Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of a Classroom-based Sensitization Intervention on Demand for Mental Health Care Among School-going Adolescents in New Delhi, India: Study Protocol for a Stepped-wedge Cluster Randomized Controlled Trial
Brief Summary: The primary objective of this embedded stepped-wedge, cluster randomized controlled trial is to evaluate the impact of a classroom sensitization (intervention condition), over and above the school-level sensitization activities (control condition), on referrals to a host trial (examining the effectiveness of a problem-solving intervention delivered by lay counsellors). The primary hypothesis is that the classroom-level sensitization intervention will be associated with a higher overall referral rate into the host trial (i.e. the proportion of adolescents referred as a function of the total sampling frame in each condition). The secondary hypotheses are that, compared with the control condition, the intervention condition will be associated with a greater proportion of referred students who meet eligibility criteria for inclusion in the host trial and a greater proportion of students who self-refer. We will also explore whether there are any differences between conditions in terms of the severity of total symptoms and symptom subtypes presented by referred adolescents.


Options:
A: CLASSROOM CLUSTERS

Inclusion criteria:

* Classes from grades 9-12 in the six collaborating schools.

Exclusion criteria:

* Classes that have received classroom sensitization sessions during earlier pilot work.

ADOLESCENT PARTICIPANTS

Inclusion criteria:

* Enrolled as a student in grades 9-12 (aged 13-20 years) at one of the collaborating schools
* Adolescent willing and able to consent for participation in the research

Exclusion criteria:

* Adolescent not proficient in written and spoken Hindi, as needed to participate fully in study procedures
* Adolescent needing urgent medical or mental health care
B: Inclusion Criteria:

* 30 years or older;
* Diagnosed with co-morbid CMD (Depression or Anxiety Disorder) and either
* Able and willing to consent and participate in the intervention and all assessments;
* Able to speak Kannada; and
* Mentally competent to provide consent and answer to study measures and participate in intervention (MMSE score greater than 26).

Exclusion Criteria:

* Under 30 years of age;
* Patients who are not diagnosed with co-morbid CMD (Depression or Anxiety Disorder) and either hypertension, diabetes, or diagnosed ischemic heart disease;
* Not mentally competent to provide consent and answer to study measures and participate in intervention (MMSE score \> 26).
* Unable to speak Kannada; and
* Participants who do not provide contact information.
C: Once youth are referred to the study, a screening tool will be administered to determine whether or not they meet eligibility requirements as described below.

The screening tool contains four sections;

1. Consent and Age: assures that participants meet the age requirements
2. Oxford Refugees Psychosocial Adjustment Scale: assesses depression, anxiety and hostility
3. Functioning: assesses the participant's ability to carry out activities of daily living
4. Psychological Analysis: clinician's assessment of the psychological state of the participant.

Inclusion Criteria:

* Participants must be between 15-24 years of age;
* Participants must prefer to have the opportunity to join an educational program but not currently be enrolled in school;
* A participant's total score on the Oxford scale must equal or exceed 30 AND
* Participants must display at least one non-zero score on the functioning questions.

Exclusion Criteria:

* Participant does not plan to reside in the Freetown urban area for the duration of the study (9 months from start date);
* Participant fails to meet age requirements;
* Participant is currently enrolled in school;
* Participant is not in favor of joining an educational program;
* Participant fails to meet Oxford psychosocial or functioning thresholds;
* Participant is judged by clinical staff as:

  * Needing mental health treatment beyond the scope of the YRI
  * Otherwise not suitable for a group treatment setting
* Participant displays the following:

  * Cognitive delays
  * Active suicidality
  * Psychosis
  * Risk of harm to themselves or others

Participants at risk of harm to themselves or others, as well as those requiring treatment beyond the scope of the YRI, will be referred to local mental health or social work treatment facilities as appropriate.
D: Inclusion Criteria:

* Participants are adults who meet the screening criteria for depression and anxiety on the self-report General Health Questionnaire (GHQ-12)

Exclusion Criteria:

* Potential participants who are currently receiving treatment for any mental health disorders will not be invited to participate in the study.

Answer: A