A Pan India Digitally Driven Capacity Building Program to Strengthen Primary Mental Healthcare: Summary of Its Implementation and Performance Evaluation

Abstract

Background: India has made significant strides in digital mental health capacity building over the past decade. This pan-India initiative was implemented through National Institute of Mental Health and Neurosciences (NIMHANS) to enhance the delivery of primary mental healthcare by digitally training medical officers (MOs), community health officers (CHOs), and field-level workers (FLWs) of India. Methods: Between October 2022 and June 2024, the program engaged MOs, CHOs, and FLWs of Karnataka, Maharashtra, Telangana, Uttarakhand, Bihar, Goa, Kerala, and West Bengal in a standardized six-week-district-wise digital training module curated to identify and manage commonly prevalent psychiatric disorders in primary care settings. Onsite training was conducted for participants in Tripura and Telangana. Participant engagement and changes in knowledge, attitude, and practice (KAP) scores were analyzed for each cadre along with ongoing support through real-time collaborative video consultations (CVCs). Results: The program engaged 42,192 participants (7248 MOs, 18,993 CHOs, and 15,951 FLWs) across nine Indian states. Overall, participants attending ≥50% of training revealed higher engagement in CHOs of Bihar (80.51%), followed by MOs of Goa (69.7%), followed by FLWs of West Bengal (64.57%). Paired t-test analysis of KAP scores showed post-training statistically significant (p < .05) improvement for MOs of Karnataka, Maharashtra, Telangana (onsite), and Goa; CHOs of Karnataka, Maharashtra, Telangana (onsite), Tripura (onsite) and Bihar; and FLWs of Karnataka, West Bengal, and Kerala. A total of 1,320 CVCs were conducted, assisting the management of psychiatric disorders in the community. Conclusion: Digital capacity building is a viable, scalable, and practical approach for mental health training of frontline workers to improve their clinical KAP.