"So what if I use tobacco or alcohol? It won't hurt me!" How women perceive substance use: insights from a community study in India.

To explore the subjective perceptions of women from rural and urban communities in Bangalore, India, regarding their perspectives about addictive substance use (ASU), and the interventions/support they need to quit use. Based on the data collected, the goal of this study was to develop an intervention that would address the women's needs. Mixed methods were used as follows: (a) door-to-door survey of women (N = 2044) regarding their use of addictive substances, and (b) focus group discussions with the women to explore their perceptions. Interviews were transcribed verbatim, themes and sub-themes identified. More than one-third (32.7%) reported past 3-month ASU, with majority reporting smokeless tobacco products (82.6%). Alcohol use was reported by 17.4%. Four major themes (with sub-themes) were identified from the focus group discussions: (1) Patterns of use (oral tobacco products-kaddipudi, thambaku; alcohol), (2) Reasons for use (to relieve stress and forget problems, tobacco use as a way of life, for postnatal benefits, due to easy availability, to reduce fatigue and pain, indigestion, hunger), (3) Low risk perception related to ASU ("We know how to use tobacco safely", "No real harm from tobacco"), and (4) Issues related to quitting ASU and help-seeking (unwillingness to quit, methods of intervention- "videos, or tablets/injections to help us quit ASU"). The findings highlight challenges involved in the development of effective interventions for women. Additionally, there is a clear need for broader community agencies to address psychological, cultural, and social dimensions.

Experiences and reactions of adolescent offspring to their fathers' heavy drinking: A qualitative study from an urban metropolis in India.

The study assessed the experiences and reactions of adolescent offspring of alcohol-dependent fathers (N = 15) to their fathers' heavy drinking. Data were analyzed qualitatively, identifying themes and sub-themes. Respondent accounts elaborated these themes with reference to explanations, experiences, reactions to their fathers' drinking. Gender differences were notable: girls were more likely to report abuse, shouldering of family responsibilities, physiological and other reactions, ambivalent feelings toward father, sadness and worthlessness. Boys were more likely to react with anger and/or aggression. The findings should guide the development of gender-sensitive family-based interventions for the adolescents, with special attention to psychological, social and legal dimensions.

Video-enabled cue-exposure-based intervention improves postdischarge drinking outcomes among alcohol-dependent men: A prospective study at a government addiction treatment setting in India.

Returning to alcohol use following inpatient treatment occurs due to various real life cues/triggers. It is a challenge to demonstrate to patients how to deal with these triggers during inpatient treatment. Aims of the current study were (a) to evaluate the effectiveness of video-enabled cue-exposure-based intervention (VE-CEI) in influencing treatment outcomes in alcohol dependence, (b) to identify postdischarge predictors of intervention failure (returning to ≥50% of baseline alcohol consumption quantity/day). The VE-CEI comprises live action videos in which human characters model various alcohol use cues and strategies to deal with them effectively. The VE-CEI was administered to an inpatient alcohol-dependent sample (n = 43) and compared with treatment as usual (TAU) (n = 42) at a government addiction treatment setting in India. Patients were followed up over 6 months postdischarge to evaluate effectiveness of the VE-CEI on specific drinking outcomes. Over 6-month follow-up, VE-CEI group (vs. TAU) reported significantly lesser alcohol consumption quantity, fewer drinking days, and lower intervention failure rates. Results of multivariate Cox regression showed that participants who did not receive VE-CEI had an elevated risk of intervention failure (hazards ratio: 11.14; 95% confidence interval [4.93, 25.15]), other intervention failure predictors being early-onset dependence and increased baseline drinking. Findings provide evidence from India for effectiveness of cue-exposure-based intervention delivered using video technology in improving postdischarge treatment outcomes.

Effectiveness of body-mind-spirit intervention on well-being, functional impairment and quality of life among depressive patients - a randomized controlled trial.

