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Impact Evaluation of Technology Driven Mental Health Capacity Building in Bihar, India

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Abstract

Task-shifting is an important means to address the barrier of inadequate specialist human resources for mental health in countries such as India. This paper aims to report the impact of one such task-shifting initiative. Twenty-two non-specialist Medical Officers of Bihar, an eastern Indian state were engaged in a ten-month long hybrid (a 15-days onsite orientation to psychiatry and periodic online mentoring in primary care psychiatry) training program to enable them to identify commonly presenting psychiatric disorders in their respective clinics. 20 online sessions (hub and spoke ECHO model) occurred over the next 10 months. Apart from didactic topics, 75 cases covering severe mental disorders, common mental disorders and substance use disorders were discussed (case presentations by the primary care doctors (PCDs)) and moderated by a specialist psychiatrist and clinical psychologist). 12 successive self-reported monthly reports (comprising of the number and nature of psychiatric cases seen by the trainee PCDs) were analyzed. The mean (SD) number of sessions attended was 9 (8.0) and median was 13 (Range: 0–20). Mean number of cases (per PCD) discussed was 3.4 (3.4) (Median: 4; Range: 0–10). Total 20,909 patients were cared for in the 12 months after initiation of the training program. Increasingly, a greater number of patients were cared for as the training progressed. This pattern was mainly driven by more identifications of severe mental disorders (SMDs), common mental disorders (CMDs), dementias and substance use disorders. Mean (SD) number of patients seen per month before and after training was 1340.33 (86.73) and 1876.44 (236.51) (t =  − 3.5, p < 0.05) respectively. A hybrid model of training PCDs is feasible and can be effective in identification of persons with psychiatric disorders in the community. Prospective, well designed studies are essential to demonstrate the effectiveness of this model.

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Acknowledgements

The researchers would like to thank all those who are involved in successful execution of the above project including all the administrative officers, patients etc.

Funding

Govt of Bihar.

Author information

Authors and Affiliations

  1. Department of Psychiatry, AIIMS – Bibinagar, Hyderabad, India

    Barikar C. Malathesh

  2. Department of Psychiatry, NIMHANS Digital Academy, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

    Bhavya K. Bairy, Aurobind Ganesh & Kanika Mehrotra

  3. Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India

    Channaveerachari Naveen Kumar

  4. Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

    P. Lakshmi Nirisha, Gopi V. Gajera, Praveen Pandey & Narayana Manjunatha

  5. Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

    Binukumar Bhaskarapillai & Durai Murukan Gunasekaran

  6. Distinguished Professor of Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA

    Sanjeev Arora

  7. Department of Health & Family Welfare, Government of Bihar, Patna, Bihar, India

    Narendra Kumar Sinha

  8. Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

    Suresh Bada Math

Authors
  1. Barikar C. Malathesh
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  2. Bhavya K. Bairy
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  3. Channaveerachari Naveen Kumar
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  4. P. Lakshmi Nirisha
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  5. Gopi V. Gajera
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  6. Praveen Pandey
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  7. Narayana Manjunatha
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  8. Aurobind Ganesh
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  9. Kanika Mehrotra
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  10. Binukumar Bhaskarapillai
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  11. Durai Murukan Gunasekaran
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  12. Sanjeev Arora
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  13. Narendra Kumar Sinha
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  14. Suresh Bada Math
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Contributions

CNK, NM, SBM, NKS and SA were involved in planning this project. CNK, NM, SBM, BKB, AG, and KM were involved in execution of this project. BCM, PLN, GVG, PP, CNK and SA were involved in prepapration of the manuscript. BB, DMG were involved in statistical analysis.

Corresponding author

Correspondence to Channaveerachari Naveen Kumar.

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Relevant consent was obtained by patients when were enrolled for the above study.

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Obtained.

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All authors declare that they have no conflict of interest.

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Malathesh, B.C., Bairy, B.K., Kumar, C.N. et al. Impact Evaluation of Technology Driven Mental Health Capacity Building in Bihar, India. Psychiatr Q 92, 1855–1866 (2021). https://doi.org/10.1007/s11126-021-09945-4

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  • DOI: https://doi.org/10.1007/s11126-021-09945-4

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