‘Early intervention through counselling in educational institutions is the key’: Prof Vikram Patel

DEPRESSION RATES among young people have risen sharply in the past decade, especially among women, which is of concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions. In their review paper, ‘Depression in Young People’ published in The Lancet on Saturday, Prof Vikram Patel and other authors have said that depression is highly heterogeneous, more so among young people, and spans a spectrum of severity. Neuroscience and genetic discoveries coupled with social and clinical data could be used to personalise treatment and improve outcomes.
Dr Patel, Professor at Department of Global Health and Social Medicine, Harvard Medical School, Boston, told The Indian Express that the key message of this review paper is the importance of prevention and early intervention targeting the social environments of educational institutions, such as the SEHER programme in Bihar (which is cited in the paper) and building emotional competencies in adolescents through life skills curricula.
Systematic reviews have shown that school-based interventions have relatively small effects, but evidence from low middle income countries is very scarce. One successful example is the strengthening evidence base on school-based interventions for promoting adolescent health programme (SEHER),” Dr Patel said.
SEHER is a school-based intervention, with universal, group, and individual targeted strategies.
A trial in rural India showed large reductions in depressive symptoms when the intervention was delivered lay counsellors (defined in this study as members of the local community aged 21 or older, who had completed at least a high school education, and had no professional health training). However, the same intervention when delivered school staff was ineffective, a finding also observed in other trials, suggesting a moderating role of the person who delivers the intervention, Dr Patel said.