“SAATHI” – Study to Adapt Adolescent Interpersonal Therapy In Nepal

Background: Adolescents in Nepal are at high risk of depression and anxiety, due to a complex picture of recent and historical trauma (two major earthquakes in 2015 and a 10-year civil war between 1996 and 2006) on a background of socio-economic deprivation. Whilst there are no national estimates of the prevalence of adolescent depression and anxiety, a recent survey reported that 12.2% of girls and 9.4% of boys aged 10-24 had felt sad and depressed in recent days (MoHP, 2012). Globally there is a lack of services for child and adolescent mental health. Specialized child and adolescent mental health services are virtually non-existent.

In this context, the World Health Organization (WHO) Mental Health Gap Action Programme outlines a role for psychological therapies including Interpersonal Therapy (IPT) in the treatment of child and adolescent emotional disorders such as depression and anxiety; however, few studies have adapted these for young people in LMICs. This project aimed to adapt and pilot the WHO group IPT intervention, which was originally developed for adults. IPT is a psychological therapy to treat depression, and has also been shown to be effective in treating anxiety. It focuses on addressing difficulties linked to four common problems that can trigger depression and anxiety: grief, interpersonal disputes, role transitions and interpersonal isolation. IPT has been shown to be beneficial for adolescent mental health and compared to other psychological therapies it may be more acceptable to adolescents. It has also been delivered by non-specialists in group settings, which is a potentially scalable model for low-resource settings such as Nepal.

Objectives: This project sought to understand how a group interpersonal psychotherapy (IPT) intervention could be made relevant, feasible and acceptable for adolescents with depression and anxiety in rural Nepal.

Target group: The study population were adolescent boys and girls aged 10-19 years living in Barhabise municipality in Sindhupalchowk district. Other participants for this study included:

• adolescents,
• representatives from the Ministry of Education (MOE) and the Ministry of Health (MOH),
• local stakeholders,
• teachers,
• parents, and
• Community health workers.

Implementation area: Sindhupalchowk district

Time frame: September 2018 to August 2020

Supported by: King’s College London (KCL)

Publications:

1. A cross-cultural interpersonal model of adolescent depression: A qualitative study in rural Nepal
2. Culturally and developmentally adapting group interpersonal therapy for adolescents with depression in rural Nepal