Psychiatrist calls for roll-out of lay counselling

Leading Indian psychiatrist Professor Vikram Patel has published two studies today that he argues provide strong evidence for the rollout of lay counselling across India to tackle depression and harmful drinking.

The trials, funded by Wellcome and run in Goa, India, show that lay counselling provides better results for harmful drinking and severe depression than enhanced care from primary care physicians. The studies, published in The Lancet, also show the approach is cost-effective, and so viable for investment and scaling up.

The use of lay counsellors aims to address the lack of mental health professionals in India. The counsellors have two weeks of intensive training and then continuing peer supervision.

The treatment programmes were developed in collaboration with Professor Christopher Fairburn at the University of Oxford. They have the same theoretical foundation as evidence-based psychological treatments used by mental health professionals in high-income countries.   

Professor Patel, who is a Wellcome Principal Research Fellow at the London School of Hygiene & Tropical Medicine, says: "The interventions are brief and, crucially, were both delivered by the same counsellor – mimicking the real world of primary care."

Dr Mary DeSilva, Wellcome’s Head of Population, Environment and Health, says the results provide food for thought for high-income countries. "Despite their affluence, mental health service provision in high-income countries is frequently sub-optimal, and people with depression and alcohol dependency often don't get the support they need."

Watch people in Goa describe how their lives have been changed by lay counselling.

Read the studies: