Improving help-seeking for depression care in Nepal: Development and testing the feasibility, acceptability, and appropriateness of a social contact-based community intervention

Background: 

Depression is a common mental disorder and is one of the leading causes of disability worldwide. Evidence demonstrates that the majority of individuals with depression do not receive minimally adequate treatment, especially in Lower and Middle-Income Countries like Nepal. There are many barriers to seeking care for depression. The societal stigma around mental health conditions and towards people with depression is one of the major causes that prevent those individuals from seeking proper healthcare services. 

In this context, TPO Nepal has been implementing a project entitled “Improving help-seeking for depression care in Nepal: Development and testing the feasibility, acceptability, and appropriateness of a social contact-based community intervention”. This is a three-year research project (1st January 2022 to 31st December 2024) which is funded by Wellcome Trust and the Department of Health and Social Care (DHSC), through the National Institute for Health Research (NIHR). The overall aim of this research project is to develop and pilot-test the feasibility, acceptability, and appropriateness of a community-based intervention that improves the help-seeking behavior of people with depression. This study will be implemented in Jhapa and Morang districts. These aims will be achieved by answering the following four broad research questions:

1) What interventions have shown effectiveness in improving help-seeking attitudes, intentions, and behavior among people with depression in LMICs? This will be achieved through a systematic review of the available evidence on interventions to improve help-seeking attitudes, intentions, and behavior among people with depression.

2) What are the perceptions of people with depression, their family members, and community stakeholders about barriers to seeking depression care and potential strategies to address those barriers? This will be achieved through a formative qualitative study with key community stakeholders.

3) How to develop a social contact-based community intervention that targets the identified barriers to improve help-seeking behavior? This objective will be achieved by developing a community-based intervention to target demand-side barriers. The intervention will be developed based on the results from the systematic review, formative qualitative study, and consultation with relevant stakeholders.

4) What are social contact-based community intervention’s feasibility, acceptability, and perceived benefits? This will be achieved using a Multiphase Optimization Strategy (MOST) approach to evaluate a community-based mental health intervention’s feasibility, acceptability, and clinical effectiveness to promote help-seeking.

Implementation Area: Jhapa and Morang districts, Koshi Province

Time Frame: 1st January, 2022 to 31st December, 2024

Supported By: Wellcome Trust and the Department of Health and Social Care (DHSC), through the National Institute for Health Research (NIHR)