By Charles F. Reynolds III,
Today is World
Mental Health Day, when the World Health
Organization works to raise awareness of mental health issues around the
globe. Recent developments are helping us better understand how to treat depression and anxiety disorders in
developing countries, but much work remains.
Late-life depression and anxiety are of particular concern
in LMICs. This is due to rapid demographic transition and aging in countries such as
India, increased prevalence of social conditions that are recognized as risk
factors - such as living alone or living with a chronic disabling condition - and the
inability of health systems to address the physical and mental health needs of
the elderly due to a lack of mental health resources.
Because of a lack of mental health specialists, there is a large need to focus on prevention interventions that can be delivered by
non-specialists and lay health workers in non-health care or primary-care
settings. In other words, mental health
care services can be provided by caregivers other than mental health experts
such as psychiatrists and psychologists.
By equipping lay and non-specialist workers with the skills
needed to help individuals in countries with few mental health resources, we
can work towards a long-term goal of scalable depression prevention in LMICs. These skills include the use of
learning-based psychotherapies, such as problem-solving
therapy for primary care and brief
behavioral treatment for insomnia, which in the West have shown to reduce
depressive and anxiety disorders by 25 percent over one to two years compared to usual
care. Such therapies can help individuals cope with stressful
relationships and situations that may trigger depressive episodes, and teach
more constructive thought patterns to replace thinking habits that magnify
feelings of worthlessness and hopelessness.
A recent study conducted in Goa, India, demonstrated that
the use of lay health counselors increased recovery rates from common mental
disorders - anxiety and depression - in a sample of patients of all ages.
Now, a new study funded by the National Institute of Mental Health
is working to investigate the use of non-specialists in an effort to prevent
late-life depression and anxiety in LMICs, specifically in Goa, India.
will develop best practices for depression and anxiety depression, and
teach learning-based psychotherapies as well. Other tactics will include education about symptoms of depression and
anxiety, instruction in breathing exercises and relaxation to manage symptoms
of anxiety, and scheduling of activities to manage symptoms of depression.
Labels: Aging Institute of UPMC, public health, University of Pittsburgh