Natania Cheguvera

Background: This study examined the lived experiences of emotional abuse (EA) in Indian parent‐adult child relationships, emphasising the intersection of systemic influences in maintaining EA. Employing a social justice framework, the research explored pathways to foster ‘change’ at both individual and societal levels to address EA.Methods: Data were collected through semi‐structured interviews with ten participants undergoing therapy, and analysed using Interpretative Phenomenological Analysis.Results: Four master themes emerged: ‘State of Lack’, ‘Lack of Relatability to Gender and Culture Norms’, ‘Therapy as a Catalyst for Regaining Sense of Self and Empowerment’, and ‘Cultural Shifts, Therapeutic Integration and Redefining Norms to Address Emotional Abuse’.Conclusion: The findings emphasise the contribution of gender and cultural norms in the reinforcement of EA, while highlighting therapy's potential in fostering individual healing while advocating for societal transformation. Our study adds valuable literature to the fields of counselling, social justice research, cultural psychology, social psychology, and feminist psychology, and provides a basis for future research.

The study explores the effectiveness, feasibility, and acceptability of a befriending intervention delivered by trained lay health workers to address the issues of the rural youth during the COVID-19 pandemic. We did an exploratory trial with 501 upskilled youth, where we randomly recruited 251 to the intervention group (REaCH) and 250 to the control group (General Enquiry Telephone Call-GETC). The outcome variables included in the study were depressive symptoms, wellbeing, and social support. The majority of the participants were females (64.2%), unmarried (63.55%), and hailed from economically poorer households (57.63%). The befriending intervention reduced depressive symptoms (OR: 0.95, p = 0.05) and significantly improved social support (OR: 1.03, p = 0.000) among participants in the intervention group. The participants in the intervention group had higher perceived social support from friends, families, and significant others when compared to the control group. Additionally, suicidality scores decreased for people in the intervention group from baseline to follow up; however, the results were not statistically significant. Befriending intervention is a practical, low-cost technique to sustain the youth in employment and ensure sustainable income. It inspires practitioners and policymakers to create mental health gatekeeping. The trial was registered prospectively on 27 July 2020 in Clinical Trial Registry India; ICMR-NIMS (Registration Number: CTRI/2020/07/026834).

Background: The lockdown associated with the COVID-19 pandemic is likely to impact people’s mental health, especially those from economically disadvantaged and vulnerable sections of society. Mental health can be affected by many factors, including fear of disease transmission, from response measures against the pandemic like social distancing, movement restriction, fear of being in quarantine, loneliness, depression due to isolation, fear of losing work and livelihood and avoiding health care due to fear of being infected. Telephonic befriending intervention by non-specialists will be used to provide social and emotional support to the youth from the Deen Dayal Upadhyaya Grameen Kaushalya Yojana (DDUGKY), an initiative of the Government of India. This study aims to promote mental wellbeing and reduce depressive symptoms by assisting participants to mobilise social support from family, friends and significant others by using the telephonic befriending intervention. Methods: In this article, we report the design and protocol of a multi-centre cluster randomised controlled trial. In total, 1440 participants aged 18–35 years who have recently completed their course out of the DDU-GKY initiative will be recruited in the study from 12 project-implementing agencies (PIAs) across six geographical zones of India. Participants from 6 of these agencies will be assigned to the telephonic befriending intervention arm, and the other six agency participants will be assigned to the general enquiry phone call arm (control). The primary outcomes of this study are mental wellbeing, depressive symptoms and perceived social support. Baseline assessments and follow-up assessments will be carried out 1 month following the intervention using WHO-5, PHQ and MSPSS-12 questionnaires. The befriending intervention will be provided by DDU-GKY staff, whom a virtual training programme will train. Discussion: This trial will help assess whether participants who are offered emotional, social and practical support through befriending will experience lesser symptoms of depression and better mental health compared to participants who do not receive this intervention through mobilised social support from friends, family and others. Trial registration: Clinical Trial Registry India (ICMR-NIMS) CTRICTRI/2020/07/026834. Registered on 27 July 2020.

Social networks protect individuals from mental health conditions of depression and anxiety. The association between each social network type and its mental health implications in the Indian population remains unclear. The study aims to determine the association of depression and anxiety with different social network types in the participants of a community cohort. We conducted a cross-sectional household survey among people aged ≥30 years in geographically defined catchment areas of Kerala, India. We used cross-culturally validated assessment tools to measure depression, anxiety and social networks. An educated male belonging to higher income quartiles, without any disability, within a family dependent network has lower odds of depression and anxiety. Furthermore, 28, 26.8, 25.7, 9.8 and 9.7% of participants belonged to private restricted, locally integrated, wider community-focused, family-dependent and locally self-contained networks, respectively. Close ties with family, neighbours, and community had significantly lower odds of anxiety and depression than private restricted networks. The clustering of people to each social network type and its associated mental health conditions can inform social network-based public health interventions to optimize positive health outcomes in the community cohort.

Background: Kerala is known as the diabetes mellitus (DM) and hypertension (HTN) capital of the world, thus compelling health professionals to model strategies, addressing their social, behavioural, and cognitive risk factors and eliminating various barriers to management. This paper describes the protocol of our study that aims to examine the effectiveness and sustainability of an integrated care model for the management of chronic conditions and their risk factors through a family-based intervention. The proposed care model targets to modify systems and processes that predispose to chronic conditions by enhancing social cohesion and social networks, preventing lifestyle risks, developing iterative cognitive interventions, and engaging the family into customised treatment adherence strategies navigated by community health social workers (CHSWs). Methods: A cluster randomised controlled trial (RCT) in selected participants will be conducted involving additional assessments prior to the baseline assessment. The assessment will identify and categorise patients into four risk groups, namely behavioural, social, cognitive, and multiple, based on dominant risks identified. Eligible participants will be randomly allocated (at a ratio of 1:1) into the intervention or control arm. The intervention arm will receive social, behavioural, and cognitive or multiple interventions corresponding to the identified risk groups, whereas the control arm will receive general intervention. Both the groups will be followed up at 6 months and 12 months post baseline to measure outcomes. The primary outcome will be the control of HTN and DM, and secondary outcomes include decreased depression and anxiety and improved functioning, social cohesion, and social network linkages. The sustainability and scalability of this intervention will be assessed through cost effectiveness, acceptability, and user friendliness of the integrated approach by performing a qualitative evaluation. Discussion: This RCT will inform the potential paradigm shift from a medical model of chronic condition management to a multidimensional, multisystem, and multidisciplinary convergence model navigated by CHSWs. Such a model is not currently considered in the management of chronic conditions in Kerala. Trial registration: Trial has been prospectively registered on Clinical Trial Registry of India- CTRI/2020/12/029474 on 1st December 2020.