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

Journal article

Abstract 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.

Authors: Malik, K; Ibrahim, M; Mathur, S; Jose, JE; Nair, P

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: Cambridge Prisms: Global Mental Health
• Volume: 9
• Pages: 521-525
• Publication date: 2022-03-09
• DOI: 10.1017/gmh.2022.7
• EISSN: 2054-4251
• ISSN: 2054-4251
• Language: English
• Keywords: Pride; Clinical psychology; Psychology; Medicine; Mental health; Psychiatry; Nursing; Distress; Intervention (counseling)