AIM: The aim of the study was to examine the efficacy of body-mind-spirit Intervention in improving the outcomes (well-being, quality of life and functional impairment) among depressive patients. BACKGROUND: Depressive disorders lead to significant dysfunction, disability and poor quality of life among sufferers. Body-mind-spirit intervention has been associated with improvements in the outcomes; however, few studies have examined this among depressive patients. DESIGN: True experimental pre-post equivalent groups design was adopted with longitudinal measurement of outcomes. METHODS: Participants were 120 adult depressive patients visiting the psychiatric outpatient department in a District Hospital in India. The participants were randomly assigned to either the body-mind-spirit group or the treatment-as-usual group between July 2011-January 2013. The treatment-as-usual group (n = 64) received only routine treatment (antidepressants and structured psycho-education) in the hospital. The body-mind-spirit group (n = 56) received four weekly body-mind-spirit group sessions in addition to the routine treatment. Outcome measures on depression, well-being, functional impairment and quality of life were evaluated for both groups at baseline and at four follow-up assessments in the 1st, 2nd, 3rd and 6th month. Treatment effects of the body-mind-spirit intervention were analysed by repeated-measures analysis of covariance. FINDINGS: Compared with the treatment-as-usual group, the body-mind-spirit group showed significant reduction in depression and functional impairment, and significant improvement in the well-being and quality of life scores over the 6-month study period. CONCLUSION: The present findings provided evidence for the effectiveness of integrating a complementary therapy such as the body-mind-spirit intervention with conventional treatment in improving prospective outcomes among the depressive patients.

Non-medical use of prescription drugs in Bangalore, India.

BACKGROUND: Non-medical prescription drug use is an ongoing problem in India; however, there is paucity of literature in the Indian population. OBJECTIVE: The objective of the present study is to explore the non-medical use of prescription medicines in urban Bangalore, South India (N = 717). MATERIALS AND METHODS: Participants were recruited using a mall-intercept approach, wherein they were intercepted in 5 randomly selected shopping malls, and interviewed on their use of prescription medicines. RESULTS: The mean age of the participants was 28 years (S.D. 5). The non-medical use of different prescription medicine classes over the past 12 months was as follows: anti-inflammatories and analgesics (26%), opioids (17%), antibiotics (13%), and sedatives (12%). The majority reported "use without prescription," while "use in ways other than as prescribed" was also reported. In all cases, chemist shops were the main source of obtaining the drugs non-medically. In multivariate logistic regression analyses, non-medical use was found to be significantly associated with participants' baseline characteristics like gender, education, current employment status, and marital status. Sixty-five percent stated that although "doctor's prescription is not required for common complaints, we can decide ourselves," while 60% stated, "it's okay to deviate from a prescription as needed." One hundred percent said that "using prescription medicines is more socially acceptable, and safer, compared to alcohol or illicit drugs." CONCLUSION: These findings underscore the need for considering various contextual factors in tailoring preventive interventions for reducing non-medical use of prescription drugs.

Knowledge, Attitude, and Expectancies Related to Cannabis Use: A Cross-sectional Community Study Among College Students from Bangalore, Karnataka.

Background: Cannabis use among youth is increasing; this study aimed to assess college students' knowledge, attitude, and expectancies toward cannabis use. Methods: Cross-sectional survey using standardized tools among undergraduate and postgraduate college students in urban Bangalore, India (N = 405). Results: Ten percent reported past three-month cannabis use, with 1% reporting daily use. Users were significantly older (median age 21, IQR 22,20 [vs. 20, IQR 21,19], p < .001) and belonged to families with higher monthly incomes (p = .02). Use was significantly higher among males than females (65.9% vs. 34.1%, p = .006) and postgraduate students than undergraduates (51.2% vs. 48%, p = .001). Users were also significantly more favorable toward cannabis use (median score 4, IQR 6,2 [vs. median 3, IQR 4,2], p = .005) and had more positive expectancies from use (median score 2, IQR 3,2 [vs. median 2, IQR 2,0], p = .001). Nearly 30% were unaware that cannabis can affect a person's ability to drive safely or that it can affect executive functions, including academic performance. Over one-third were unaware of the current legal status of cannabis in India. Overall, 36%, 25%, and 17%, respectively, said that cannabis use is safe when used for recreational purposes, cannabis should be legalized as it helps to relieve stress, and cannabis use among youngsters should be acceptable in society as it is "part of college life." Conclusion: Findings build on existing literature on cannabis use among college youth in India, which can guide preventive interventions and policies for this vulnerable group.

