Effectiveness of non-medical health worker-led counselling on psychological distress : a randomized controlled trial in rural Nepal

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dc.contributor.author Markkula, N.
dc.contributor.author Lehti, V.
dc.contributor.author Adhikari, P.
dc.contributor.author Pena, S.
dc.contributor.author Heliste, J.
dc.contributor.author Mikkonen, E.
dc.contributor.author Rautanen, M.
dc.contributor.author Salama, E.
dc.contributor.author Guragain, B.
dc.date.accessioned 2019-10-15T07:14:01Z
dc.date.available 2019-10-15T07:14:01Z
dc.date.issued 2019
dc.identifier.citation Markkula , N , Lehti , V , Adhikari , P , Pena , S , Heliste , J , Mikkonen , E , Rautanen , M , Salama , E & Guragain , B 2019 , ' Effectiveness of non-medical health worker-led counselling on psychological distress : a randomized controlled trial in rural Nepal ' , Global mental health , vol. 6 , 15 . https://doi.org/10.1017/gmh.2019.15
dc.identifier.other PURE: 127437111
dc.identifier.other PURE UUID: 19712fc3-4aac-438f-bdab-432dfb2887da
dc.identifier.other WOS: 000475616200001
dc.identifier.uri http://hdl.handle.net/10138/306014
dc.description.abstract Background. An essential strategy to increase coverage of psychosocial treatments globally is task shifting to non-medical counsellors, but evidence on its effectiveness is still scarce. This study evaluates the effectiveness of lay psychosocial counselling among persons with psychological distress in a primary health care setting in rural Nepal. Methods. A parallel randomized controlled trial in Dang, rural Nepal (NCT03544450). Persons aged 16 and older attending primary care and with a General Health Questionnaire (GHQ-12) score of 6 or more were randomized (1:1) to receive either non-medical psychosocial counselling (PSY) or enhanced usual care (EUC). PSY was provided by lay persons with a 6-month training and consisted of 5-weekly counselling sessions of 35-60 min with a culturally adapted solution-focused approach. EUC was provided by trained primary health workers. Participants were followed up at 1 (T1) and 6 months (T2). The primary outcome, response to treatment, was the reduction of minimum 50% in the Beck Depression Inventory (BDI) score. Results. A total of 141 participants, predominantly socially disadvantaged women, were randomized to receive PSY and 146 to EUC. In the PSY, 123 participants and 134 in the EUC were analysed. In PSY, 101 participants (81.4%) had a response compared with 57 participants (42.5%) in EUC [percentage difference 39.4% (95% CI 28.4-50.4)]. The difference in BDI scores at T2 between PSY and EUC was -7.43 (95% CI -9.71 to -5.14). Conclusions. Non-medical (lay) psychosocial counselling appears effective in reducing depressive symptoms, and its inclusion in mental health care should be considered in low-resource settings. en
dc.format.extent 11
dc.language.iso eng
dc.relation.ispartof Global mental health
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Common mental disorders
dc.subject lay counselling
dc.subject Nepal
dc.subject randomized controlled trial
dc.subject task shifting
dc.subject MIDDLE-INCOME COUNTRIES
dc.subject COMMON MENTAL-DISORDERS
dc.subject CARE PLANS
dc.subject DEPRESSION
dc.subject ANXIETY
dc.subject INTERVENTION
dc.subject INVENTORY
dc.subject CONFLICT
dc.subject OUTCOMES
dc.subject 3124 Neurology and psychiatry
dc.title Effectiveness of non-medical health worker-led counselling on psychological distress : a randomized controlled trial in rural Nepal en
dc.type Article
dc.contributor.organization HUS Psychiatry
dc.contributor.organization Department of Psychiatry
dc.contributor.organization University of Helsinki
dc.contributor.organization Institute for Molecular Medicine Finland
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1017/gmh.2019.15
dc.relation.issn 2054-4251
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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