ArticleTrials2021
An integrated community and primary healthcare worker intervention to reduce stigma and improve management of common mental disorders in rural India: protocol for the SMART Mental Health programme.
Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The range of countermeasures to reduce inequalities in mental health care for socially marginalized or medically vulnerable adults: a PRISMA systematic review.BMC health services research · 2026Pooled it
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study.JMIR mental health · 2026Article
- Co-Development of the CoMUni Intervention: A Social-Media-Based Resource to Increase Mental Health Help-Seeking Behaviours in UK Undergraduates.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Diagnosis of mental disorders using machine learning: Literature review and bibliometric mapping from 2012 to 2023.Heliyon · 2024Review
- Learnings From Implementation of Technology-Enabled Mental Health Interventions in India: Implementation Report.JMIR medical informatics · 2024Article
- Using formative research to inform a mental health intervention for adolescents living in Indian slums: the ARTEMIS study.Child and adolescent psychiatry and mental health · 2024Article
- A mediation analysis evaluating change in self-stigma on diabetes outcomes among people with depression in urban India: A secondary analysis from the INDEPENDENT trial of the collaborative care model.PLOS global public health · 2024Article
- Cultural adaptation of INDIGO mental health stigma reduction interventions using an ecological validity model in north India.Frontiers in psychiatry · 2024Article
- Article
- Mental health related stigma, service provision and utilization in Northern India: situational analysis.International journal of mental health systems · 2023Article
- Article
- Incentivizing community health workers for scaling up mental health care in rural communities in India: A critical look at principles that work.Frontiers in health services · 2023Article
- Operational challenges in the pre-intervention phase of a mental health trial in rural India: reflections from SMART Mental Health.International journal of mental health systems · 2022Article
- Article
- Protocol for a process and implementation evaluation of the SMARThealth pregnancy hybrid type 2 cluster randomised controlled trial.Women's health (London, England)Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundAround 1 in 7 people in India are impacted by mental illness. The treatment gap for people with mental disorders is as high as 75-95%. Health care systems, especially in rural regions in India, face substantial challenges to address these gaps in care, and innovative strategies are needed.
methodsWe hypothesise that an intervention involving an anti-stigma campaign and a mobile-technology-based electronic decision support system will result in reduced stigma and improved mental health for adults at high risk of common mental disorders. It will be implemented as a parallel-group cluster randomised, controlled trial in 44 primary health centre clusters servicing 133 villages in rural Andhra Pradesh and Haryana. Adults aged ≥ 18 years will be screened for depression, anxiety and suicide based on Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorders (GAD-7) scores. Two evaluation cohorts will be derived-a high-risk cohort with elevated PHQ-9, GAD-7 or suicide risk and a non-high-risk cohort comprising an equal number of people not at elevated risk based on these scores. Outcome analyses will be conducted blinded to intervention allocation. EXPECTED OUTCOMES: The primary study outcome is the difference in mean behaviour scores at 12 months in the combined 'high-risk' and 'non-high-risk' cohort and the mean difference in PHQ-9 scores at 12 months in the 'high-risk' cohort. Secondary outcomes include depression and anxiety remission rates in the high-risk cohort at 6 and 12 months, the proportion of high-risk individuals who have visited a doctor at least once in the previous 12 months, and change from baseline in mean stigma, mental health knowledge and attitude scores in the combined non-high-risk and high-risk cohort. Trial outcomes will be accompanied by detailed economic and process evaluations. SIGNIFICANCE: The findings are likely to inform policy on a low-cost scalable solution to destigmatise common mental disorders and reduce the treatment gap for under-served populations in low-and middle-income country settings.
trial registrationClinical Trial Registry India CTRI/2018/08/015355 . Registered on 16 August 2018.
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