Feasibility trial of a technology-based intervention (TI) among men with alcohol dependence from rural settings in India.

This feasibility study utilized two-arm randomized controlled trial (RCT), conducted in a de-addiction unit of tertiary mental care setting, India, between August 2021 and January 2022. Sixty-one participants diagnosed with alcohol dependent syndrome was randomly assigned to receive TI (n = 31) or Treatment as usual (TAU) (n = 30). Participants of both groups were initially assessed for craving, quantity and frequency of alcohol consumption and severity of alcohol use. TI participants received 8 video enabled cue exposure group sessions and periodic mobile phone interventions along with text message reminders after discharge along with routine treatment at de-addiction wards. TAU group participants received only routine treatment. All the participants were followed up over 3 months post-discharge. Results showed that majority (77 %) participants attended all 8-video enabled cue exposure group sessions. Rural men were willing to engage in the program and participated in behavioral rehearsals. Mobile intervention and text messages were accepted. We observed that at 3 months follow-up TI group subjects reported lesser mean craving scores, fewer drinking days, lesser quantity of alcohol consumption and less AUDIT scores compared to TAU group participants. This study provides preliminary support for the hypotheses that it is feasible to implement technology-based alcohol intervention for men with alcohol dependence.

A randomized controlled trial of nurse-led Brief Focused Intervention for patients with alcohol use-related mild traumatic brain injury in the emergency and casualty services of a tertiary hospital.

Objectives: Driving under the influence of alcohol is one of the leading causes of road traffic accidents in India. Individuals with acute injuries often present to emergency hospital services. Carrying out brief interventions in the emergency can prevent further injury and even progression to severe patterns of drinking. However, there are no known studies from India examining the effectiveness of such interventions in emergency settings. Against this background, the objective of this randomized controlled trial was to evaluate the effectiveness of a nurse-led Brief Focused Intervention (BFI) in comparison with the minimal intervention for patients with mild Traumatic Brain Injury (TBI) reporting to the emergency and casualty services of a tertiary hospital in Bengaluru, South India, who screened positive for alcohol use. Materials and Methods: The BFI comprised a video portraying the effects of alcohol on the brain and muscles and brief advice on how to reduce or avoid alcohol use. Subjects (N = 90) were randomly allocated to two groups: BFI (n = 45) or Minimal Intervention Group (MIG) (n = 45). Standardized tools were used to assess both groups on specific outcomes for up to six months following discharge from the emergency and casualty services. At the end of six months, complete data wasavailable for 73 patients. Results: Participants' (N = 73) mean age was 35 years (standard deviation [SD]-11). Over the six-month follow-up, the BFI group reported significantly lesser quantity of alcohol consumption (Alcohol Use Disorder Identification Test [AUDIT] Score - 5.03, SD 4.09, 95% confidence interval [CI] = 3.70, 6.35) compared to MIG (AUDIT Score - 9.76, SD 2.96, 95% CI = 8.73, 10.80), and fewer alcohol use-related problems in BFI group (Mean - 4.18, SD 3.21, 95% CI = 3.14, 5.22) compared to MIG (Mean - 5.88, SD 2.59, 95% CI = 4.98, 6.79). Results of logistic regression showed that being in MIG as well as baseline hazardous use of alcohol were associated with unfavorable outcomes at the end of six months follow-up. Conclusion: Findings provide the first known evidence from India for the effectiveness of nurse-led BFI in the emergency and casualty services in improving post-discharge outcomes for patients with alcohol use-related mild TBI. While the findings of the study are statistically significant, these findings also have significant clinical relevance, as they have shown that the BFI improved clinical outcomes. Thus, brief interventions should be implemented for these patients whenever possible in the Emergency setting.

Prevalence and Predictors of Internet Addiction Among Adolescents Before the First Wave of COVID-19 Lockdown in India.

