Evaluating a community-based mental health intervention to promote help-seeking for depression care in Nepal
| ISRCTN | ISRCTN87762579 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN87762579 |
| Wellcome Trust grant: ‘Improving help-seeking for depression care in Nepal: Development and testing the feasibility, acceptability and appropriateness of a social contact-based community intervention’ | 222001_Z_20_Z |
| Sponsor | Wellcome Trust |
| Funder | Wellcome Trust |
- Submission date
- 13/09/2026
- Registration date
- 16/09/2026
- Last edited
- 15/09/2026
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Depression is a common mental health condition that can affect how people think, feel, and manage everyday activities. Although effective treatments are available, many people do not seek professional help because they are unaware of available services, have limited knowledge about depression, or experience stigma related to mental health problems. This study aimed to evaluate a community-based intervention designed to encourage people with depression to seek treatment. It also examined which parts of the intervention were most effective in promoting help-seeking behaviour.
Who can participate?
Adults aged 18 years and over who live in two municipalities in eastern Nepal, meet the screening criteria for depression using the Community Informant Detection Tool (CIDT), are able to provide written informed consent, and can communicate in Nepali can take part.
What does the study involve?
Female Community Health Volunteers are trained to identify people who may have depression using the CIDT. Eligible participants are randomly allocated to receive different combinations of four intervention components. These components provide information about depression, explain available mental health services, address myths and stigma surrounding depression, and share recovery stories from people who have experienced depression. Information is delivered using materials such as flipcharts, booklets, calendars, and videos. Researchers then assess whether participants seek help for depression treatment and whether the intervention affects treatment adherence and depression symptoms.
What are the possible benefits and risks of participating?
Participants may benefit from learning more about depression, available treatments, and local support services. The intervention may encourage people to seek appropriate care and improve their understanding of mental health. Risks are expected to be minimal, although some participants may find discussions about depression or personal experiences of mental health difficulties uncomfortable.
Where is the study run from?
The study is coordinated from Kathmandu, Nepal and was carried out in two municipalities in eastern Nepal.
When is the study starting and how long is it expected to run for?
The study began recruiting participants in July 2024 and completed recruitment in December 2024. The study was completed in March 2025.
Who is funding the study?
Wellcome Trust, UK.
Who is the main contact?
Dr Nagendra Prasad Luitel, Npluitel@tponepal.org.np, luitelnp@gmail.com.
Contact information
Principal investigator, Public, Scientific
Baluwatar
Kathmandu
44600
Nepal
 ORCID ID |
0000-0002-8291-0205 |
|---|---|
| Phone | +977 9841333725 |
| Npluitel@tponepal.org.np |
Study information
| Primary study design | Interventional |
|---|---|
| Allocation | Randomized controlled trial |
| Masking | Blinded (masking used) |
| Control | Dose comparison |
| Assignment | Factorial |
| Purpose | Health services research |
| Scientific title | Evaluating individual components of a community-based mental health intervention to promote help-seeking for depression care in Nepal: a multiphase optimization trial |
| Study objectives | This study evaluated the impact of the community intervention on help-seeking behavior and examine the contribution of its four core components: information on depression, awareness of treatment options, stigma reduction and dispelling myths about depression, and sharing personal recovery stories. |
| Ethics approval(s) |
Approved 15/05/2024, Nepal Health Research Council (NHRC) (Ramshah Path, P.O.Box 7626, Kathmandu, 44600, Nepal; +977-1-5327460; nhrc@nhrc.gov.np), ref: 184_2024 |
| Health condition(s) or problem(s) studied | Adults who meet Community Informant Detection Tool (CIDT) threshold for depression. |
| Intervention | Adults aged 18 years or older who met the Community Informant Detection Tool (CIDT) threshold for depression were identified by trained Female Community Health Volunteers (FCHVs), provided written informed consent, and individually randomised to one of eight intervention conditions according to a randomisation schedule generated by an independent statistician. The study used a 2×3 factorial, single-blinded design, with research assistants blinded to allocation. The intervention comprised four community-based components delivered by FCHVs: (1) information about depression, (2) information about available mental health services, (3) information addressing myths, facts and stigma related to depression, and (4) recovery-story videos. All participants received Component 1, which provided information on the causes, symptoms and consequences of untreated depression, including stressful life events, socio-cultural influences, genetic predispositions, cultural practices, economic hardship, family stress, and culturally specific symptoms such as stomach aches and headaches. Depending on randomised allocation, participants also received Component 2, which described available mental health services in the community and surrounding areas, including service types, costs and operating hours; Component 3, which addressed common myths, misconceptions and stigma associated with depression through a myths-versus-facts format; and/or Component 4, which consisted of two approximately 8-minute recovery-story videos featuring individuals who had recovered from depression and discussed symptoms, treatment, challenges and the importance of family support. Components were delivered using flipcharts, booklets, wall calendars and tablet-based videos, as appropriate. Each component took approximately 45 minutes to 1 hour to deliver, and a maximum of two components were delivered during a single visit. Participants were assessed by research assistants at one and three months after the intervention. Follow-up assessments examined whether participants had sought, initiated or continued mental health treatment, reasons for seeking or not seeking care, depression symptoms and other relevant outcomes. Total participant follow-up was three months. |
| Intervention type | Other |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
|
| Completion date | 03/03/2025 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 18 Years |
| Upper age limit | 99 Years |
| Sex | All |
| Target sample size at registration | 288 |
| Total final enrolment | 290 |
| Key inclusion criteria | 1. Being a resident of Kanepokhari Rural Municipality or Pathari Sanischare Municipality 2. Being aged 18 years or older 3. Meeting the CIDT threshold for depression 4. Being able to provide written informed consent 5. Being proficient in Nepali |
| Key exclusion criteria | Participants who were receiving mental health services or had been diagnosed with another mental health condition |
| Date of first enrolment | 11/07/2024 |
| Date of final enrolment | 08/12/2024 |
Locations
Countries of recruitment
- Nepal
Study participating centres
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 16/08/2025 | 15/09/2026 | Yes | No |
Editorial Notes
15/09/2026: Study’s existence confirmed by the Nepal Health Research Council (NHRC).
