Journalism of Courage
The rate of depression among youngsters has risen sharply in the last decade, especially among young girls, which is a concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions, noted a study published in The Lancet.
In a review paper — ‘Depression in young people’ — published Saturday, Prof Vikram Patel and the other authors said depression is highly heterogeneous, more so in young people and spans across 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 by 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.
“Depression in adolescents is under-recognised leaving it often undertreated. 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 the 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 by 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 by school staff, was ineffective, the finding also observed in other trials, suggesting a moderating role of the person who delivers the intervention, Dr Patel explained.
The National Mental Health Survey of India has reported that 3% of India’s youth have experienced a major depressive episode but many more will have experienced emotional distress with symptoms of anxiety and depression.
“Indeed, such distress is a key driver of the high suicide rates in youth in whom suicide is the leading cause of death,” Dr Patel said. He also stressed that providing early intervention through counselling services in educational institutions and tele-medicine platforms may help reduce the risk of escalation into more serious mental health problems.