Background Internet dependency behavior was found to be prevalent among adolescents even before the first wave of COVID-19 lockdowns across the world including India. Adolescent users develop Internet addiction due to various risk factors. Aim The aim is to measure the prevalence and psychosocial predictors of internet addiction among adolescents before the first wave of the COVID-19 lockdown in India. Methods A cross-sectional, descriptive study before the first wave of the COVID-19 lockdown, included 1199 adolescents of both genders, aged 11 to 19 years, at selected educational settings from a city in south India, by using Young's Internet addiction test (IAT)-20 and structured questioner. Results The study found almost all the participants (100%) were using the internet in a day and the highest number of subjects started using the internet during their 6th standard of education (13%). Before the first wave of COVID-19 lockdown, the prevalence of a total of mild, moderate, and severe forms of internet addiction among adolescents was 65%. Individual, family, and community-related risk factors were found significant association with Internet addiction. The age of 14-16 years (OR 2.050, p= 0.000), duration of internet use in a day (OR 0.740, p= 0.064), financial matters (OR 0.981, p=0.016), total internet addiction score (OR 1.03, p=0.035) and timings of internet use (OR 1.161, p=0.004), were significant predictors of Internet addiction. Conclusion Internet addiction was prevalent and a notable behavior addiction among adolescents during the margin time of pre-pandemic and the first wave of the COVID-19 lockdown in India. The study highlighted many significant psychosocial risk factors and predictors of Internet Addiction in adolescents, thus the need for a panoramic approach to identify internet addiction in adolescents, to bring the modest behavior of healthy use of the internet in adolescents.

Effectiveness of Digital Learning in Community Mental Health Care Among Nurses in India.

Background: Digital learning is a cost-effective and time-saving approach in higher education. The present study aimed to check the impact of continuing nursing education programs through digital learning by connecting Indian nurses to NIMHANS Digital Academy (NDA). Materials and Methods: One group pre-test and post-test design was used for this study. Overall, 217 nurses registered for the course and 146 nurses were recruited on the basis of eligibility and their Expression of Interest (EoI) through the online registration portal. All the nurses who had access to the internet and enough internet literacy were included in the study. 64 nurses had not submitted the post-test due to various reasons within the stipulated time. Hence, the final sample achieved and calculated for the analysis was n = 82. The data for this study were collected through the retrospective chart review method. Result: The findings of this study reveal that most of the nurses in India had willingness and readiness for digital learning. All the nurses who joined the NDA learning program stated that they would like to improve their knowledge regarding mental health and illness, to identify and manage mentally ill patients efficiently. The results indicated that the training provided through NDA positively impacted the nurses' knowledge and fulfilled their learning needs. Statistical analysis showed a significant difference between knowledge, practice, and confidence score changes for the two-time point period, i.e. before and after the training. Conclusion: It can be concluded that conducting Continuing Nursing Education (CNE) through a digital learning program is an effective teaching-learning method in the nursing curriculum.

Lived-in experiences of health care professionals affected with COVID-19.

Background and Objective: Healthcare providers (HCPs) were vital during the COVID-19 pandemic. The healthcare providers affected by COVID-19 underwent various life changing events while continuing their profession during the pandemic. This study is aimed to explore the lived-in experiences of HCPs affected by COVID-19 at a tertiary care Mental Health Institute in India. Materials and Methods: The sampling method was purposive. Twenty two HCPs (eight nursing educators, seven nursing officers, five contractual cleaning workers, and two laboratory technicians) participated in the interviews conducted by the researchers to obtain the lived-in experiences of HCPs who have recovered from COVID-19. Researchers used a sociodemographic form and an interview guide to collect the data. Interviews were audio recorded and analyzed by using Atlas-ti-9 software. Results: All the participants were female, and they revealed various physical, psychological, and social issues faced by HCPs while balancing home and workplace. Thematic data analysis resulted in the emergence of two themes and 11 subthemes related to life changing events. Conclusion: The findings concluded that although the healthcare providers had working experience in the field of mental health, they too experienced mild psychological issues like anxiety, depression, and fear of death because of this pandemic situation.

Effectiveness of multi-disciplinary structured training program on mentoring and mental well-being for officers and instructors in the Indian Air Force.

