Impact of mental health training on village health workers to manage depression in rural India

Background: Community health worker (CHW) programs are known to be effective means of promoting health of underserved communities. Depression is one of the major health issues globally and CHWs might potentially be useful to prevent and address mental health issues. Comprehensive Rural Health Project (CRHP) in India has recently trained village health workers (VHW) to identify, refer, and help people with mental health issues. This study evaluated the effectiveness of the mental health training program focusing on depression. Methods: Qualitative study was designed and five focus group discussions (FGD) with 4-6 members in each group were conducted among 70.5% (N=34) of the VHWs who underwent mental health training at CRHP. VHWs, all women, were selected based on convenience sampling. Verbatim transcription was done, data were de-identified, consensus themes were generated and the FGD results were analyzed qualitatively. Results: Four out of five groups were able to diagnose the presented case correctly as depression. VHWs were able to identify many symptoms and to suggest management options for clinical depression. Common management options identified by VHWs were referral to hospital, counseling, intake of medication, behavioral therapies and yoga classes, and addressing socio-cultural factors. VHWs showed supportive and empathetic attitudes toward depressed patients. Many VHWs had already helped patients with similar mental health problems. Conclusion: VHWs are likely to be useful at identifying and assisting people with depression in the rural communities of Jamkhed, India provided they receive ongoing training and supervision.