Please select the eligibility criteria that correspond to the clinical trial below.
Title: Strengthening Mental Health Care in Chronic Care Patients With Hypertension. A Cluster Randomised Control Trial
Brief Summary: A pragmatic cluster randomized controlled trial (RCT) in 20 public sector primary care clinics in the Dr Kenneth Kaunda district of the North West Province of South Africa to assess mental health and health outcomes for depressed adults receiving hypertensive treatment by measuring the real-world effectiveness of a facility-based stepped care intervention combining stress and depression case detection and management by non-physician clinicians and referral pathways for anti-depressant medication and/or group/individual counselling delivered by lay-health workers for patients with depression. The control condition is enhanced usual primary health care where non-physician clinicians have been equipped with the basic skills to identify stress and depression/anxiety but with limited access to doctors authorized to prescribe antidepressant medication, and with no specific psychosocial interventions.


Options:
A: Inclusion Criteria:

Clinics

* Twenty (20) largest clinics providing chronic care Patients
* Receiving hypertensive treatment at time of enrolment
* Depressive symptoms as indicated by total score of 9 or more on PHQ-9
* Planning to reside in area for the next year
* Capable of actively engaging in interviewer-administered questionnaire at time of recruitment, 6 months and 12 months later
* Written consent to participate in the study

Exclusion Criteria:

Clinics

* Clinics that do not provide Integrated Chronic Disease Management
* Small (\<10 000 attendances/ year)
* Mobile or satellite
* Participated in piloting of intervention \& data collection. Patients
* Inability to meet the above inclusion criteria
B: Inclusion Criteria:

1. Age 18 or above;
2. Able to speak and understand the target languages: Arabic, and/or Urdu, and/or Dari, and/or English;
3. Asylum seeker or refugee;
4. Presence of psychological distress, as shown by a score of 3 or more at the 12 item General Health Questionnaire (GHQ-12 ≥ 3);
5. Both oral and written informed consent to enter the study.

Exclusion Criteria:

1. Presence of any mental disorders according to DSM-V and ICD-10, as shown by a positive M.I.N.I.;
2. Acute medical conditions contraindicating study participation, based on clinical judgment of the health care professional with a clinical background who performs the screening;
3. Clinical evidence of imminent suicide risk or suicide risk scored as "moderate or high" (or a positive suicidality behaviour disorder) by the M.I.N.I. (section SUICIDALITY);
4. Clinical evidence that the decision-making capacity is impaired.
C: Inclusion Criteria:

* Diagnosis of threshold or subthreshold for Bulimia Nervosa or Binge Eating Disorder (DSM-5/ICD-11)
* BMI between ≥ 27 and \< 40

Exclusion Criteria:

* Diagnosis of psychosis, bipolar disorder or substance abuse dependence and/or a high level of suicide risk.
* Use of weight loss medication or medications that interfere with appetite.
* Cushing or Prader-Willi syndromes
* History of bariatric surgery
* Patients who are already in treatment
D: Inclusion Criteria:

* detection of pregnancy through 24 weeks gestation (to ensure at least 12 weeks remaining antenatal period for assessing adherence to all stages of PMTCT care cascade)
* HIV-positive
* positive screen for potential depression on 2-item Patient Health Questionnaire (PHQ-2\>0)
* on ART for at least 4 weeks

Exclusion Criteria:

* unstable health (about to start ART or on ART \< 4 weeks; active, untreated opportunistic infection)

Answer: A