Background: The military environment is characterized by unpredictable situations, intensive training, demanding workload, and job-associated stressors, which make it highly stressful. Mentorship and mental well-being training could be beneficial to both officers and the new adolescent recruits of the Indian Air Force (IAF). Aim: This study aimed at evaluating the effect of a multi-disciplinary structured training on mentoring and mental well-being among officers and instructors in the IAF. Methods: Seventy IAF officers/instructors underwent a week-long multi-disciplinary structured training program, which was conducted at a tertiary care neuro-psychiatric hospital in South India. A quasi-experimental design with a single-group pre- and post-test was adopted. Outcome measures included a) knowledge on mentorship and mental health and b) self-perceived competence in addressing mental health distress. Results: Post training, there was a statistically significant improvement in scores on mentorship/mental health knowledge and a significant increase in self-perceived competence in addressing mental distress. Conclusion: Mentorship and mental well-being training for officers and instructors in the IAF improved mental health knowledge and self-perceived competence. Therefore, administration of regular and in-depth structured mental health-related training interventions could be beneficial not only to the officers but also to the new recruits/mentees in the IAF.

Motives and simultaneous sedative-alcohol use among past 12-month alcohol and nonmedical sedative users.

BACKGROUND: Simultaneous sedative-alcohol use (SSAU) is a matter of public health concern. It is important to address the various motives individuals may have for involvement in SSAU. OBJECTIVE: To explore the motives associated with SSAU. METHODS: Data were collected as part of the ongoing Prescription Drug Misuse, Abuse, and Dependence study in St. Louis. For this analysis, the sample included 173 participants who reported nonmedical sedative use for more than 5 days, and use of alcohol, in the past 12 months. SSAU was defined as past 12-month use of sedatives and alcohol together/at the same time. RESULTS: Past 12-month SSAU was reported by 61% of the sample. Multivariate logistic regression indicated that for every increment of one motive, participants were significantly more likely to report SSAU (adjusted odds ratio (aOR): 1.30; 95% confidence interval (CI): 1.12-1.52). Furthermore, reporting sedative use "to get high, to change mood, to relieve stress, to party, and 'just because' " was independently associated with the past 12-month SSAU. Past 12-month SSAU was also found to be significantly associated with simultaneous use of sedatives and cannabis in the past 12 months. CONCLUSION: A higher number of motives, as well as specific motives reported for sedative use, were found to be significantly associated with past 12-month SSAU. SCIENTIFIC SIGNIFICANCE: Findings underscore the need for considering motives in tailoring preventive interventions for reducing SSAU. It may be equally important to direct efforts toward decreasing the number of motives, as well as addressing the specific motives reported for sedative use.

Effectiveness of psychosocial intervention for internalizing behavior problems among children of parents with alcohol dependence: Randomized controlled trial.

BACKGROUND: Parental drinking has a direct bearing on children. Behavioral problems such as anxiety and depression are common problems among children whose parents drink heavily. Psychosocial interventions have shown promising results for anxiety and depression among children; however, few studies have been conducted in the context of children of parents with alcohol dependence in India. AIM: To evaluate the efficacy of psychosocial intervention for internalizing behavioral problems among children of parents with alcohol dependence. METHODS: A randomized controlled trial with a 2 × 4 factorial design was adopted with longitudinal measurement of outcomes for 6 mo. Two-hundred and eleven children who met the eligibility criteria (at least one parent with alcohol dependence) at government high schools in Bangalore, India, were randomized to the experimental (n = 97) or control group (n = 98). The psychosocial intervention was administered to the experimental group in eight sessions (biweekly) over 4 wk after baseline assessment. The intervention focused on identifying and modifying negative thoughts, replacing thinking errors with realistic alternatives, modification of maladaptive behavior, developing adaptive coping skills and building self-esteem. The data was collected pre-intervention and at 1, 3 and 6 mo after the intervention. Data were analyzed using SPSS 28.0 version. RESULTS: Mean age of the children was 14.68 ± 0.58 years, 60.5% were male, 56% were studying in 9th standard, 70.75% were from nuclear families, and mean family monthly income was 9588.1 ± 3135.2 INR. Mean duration of parental alcohol dependence was 7.52 ± 2.94 years and the father was the alcohol-consuming parent. The findings showed that there were significant psychosocial intervention effects in terms of decreasing anxiety and depression scores, and increasing self-esteem level among experimental group subjects over the 6-mo interval, when compared with the control group (P < 0.001). CONCLUSION: The present study demonstrated that the psychosocial intervention was effective in reducing anxiety and depression, and increasing self-esteem among children of parents with alcohol dependence. The study recommends the need for ongoing psychosocial intervention for these children.

