Safeguarding adolescent mental health in India (SAMA): study protocol for codesign and feasibility study of a school systems intervention targeting adolescent anxiety and depression in India.

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences.

Development of "My Experiences Scale" for Children and Adolescents in India.

BACKGROUND: Experiences that a child or adolescent goes through play a critical role in their development as an individual. To understand the world of adolescents and their mental health and well-being, it would be important to be able to access their experiences. Therefore, an objective measure to assess experiences is necessary. The study aimed to develop a scale to assess experiences and establish their psychometric properties. MATERIALS AND METHODS: My Experiences Scale (MES) is a newly developed 50-item, multiple-choice, self-report measure. Various steps involved in developing the MES and establishing its psychometric properties have been elaborated. The study was carried out across four phases, and the sample consisted of 1,260 school-going children and adolescents. The participants were representative of both genders, a wide age range, and diverse socioeconomic backgrounds. RESULTS: MES was found to have good internal consistency (Alpha 0.85) and test-retest reliability (0.96). MES was found to have significant correlations with Strengths and Difficulties Questionnaire and global self-worth. CONCLUSIONS: The newly developed experiences scale shows promising psychometric properties and a wide scope for application.

Experience of Administering Life Grid in the Qualitative Interviews with Adolescent Children of Parents with Mental Illness.

BACKGROUND: Methodological literature on qualitative research with children and young people suggests that traditional data collection methods can be strengthened through the use of creative and task-based methods. This article discusses the experience of using one such task-based method called the life grid, to explore the experiences of adolescent children who have a parent with psychotic illness, in the Indian context. METHODS: The life grid was adapted for the present study and used with 24 adolescents aged 15-19 years. Feedback about their experience was collected on a five-point rating scale and via open-ended questions. The researchers' observations and reflections were noted down as field notes. RESULTS: A majority of the adolescents (83%) reported liking the activity. They appreciated the opportunity to use the life grid to generate a holistic perspective of their lives. Difficulties in recalling negative past events and language barriers were some of the challenges in the activity. CONCLUSIONS: The life grid appears to be an appropriate and useful tool for qualitative research with adolescents in India. This article contributes to ongoing discussions over culturally relevant methodologies and issues among child researchers in India.

Parental-Group Interventions for Parents of Children with Mental Health Problems Admitted in a Tertiary Care Center: An Experience from India.

BACKGROUND: Families play a critical role in their children's development and learning. Parents' understanding of their child's illness has a significant impact on the parent-child relationship and helps them to have realistic expectations. OBJECTIVES: The objective of this study is to understand the use of parental-group intervention for making parents understand the problems of the children and to develop skills to deal with the problems. METHODS: A six-session parental-group intervention module was developed and tested. Data from the group session were collected for 6 months and have been analyzed. RESULTS: Majority of the parents appreciated the intervention program as it led to skill-building and understanding of the mental health problems among children. Demonstration was liked most of the parents (74) parenting skills and stress management (71 parents); 68 parents liked session on school-related issues; 60 parents liked session on developmental disorders; 54 parents liked session on emotional and behavioral problems. CONCLUSION: Group-based parenting programs are found to be effective in improving the overall psychosocial health of parents and the emotional and behavioral problems of children and adolescents as a result of better parenting.

Barriers to Disclosure of Intimate Partner Violence among Female Patients Availing Services at Tertiary Care Psychiatric Hospitals: A Qualitative Study.

BACKGROUND: Intimate partner violence (IPV)/domestic violence is one of the significant public health problems, but little is known about the barriers to disclosure in tertiary care psychiatric settings. METHODOLOGY: One hundred women seeking inpatient or outpatient services at a tertiary care psychiatric setting were recruited for study using purposive sampling. A semi-structured interview was administered to collect the information from women with mental illness experiencing IPV to know about their help-seeking behaviors, reasons for disclosure/nondisclosure of IPV, perceived feelings experienced after reporting IPV, and help received from the mental health professionals (MHPs) following the disclosure of violence. RESULTS: The data revealed that at the patient level, majority of the women chose to conceal their abuse from the mental health-care professionals, fearing retaliation from their partners if they get to know about the disclosure of violence. At the professional level, lack of privacy was another important barrier for nondisclosure where women reported that MHPs discussed the abuse in the presence of their violent partners. CONCLUSION: The findings of the study brought out the need for mandatory screening of violence and designing tailor-made multicomponent interventions for mental health care professionals at psychiatric setting in India.

Discrimination against differently abled children among rural communities in India: Need for action.

BACKGROUND: Persons with disabilities comprise at least 4 to 8 percent of the Indian population. Children with disabilities in India are subject to multiple deprivations and limited opportunities in several dimensions of their lives. Their families and caregivers also go through lot of stress and challenges in having a person with disability at home which ultimately leads to grave discriminatory practices towards these children. MATERIALS AND METHODS: The article attempts to analyze and describe the common discriminatory grounds that children with disabilities commonly face from their immediate families and from the larger community through analyzing the filed visit reports of the Basic Needs India Staff providing on job training (handholding support) for the community based rehabilitation workers. RESULTS: The case studies describes the various ugly forms of the discriminatory practices seen in the community towards differently abled children, same been categorized as denial of disability, physical restraints, social boycott, denial of property rights, decreased marital life prospects due to disabled member in family, implications on sexuality of people with disability, women with disability, discrepancies in state welfare programs, and problems in measuring disabilities. CONCLUSION: During the last two decades, there has been a growing realization that institutional care for the disabled is not entirely suitable for their individual needs, dignity and independence. A movement towards community based rehabilitation has picked up pace and contribute toward greater independence and self sustainability of the disabled.