Effect of lay counselling on mental health and TB treatment outcomes: an experience from Gujarat state, India
| Date | 26 July 2024 |
| Pages | 108-116 |
| DOI | https://doi.org/10.1108/MHSI-06-2024-0095 |
| Published date | 26 July 2024 |
| Subject Matter | Health & social care,Mental health,Social inclusion |
| Author | Deepti Bhatt,Apurvakumar Pandya,Vibha Salaliya,Ajay Chauhan,Rutu Trivedi,Siddharth Chowdhury,Amar Shah,Prachi Shukla,Pankaj Nimavat,Chandra Shekhar Joshi,Vivekanand Pandey |
Effect of lay counselling on mental health
and TB treatment outcomes: an
experience from Gujarat state, India
Deepti Bhatt, Apurvakumar Pandya, Vibha Salaliya, Ajay Chauhan, Rutu Trivedi,
Siddharth Chowdhury, Amar Shah, Prachi Shukla, Pankaj Nimavat, Chandra Shekhar Joshi
and Vivekanand Pandey
Abstract
Purpose –Depression and anxiety are the most common comorbidities in TB patients, adversely
impacting TB treatment outcomes.The purpose of this study is to assess the effect of lay counselling in
reducingsymptoms of depression and anxietyand TB treatment completion.
Design/methodology/approach –The study used a pre-post interventional research design. Patients
were screenedfor depression and anxiety. Allsymptomatic TB patients were followedup and offered four
to six or more lay counselling sessions whenever necessary. The authors assessed changes in
depression and anxiety symptoms before lay counselling intervention and after fourth lay counselling
sessionor the completion of TB treatment, whichever occurredthe last.
Findings –Approximately 6,974 TB patients were screened for symptoms of depression and anxiety.
The mean age was 36.7614.7 years. Total 25.9% patients were symptomatic. About 99.8% were
provided lay counselling and received at least one to two follow-up sessions, while two patients who
screened with severe depressionwere referred to a mental health specialist. Nearly 96.9% TB patients
did not report symptoms ofdepression or anxiety after four lay counselling sessions, and TB treatment
completion rate was higher among symptomatic TB patients who completed at least four counselling
sessions(92.5%).
Practical implications –Lay counselling services delivered by field coordinators offer a promising
approachto address mental health comorbiditiesamong TB patients in resource-limitedsettings.
Originality/value –It explores a novel approach –lay counselling delivered by field coordinators –in
tackling depressionand anxiety among TB patients, which is a potentiallyscalable solution in resource-
limitedsettings.
Keywords Tuberculosis, Depression, Anxiety, Lay counselling, Task-shifting,
TB Treatment adherence, TB Treatment outcomes, Gujarat
Paper type Research paper
Introduction
Tuberculosis (TB) remains a significantworldwide public health concern, causing millions of
new TB cases and deaths annually (WHO, 2023). TB patients often experience comorbid
mental health conditions (Patel and Weissman, 2017;Walker and Mittal, 2008). The
prevalence of mental health comorbid conditions particularly depression and anxiety
among TB patients ranges from32% to 50.5% (Assefa et al., 2023;Ahmed et al., 2016;Rouf
et al., 2021;Sutar et al., 2024). Depression and anxiety among TB patients are reportedly
linked with treatment non-adherence and consequently poor TB treatment outcomes
(Agbeko et al.,2022;Koyanagi et al.,2017). Treatment non-adherence poses serious risks
like treatment failure, drug resistance, more extended treatment periods and increased
(Informationabout the
authorscan be found at the
end of this article.)
Our findings contribute to the
evidence on the effectiveness
of lay counselling by non-
specialist health workers for
mental health service provision
in existing programmes.
Further research and
programme optimization are
warranted to strengthen the
evidence base and ensure
long-term
sustainability.
The authors acknowledge
support from all participants.
Funding: The work described in
this article was implemented
under the USAID Closing the
gap in TB care cascade
Project, managed by World
Health Partners under the terms
of Cooperative Agreement
Number 72038620CA00012.
Declaration of conflicting
interests: The author(s)
declared no potential conflicts
of interest with respect to the
research, authorship and/or
publication of this article.
Ethical approval: Ethical
approval was sought from
Parul Institute of Public Health’s
Research Review Committee
reference no. PU/PIPH/RRC/
2021/08. Informed consent was
obtained from all study
participants. The privacy and
confidentiality of participants’
data were strictly maintained.
PAGE 108 jMENTAL HEALTH AND SOCIAL INCLUSION jVOL. 29 NO. 1 2025, pp. 108-116, ©Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-06-2024-0095
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