Objectives: The increasing prevalence of mental health disorders in children is a growing concern in India. Community based therapy, such as school based therapy (SBT) and psychotherapy (PT) is used in the treatment. This paper aims to investigate the disease burden of mental health disorders, and assess the clinical and economic impact (by cost-effectiveness analysis) of SBT and PT on the symptoms of depression in Indian children aged below 15 years. Methods: Health technology assessment by systematic review of published literature. An electronic literature search was performed in Cochrane Review, Elsevier, PubMed and Medline databases for randomized controlled trials and cohort studies pertaining to community based therapies, particularly SBT and PT, in Indian children aged below 15 years suffering from depression. RevMan 5.0 was used for data analysis and quantitative data synthesis. Cochrane Review Manager's Risk of Bias Table was used to assess the risk of bias. Results: Out of 32 studies which were screened, 6 studies involving a total of 1,375 participants (377 received SBT, 325 received PT, 673 received neither) were included. In comparison with no therapy, SBT significantly reduced symptoms of depression: standard mean difference (SMD) -0.20 (95% confidence interval (CI) -0.35 to -0.04); PT significantly reduced symptoms of depression: SMD -0.64 (95% CI -1.44 to 0.16). Economic burden: a total of 95,295.50 DALY/year was lost due to the condition in specific the patient population. Assuming the cost of PT as INR 300 (US$ 4.75) per session, INR 962,000 (US$ 15220.341) was required per year to avert 1 DALY. By reducing the cost of each session by INR 50 (US$ 0.80), the PT can be made more cost-effective. Conclusions: SBT and PT are clinically and economically effective in reducing the symptoms of depression in Indian children aged below 15 years suffering from depression.
Chahar, A., Gulati, R., Sharma, J., Likhar, N., & Dang, A. (2015). Impact of Community Based Therapy on Children with mental health disorders: a health technology assessment. Value in Health, 18(3), A275. https://doi.org/10.1016/j.jval.2015.03.1605