Vikram Patel|Helen A. Weiss|Neerja Chowdhary|Smita Naik|Sulochana Pednekar|Sudipto Chatterjee|Mary J De Silva|Bhargav Bhat|Ricardo Araya|Michael King|Gregory E. Simon|Helen Verdeli|Betty Kirkwood
Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial
London School of Hygiene & Tropical Medicine|Medical Research Council|Sangath|Sangath|Sangath|Sangath|London School of Hygiene & Tropical Medicine|Voluntary Health Association of Goa|University of Bristol|University College London|Group Health Cooperative|Columbia University|London School of Hygiene & Tropical Medicine
depression anxiety disorders common mental disorders worldwide manas trial aimed test effectiveness intervention led lay health counsellors primary care settings improve outcomes people disordersin cluster randomised trial primary care facilities goa india assigned 11 computergenerated randomised sequence intervention control enhanced usual care groups adults screened positive common mental disorders eligible collaborative steppedcare intervention offered case management psychosocial interventions provided trained lay health counsellor supplemented antidepressant drugs primary care physician supervision mental health specialist research assessor masked primary outcome recovery common mental disorders defined international statistical classification diseases related health problems10th revision icd10 6 months study registered clinicaltrialsgov number nct0044640724 study clusters equal proportion public private facilities randomised equally groups 1160 1360 85 patients intervention group 1269 1436 88 control group completed outcome assessment patients icd10confirmed common mental disorders intervention group likely recovered 6 months control group n620 650 vs 553 529 risk ratio 122 95 ci 100147 risk difference121 95 ci 16225 intervention strong evidence effect public facility attenders 369 659 vs 267 425 risk ratio 155 95 ci 102235 evidence effect private facility attenders 251 641 vs 286 659 risk ratio 095 074122 three deaths four suicide attempts collaborative steppedcare group six deaths six suicide attempts enhanced usual care group none deaths suicidea trained lay counsellorled collaborative care intervention lead improvement recovery cmd among patients attending public primary care facilitiesthe wellcome trust