Table 1 Detailed steps of the collaborative stepped care intervention
Step | For whom | Timing | Treatment | BY WHOM |
|---|---|---|---|---|
Recognition | Adult PHC patients | Before consultation with PHC doctor | Screening questionnaire; report for doctor | Health Assistant |
1 | Patients screened with CMD | At first consultation | Advice regarding screening questionnaire results; advice regarding seeing HC Psychoeducation; follow up appointment within 2 weeks. Yoga | PHC doctor HC HC |
2 | Patients who are severely ill at first consultation, or whose symptoms persist at follow-up | At first consultation or at follow up if not responding to Step 1 | Antidepressants OR start IPT in case the patient does not want Antidepressants & Adherence Management | PHC doctor HC HC |
3 | For participants who remain unwell, or are not adherent | Patients who do not respond to Step 2 despite taking the treatment | Antidepressants & IPT & Adherence Management | PHC doctor HC HC |
4 | For participants who do not respond despite good adherence | Patients who do not respond to Step 3 despite taking the treatment & Patients who are expressing suicidal ideas at any time | Continue all existing treatments Refer to Clinical Specialist | HC & PHC doctor Clinical Specialist |