pilot study examining acceptability and feasibility
Open accessAbstract
Background: The ‘PRemIum for aDolEscents’ (PRIDE) project has developed a school-based, transdiagnostic stepped care programme for common adolescent mental health problems in India. The programme comprises a brief problem-solving intervention (‘Step 1’) followed by a personalised cognitive-behavioural intervention (‘Step 2’) for participants who do not respond to the first step. Methods: A mixed-method design was used to evaluate the acceptability and feasibility of the stepped care programme in five schools in New Delhi. Participants were N = 80 adolescents (mean age = 15.3 years, females = 55%) with elevated mental symptoms and associated distress/impairment. Results: 61 (76%) of the enrolled sample were assessed following Step 1, from which 33 (54%) met non-remission criteria. Among these 33 non-remitted cases, 12 (36%) opted for Step 2 and five (42%) completed the full programme. The remaining non-remitted cases (n = 21, 64%) opted out of further treatment. Perceived resolution of the primary problem (n = 9, 43%) was the most common reason for opting out. The median time to complete each step was 22 and 70 days respectively, with a gap of 31 days between steps. Qualitative feedback from adolescents and counsellors indicated requirements for a shorter delivery schedule, greater continuity across steps and more collaborative decision-making. Conclusions: This study provides preliminary evidence for a stepped care programme aimed at common adolescent mental health problems. Modifications are recommended to enhance the acceptability and feasibility of the programme in low-resource settings.
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Evidence was found for the incremental benefit of a tailored, second-step intervention for non-responders to step one.
“Evidence was also found for the incremental benefit of a tailored, secondstep intervention for non-responders to step one.”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [342]
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Research works printed but not linked: 5
- Boustani MM, Daleiden E, Bernstein A, Michelson D, Gellatly R, Malik K, Patel V and Chorpita B (2020) Using relevance mapping methodology to design an adolescent mental health intervention in India. Global Health Action 13, 1775062. doi: 10.1080/16549716.2020.1775062 · DOI
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- Parikh R, Hoogendoorn A, Michelson D, Ruwaard J, Sharma R, Bhat B, Malik K, Sahu R, Cuijpers P and Patel V (2021) Increasing demand for school counselling through a lay counsellor-delivered classroom sensitisa- tion intervention: a stepped-wedge cluster randomised controlled trial in New Delhi, India. BMJ Global Health 6, e003902. doi: 10.1136/ bmjgh-2020-003902 · DOI · Paper page
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The Lancet Psychiatry Commission on youth mental health
McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., et al. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00163-9 · Cited by 663 · see citing works
- Authors
- Malik, K., Ibrahim, M., Mathur, S., Jose, J. E., Nair, P., Sahu, R., Krishna, M., Jangra, D., Mathews, R., Cuijpers, P., Chorpita, B., Fairburn, C. G., Patel, V., & Michelson, D.
- Affiliations
- Sangath (IN)
- United Nations Children's Fund (US)
- Vrije Universiteit Amsterdam (NL)
- University of California, Los Angeles (US)
- University of Oxford (GB)
- Harvard University (US)
- University of Sussex (GB)
- Corresponding author
- Michelson, Daniel
- ORCID
- Venue
- Global Mental Health
- Publisher
- Cambridge University Press (CUP)
- Published
- 2022
- Volume
- 9
- Pages
- 521-525
- ISSN
- 2054-4251 (ISSN-L)
- OpenAlex
- W4221086831
- Cited by
- 10
- References
- 4
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 3
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
- Research Portal (King's College London) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
- Funders
- Wellcome (106919/Z/15/Z)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- stepped care, adolescent mental health, school-based mental health programs, transdiagnostic treatment, problem-solving intervention, cognitive-behavioural intervention, acceptability, feasibility, treatment discontinuation, resource-limited settings, India
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