Effect of lay counselling on mental health and TB treatment outcomes: an experience from Gujarat state, India

Abstract

Purpose Depression and anxiety are the most common comorbidities in TB patients, adversely impacting TB treatment outcomes. The purpose of this study is to assess the effect of lay counselling in reducing symptoms of depression and anxiety and TB treatment completion. Design/methodology/approach The study used a pre-post interventional research design. Patients were screened for depression and anxiety. All symptomatic TB patients were followed up and offered four to six or more lay counselling sessions whenever necessary. The authors assessed changes in depression and anxiety symptoms before lay counselling intervention and after fourth lay counselling session or the completion of TB treatment, whichever occurred the last. Findings Approximately 6,974 TB patients were screened for symptoms of depression and anxiety. The mean age was 36.7 ± 14.7 years. Total 25.9% patients were symptomatic. About 99.8% were provided lay counselling and received at least one to two follow-up sessions, while two patients who screened with severe depression were referred to a mental health specialist. Nearly 96.9% TB patients did not report symptoms of depression or anxiety after four lay counselling sessions, and TB treatment completion rate was higher among symptomatic TB patients who completed at least four counselling sessions (92.5%). Practical implications Lay counselling services delivered by field coordinators offer a promising approach to address mental health comorbidities among TB patients in resource-limited settings. Originality/value It explores a novel approach – lay counselling delivered by field coordinators – in tackling depression and anxiety among TB patients, which is a potentially scalable solution in resource-limited settings.