Nurses' perspectives regarding integrated nursing interventions for psychoactive substance use cessation: A mixed methods study from South India.

PURPOSE: To obtain nurses' perspectives regarding integrated interventions for substance use cessation for patients in general hospital settings. DESIGN AND METHODS: (a) Quantitative survey (N = 207) (nurses' knowledge, attitude, practice, confidence regarding integrated interventions; (b) Focus groups exploring nurses' perspectives regarding integrated interventions (N = 32). FINDINGS: Participants' scores (mean, SD): Knowledge-112.5 (10.4) (maximum score-198); Attitude-30.99 (7.05) (maximum-52); Practice-1.66 (2.63) (maximum-28); Confidence-11.90 (3.82) (maximum-24). From the focus groups, four themes were identified: Substance use patterns among patients seeking treatment at the hospitals where the nurses are employed; Nurses' role in providing integrated interventions; Nurses' training needs for providing integrated interventions; Feasibility of providing integrated interventions. PRACTICE IMPLICATIONS: Findings provide clear justification for module development to train nurses in providing integrated interventions.

Development and pilot-testing of a skill-based intervention to prevent psychoactive substance use among college students: A study from Bangalore, India.

Background: Psychoactive substance use among college youth is increasing in low- and middle-income countries like India. However, there are few systematically developed interventions for this vulnerable group. Aim: The aim of this study was to develop a skill-based intervention to prevent substance use among college students (or enable them to quit, if already initiated use). Method: The skill-based intervention was informed by focus group discussions with college students regarding the kind of help they perceived would be useful. The intervention was pilot-tested for its appropriateness and acceptability in this population, and revised based on their inputs. Results: The feedback received from the students was incorporated and the intervention was suitably revised. The final intervention adopted a disease prevention and health promotion approach, by addressing psychoactive substance use as a risk factor for several major illnesses, and providing practical guidance on how to overcome use. The intervention consisted of four sections: (i) Health effects of substances, with realistic depictions through computer graphics (e.g., to illustrate arterial blockage, brain shrinkage, lung damage, erosion of gastric mucosa, impaired sexual performance, premature aging); Clarification of Myths, Providing Medical Facts, (ii) How to Overcome Substance Use, with practical strategies for quitting, (iii) Quitting Substance Use as part of a Healthy Lifestyle, (iv) Conclusion, portraying life after quitting substances, with motivational messages. Conclusion: The skill-based intervention received positive feedback regarding its applicability and acceptance among college students. An experimental trial can be planned to examine the efficacy of the intervention in bringing about improvement in specific outcomes.

Association between Parent-Reported Executive Functions and Self-Reported Emotional Problems among Adolescent Offspring of Fathers with Alcohol-Dependence.

Objectives To compare the executive functions in adolescents of fathers with alcohol dependence (AOFADs) with a control group of adolescents without a paternal history of alcohol dependence and examine the association between executive functioning problems and behavioral and emotional problems. Materials and Methods The study included 39 AOFADs and 45 adolescent offspring of fathers without a history of alcohol-use disorders, who were matched for age and sex. They were assessed using standardized measures of executive functions and emotional and behavioral problems. Statistical Analysis A comparison was made between the two groups about the parental report of adolescents' executive functions and adolescents' self-reported emotional and behavioral problems. ANCOVA was performed to understand the covariance of educational and socio-economic status on executive functions. Correlation between executive functions, emotional and behavioral problems, and the duration of father's alcohol dependence was examined with Spearman's rho. Results AOFAD group showed significant impairment on all subdomains of executive functions and emotional and behavioral disturbances ( p < 0.01) but not on the prosocial behavioral dimension ( p < 0.01). The group differences were independent of child's education and family income. Executive functional impairments positively correlated with psychopathology ( p < 0.01). Problems with executive functions and psychopathology correlated with the duration of the father's alcohol dependence. Conclusions AOFADs are at risk for executive function impairments which in turn are strongly associated with emotional and behavioral problems. The association is independent of child's education and family economic status. The duration of alcohol dependence in fathers is associated with these problems. It has implications for targeted interventions for both adolescents and families.

