A Study To Assess Efficacy Of Community Based Intervention For Empowering Community Leaders For Rendering Mental Health First Aid To People In Crisis

Abstract

Introduction: India is currently facing a looming mental health crisis, with a significantly higher number of individuals experiencing mental health issues with anxiety and depressive disorders the most common. Researches demonstrated that the mental health first aid (MHFA) program effectively enhances participants' knowledge of mental health, fosters more positive attitudes, and encourages supportive behaviours towards individuals facing mental health challenges. Community leaders including ASHAs can play a useful role in rendering basic mental health first aid skills to the people with mental crisis as they are link or bridge between the rural and vulnerable population within the health service centres and mostly accepted by the community. There is lack of knowledge, attitude and practice (competency) assessment tool regarding MHFA for ASHAs in English as well as in Marathi. Objectives: To generate, validate and test for reliability of the knowledge, attitude and practices/competency regarding MHFA (KAP (C)-MHFA) assessment tool. To test efficacy of community-based intervention regarding MHFA (CBI-MHFA) training program for empowering community leaders to help people in crisis by piloting. To evaluate and compare the efficacy of CBI-MHFA training program as against conventional method in improving knowledge, attitude and practices (competencies) of community leaders in rendering Mental health first aid to people in crisis. To find out correlation between knowledge, attitude and practices (competencies) among the community leaders regarding MHFA. Methodology: Randomized two parallel arm interventional study design was used for the study. 165 ASHAs were randomly allocated to control and experimental group. After loss 150 were finally analysed. Study conducted in 2 phases. In first phase the KAP (C) MHFA tool (Marathi) was developed, validated and tested for reliability and also CBI-MHFA training program (Marathi) was developed and tested its efficacy by piloting. In second phase, efficacy of CBI-MHFA training program was evaluated and compared as against conventional method. Results: Significant improvement in knowledge, attitude and competency score was observed in experimental group as compare to control group as p<0.01. The improvement % of knowledge, attitude and practice (competency) in experimental compared to control group at good/most favourable category was 40.1%, 41.4% & 56% respectively, which is higher than the efficacy margin of 40%. Thus rejected the null hypothesis & accepted the alternative hypothesis, that the CBI-MHFA is clinically efficacious for improvement of knowledge, attitude and practices (competency) of community leaders to render Mental Health First Aid to people in crisis as against conventional method. Conclusion: Generated KAP (C)-MHFA Marathi assessment tool was valid and reliable. The CBI- MHFA training program was found to be clinically efficacious in empowering community leaders to render MHFA to people in crisis.