Perinatal depression–knowledge gap among service providers and service utilizers in India

Ransing, Ramdas; Kukreti, Prerna; Deshpande, Smita N.; Godake, Shashwati; Neelam, Neelam; Raghuveer, Pracheth; Mahadevaiah, Mahesh; Kataria, Dinesh; Patil, Suvarna; Puri, Manju; Padma, Kumari

doi:10.1016/j.ajp.2019.10.002

Cited by 33 publications

(42 citation statements)

References 39 publications

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“…Research into interventions addressing issues with service delivery and rehabilitation, as well as encouraging innovation complements these goals, and has been another priority in the region given the high treatment gap; up to 70%‐80% of the population have no access to professional mental health care (Gautham et al, 2020; Johnson et al, 2020). Specific and vulnerable populations, such as the rurally located, children and adolescents, perinatal, geriatric, and early psychosis, are especially affected (Dhandapani et al, 2020; Ransing, Kukreti, et al, 2020; Verma, Grover, Singh, Dahiya, & Nehra, 2020). Examples of initiatives to tackle these issues include Project BIND‐P, a perinatal mental health project (Ransing, Deshpande, et al, 2020), a healthcare worker‐based collaborative model for the National Mental Health program, as well as various community mental health programs and mHGAP specific initiatives (Ahuja et al, 2020; Pandya, Shah, Chauhan, & Saha, 2020; Parker et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

The state of psychiatric research in the Asia Pacific region

Roche

Fung

Ransing

et al. 2020

Asia-Pacific Psychiatry

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Introduction This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia‐Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. Methods Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. Results While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. Discussion Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi‐center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.

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Section: Methodsmentioning

confidence: 99%

The state of psychiatric research in the Asia Pacific region

Roche

Fung

Ransing

et al. 2020

Asia-Pacific Psychiatry

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“…We also gained insights from health care providers, particularly physicians and nurses, about their experiences of providing care for PD. 13 , 29 We brainstormed and prepared the first draft of the intervention after an extensive literature review on various aspects of PD like systematic reviews on clinical and psychosocial presentations, epidemiological studies, existing interventions and models, potential challenges in implementations and strategies. We sought inputs from research experts in a capacity building workshop and fine-tuned the intervention.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of a Brief Psychological Intervention Delivered by Nurse for Depression in Pregnancy: Study Protocol for a Multicentric Randomized Controlled Trial from India

Raghuveer

Ransing²,

Kukreti

et al. 2020

Indian Journal of Psychological Medicine

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Background: Perinatal depression (PD) has important implications for maternal and infant well-being but largely goes undetected. There is a need to develop low-intensity psychosocial interventions applicable to obstetric health care facilities. Objective: To assess the effectiveness of a brief psychological intervention for mild to moderate PD delivered by a nurse as compared to treatment-as-usual (TAU). Methods: This study is a randomized, open-label, parallel-group, multicentric trial being conducted in four sites of India. A total of 816 pregnant women with mild to moderately severe depression (Patient Health Questionaire-9 score of 5–19) are being assessed for the effectiveness of the intervention. Participants are randomly allocated to two groups of trial intervention (psychological intervention given by nurse) and TAU. The primary outcome is to compare the proportion of women reporting improvement across both groups. Participants are serially followed-up in each trimester and at 6, 10, 14 weeks, and 6 months postpartum. Secondary outcomes include pregnancy outcomes, feeding practices, physical growth, and immunization status of the infants. Conclusion: It is a prospective pregnancy birth cohort with a robust design and long-term follow-up. This is one of the largest studies utilizing non-specialist health workers for the screening and management of PD. This study also holds promise to cast light on the course and outcome of depression during pregnancy in different parts of India. It is envisaged to help in developing a sound screening and referral-based protocol for obstetric settings.

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“…NIMHANS has initiated short-term strategies, such as training for general practitioners (3-month course), and midlevel health care service providers such as the NIMHANS ECHO model. 3,29,30 However, the success of these training strategies is often limited due to lack of organizational support for primary care physicians/service providers, lack of financial support, and poor attendance in training sessions. 10 Despite having more private psychiatry training institutes, total seats in government institutes are higher in India.…”

Section: Table 4 Trainee Seats and Requirement Of Staff/psychiatristsmentioning

confidence: 99%

“…1 Human resource deficit, financial constraints, social stigma, poor community participation, ineffective training, knowledge gap among service providers, lack of nongovernment organization/private partnership, and lack of robust monitoring and evaluation (M and E) systems are the critical determinants for this treatment gap. 2,3 Filling these gaps is often difficult but essential for addressing the high burden of mental disorders and for planning adequate mental health services. The district mental health program (DMHP) was started as a component of the national mental health program (NMHP) for the decentralization of mental health services, provision of mental health services at the primary care level, and integration of mental health care in the primary health care system.…”

Section: Introductionmentioning

confidence: 99%

Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

Ransing¹,

Agrawal

Bagul

et al. 2020

JNRP

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Background The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes (n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst (n = 9), poor (n = 8), fair (n = 9), average (n = 7), good (n = 1), and excellent (n = 2). Conclusion A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.

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Perinatal depression–knowledge gap among service providers and service utilizers in India

Cited by 33 publications

References 39 publications

The state of psychiatric research in the Asia Pacific region

The state of psychiatric research in the Asia Pacific region

Effectiveness of a Brief Psychological Intervention Delivered by Nurse for Depression in Pregnancy: Study Protocol for a Multicentric Randomized Controlled Trial from India

Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

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