The proposed ‘frugal innovation’ will fill a critical gap in service provision for common mental health disorders in Vietnam. It will involve the provision of low-cost and accessible evidence- based psychosocial interventions to address depression and anxiety disorders in adults and behavioral disorders in children.
Strongest Families (SF)
This component involves:
240 families will be recruited for the study. The families will receive the intervention for around four months, with an additional one-month follow-up ‘booster’.
Coaches are recruited and trained in accordance with the existing Strongest Families protocol, which has been extensively tested for quality assurance.
The outcome measure will be collected at baseline and at the end of treatment by an outcome assessor who is part of the research team.
Supported Self-Management (SSM)
This component will make use of existing health workers to implement a low-cost and evidence-based intervention to adults with depression.
The intervention will involve:
The intervention will be tested using a cluster-randomized controlled trial design. Randomization will occur at the commune level, where communes will receive either the SSM intervention first or the control condition. Those assigned to the control condition first will later receive the SSM intervention.
Adult patients attending primary care centers will be screened for depression by a health worker who will administer a self-reporting questionnaire.
Patients meeting the case criteria for depression will be informed about the study and provided with information about informed consent.
At-risk individuals, including mothers of children under one year old, caregivers of people with a serious illness, people who have experienced trauma etc., will be screened by social workers. Social workers are well-placed to identify people at greater risk of depression. They will screen community members using the questionnaire and, based on the depression score, will make referrals to the primary care centers. At the centers, health workers will recruit patients to the study and further assess functional ability.
For participants in the intervention group, social workers will provide ongoing support to use the anti-depressant skills workbook through home visits, in between visits to the centers.
Benefits of the innovation:
The innovation will prove beneficial in:
The innovation aims to improve the quality of life of children and adults experiencing common mental health problems and their families. This improvement will be assessed using the appropriate measures for depression (SRQ-20) and for behavioral disorders (Strengths and Difficulties Questionnaire), and by measuring disability scores using the WHODAS 2.0.
The innovation will also help strengthen the mental health system in Vietnam by improving the availability of cost-effective and accessible services for common mental disorders.
The involvement of our partners, in particular MOLISA and Ministry of Health (MoH), will help integrate these enhanced interventions into the health system.