Design and development of a training video for Accredited Social Health Activists (ASHAs) on brief psychological intervention for depression.

Background: Depression poses a major public health burden and has a large treatment gap in India. The study attempts to address this treatment gap by developing a training video for Accredited Social Health Activists (ASHAs), who are community health workers, on brief psychological intervention for depression. Methods: The systematic steps utilized in the design and development of the training video on depression were: 1) Content development of the video script and training booklet for ASHAs based on the review of research literature and two Focus Group Discussions, 2) Mental Health Professionals' evaluation of the video script and training booklet for ASHAs, 3) Translation from English to Kannada, 4) ASHAs' evaluation of the video script and training booklet for ASHAs, 5) Conversion of the video script into a 'shooting script', 6) Video production, 7) Evaluation of the training video, 8) Post-production of the training video, and 9) Development of the training guide. Results: The training video titled "Light of Hope: A Training Video on Depression" was developed along with two training booklets, which are complementary resource materials, for ASHAs and the training Facilitators. The brief psychological intervention for depression elucidated in the training video incorporates the evidence-based strategies of Psychoeducation, Activity Scheduling, Problem-Solving Skills Training, and Diaphragmatic/Abdominal Breathing Skills Training. Conclusion: The study demonstrates the systematic approach that can be employed for the design and development of a mental health training video, which has evidence-based content, incorporates stakeholders' evaluative perspectives, and is culturally contextualized.

Psychiatric nurse delivered group-cognitive-behavioral therapy for internalizing behavior problems among children of parents with alcohol use disorders.

PURPOSE: The present study aimed at assessing the effectiveness of group-cognitive-behavioral therapy for anxiety, depression, and self-esteem among children of parents with alcohol use disorder. DESIGN AND METHODS: A randomized, controlled trial study was conducted with 70 children of parents with alcohol use disorder. The children were initially screened for the presence of behavioral problems and living with parents with alcohol use disorder, then assigned randomly to experimental and control groups. The experimental group received eight biweekly group CBT sessions. RESULTS: Over 3-month study period, the results showed a statistically significant reduction in depression and anxiety scores and a significant improvement in self-esteem scores among CBT group children compared with the control group children. CONCLUSION: Our study demonstrates the effectiveness of CBT group treatment for children of parents with an alcohol use disorder and that school mental health nurses/psychiatric nurses can effectively deliver psychotherapy for behavioral and emotional problems of high-risk children.

Mental health orientation among ASHAs: A study from Karnataka State, India.

INTRODUCTION: The high mental health treatment gap in India, necessitates mental health service delivery through the primary health care system. Accredited Social Health Activists (ASHAs) as frontline community health workers are a key member of the primary health care team. The ASHAs training needs related to mental health, require to be determined in order to accordingly tailor capacity-building programs. In this context, the present study aims to examine the ASHAs mental health orientation utilizing a factorially validated Indian tool. METHODS: In this cross-sectional study, 91 ASHAs from a taluk of Bengaluru Urban District, responded to the self-administered Orientation towards Mental Illness (OMI) scale. Data were analysed using descriptive statistics viz. frequencies, percentages, means, and standard deviations. RESULTS: The ASHAs reported an overall unfavourable mental health orientation and the specific OMI factors on which unfavourable orientation was observed were Psychosocial stress, Non-restrained behaviour, Weak cognitive control, Fidgety behaviour, Bizarre behaviour, Psychosocial manipulation, and Hypo-functioning. CONCLUSION: The findings of the study suggest that capacity-building programs for ASHAs will need to first examine their orientation to mental health and collaboratively address an unfavourable orientation when present, as it would have a bearing on ASHAs mental health service delivery in the community.