Lay social workers implementing a task-sharing approach to managing depression in Vietnam

Abstract

Background While depression is a leading contributor to burden of disease in Vietnam, there is a critical gap in depression care due to the shortage of mental health specialists and extremely limited mental health services in general health care settings. We have previously reported the effectiveness of a supported self-management (SSM) task-sharing intervention for depression, delivered by social collaborators (lay social workers). The purpose of this study was to identify factors influencing the effectiveness of delivery of SSM by social collaborators and delineate areas for further attention that are relevant for scale-up. Methods A hundred and ten (110) key informant interviews were conducted with three stakeholder groups (patients, social collaborators, experts) from eight provinces in Vietnam. Participants were identified through records from a recently completed randomized trial that showed the effectiveness of SSM in community-based settings in Vietnam. Qualitative descriptive methods and thematic analysis were used to examine the interviews. A coding framework and corresponding themes were developed deductively, based on the findings from the randomized trial and the literature, and through inductive analysis, to describe the contextual factors that impacted the social collaborators’ role in successfully implementing the SSM intervention. Results Our analysis identified the following benefits of working with social collaborators: (1) increased awareness of mental health in the family and community; (2) reduced stigma; (3) a better understanding that depression is treatable; (4) increased help-seeking; and (5) improved access to care. There were also significant challenges, including social collaborator characteristics (age, education, pre-existing training and skills) and contextual factors influencing their work (roles and responsibilities, training, compensation, support from government). Conclusions Engaging social collaborators in the delivery of SSM in the community can help fill a critical gap in depression care in Vietnam. However, several contextual challenges that are an impediment to increased engagement and sustainable integration into health and social systems need to be resolved through policy change to regulate their practice, define their scope of work, and provide adequate remuneration.

Evaluating the effectiveness and cost-effectiveness of a digital, app-based intervention for depression (VMood) in community-based settings in Vietnam: Protocol for a stepped-wedge randomized controlled trial

“…Supported self-management (SSM) is an evidence-based approach to the management of chronic disease which empowers the patient to participate in their own care by building appropriate skills with the support of a physician, lay provider, or other carer [31]. The in-person SSM for depression intervention that was previously tested [25] included a cognitive-behavioural therapy (CBT)-informed bibliotherapy intervention provided via the ASW [32] with supportive coaching provided face-to-face by non-specialist providers [33]. For the digital intervention used in this study, ASW was adapted to be delivered via the VMood smartphone app, with supportive coaching as needed provided through an online chat function by social workers.…”

Empowerment Program for a Poor Elderly Group in Boyolali, Indonesia

“…According to Bassuk, Glass & Berkman (1991), social engagement is a form of maintaining social relations in the form of individual social interactions through facilitated social activities (26). The results of the research showed that what is done in a company, that social engagement as a strength possessed by individuals who act as an internal stakeholders in the company can create social capital, provide social resources, loyalty, and trust that will have implications for future development (27), using a social engagement approach to overcome various mental health problems in the community (28), the negative stigma for PLWHA that develops in the community can be controlled through a social engagement approach by increasing HIV care and prevention (29), early depression associated with peptic ulcer disease in the elderly can be reduced by increasing social engagement in social activities (30), social engagement contributes to cognitive changes in disease-prone groups in the elderly who suffer from Alzheimer's (31), the social engagement approach can describe the problem of limited energy access in Spain by providing a basic understanding, socialization aimed at leading to institutional responses and policy making, as well as a deeper understanding related to the confrontation of unequal access issues. to energy resources (32), social engagement approaches can be found through participation in income-generating activities, community activities, and care work (33).…”