{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:54:38Z","timestamp":1777521278445,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Douglas Mental Health University Institute"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>In low- and middle-income countries (LMIC), major mental disorders often remain untreated because of barriers related to access and resources. In rural areas and in conflict-ridden regions, the problem can be exacerbated by increased rates of mental illness and by reduced access to care. This paper describes a project designed to provide mental health services for major mental disorders among youth using a low-cost model in a rural district of the troubled Kashmir valley.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We describe the geographic and political context, the guiding principles and adaptation of the service model (through partnership with a voluntary organization and use of technology), and the implementation of the model using Theory of Change framework. The core of the intervention was to train a pool of lay health workers (LHWs) to provide mental health services to young (aged 14-30 years) people with major mental disorders in their own communities, supported by clinical professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Despite political turmoil and major floods, 40 (male and female) LHWs were trained. The LHWs efficiently engaged in case identification, basic interventions, and data collection on outcomes. Several different stakeholders were engaged in activities relevant to the objectives of the project; however, the use of technologies was moderated by several challenges, including access to internet services and patient preference for personal contact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This service model is applicable in an environment where protracted political and armed conflict, low resources, and geographical isolation make exclusive reliance on scarce professional services impractical.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0706743719839318","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:36:15Z","timestamp":1553733375000},"page":"621-629","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["A Model of Mental Health Care Involving Trained Lay Health Workers for Treatment of Major Mental Disorders Among Youth in a Conflict-Ridden, Low-Middle Income Environment: Part I Adaptation and Implementation"],"prefix":"10.1177","volume":"64","author":[{"given":"Ashok","family":"Malla","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Douglas Hospital Research Centre, McGill University, Montr\u00e9al, Quebec, Canada"},{"name":"Douglas Hospital Research Centre, ACCESS Open Minds network, Montr\u00e9al, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mushtaq","family":"Margoob","sequence":"additional","affiliation":[{"name":"Cognitive and Behavioral Sciences Studies Research Centre, Islamic University of Science and Technology, Awantipore, Kashmir, India"},{"name":"Advanced Institute of Management of Stress and life style related Problems (AIMS), Nigeen, Hazratbal, Srinagar, Kashmir, India"},{"name":"Supporting Always Wholeheartedly All Broken-hearted (SAWAB), Kashmir, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srividya","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Douglas Hospital Research Centre, McGill University, Montr\u00e9al, Quebec, Canada"},{"name":"Douglas Hospital Research Centre, ACCESS Open Minds network, Montr\u00e9al, Quebec, Canada"},{"name":"Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montr\u00e9al, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ridha","family":"Joober","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Douglas Hospital Research Centre, McGill University, Montr\u00e9al, Quebec, Canada"},{"name":"Program of Early intervention and Prevention of Psychoses, Douglas Institute, Montreal, Quebec, Canada"},{"name":"Research Program on Psychotic and Neurodevelopmental Disorders, Douglas Mental Health University Institute, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini","family":"Lal","sequence":"additional","affiliation":[{"name":"School of Rehabilitation, CHUM Research Center, Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada"},{"name":"CHUM Research Center, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada"},{"name":"CHUM Research Center, Douglas Mental Health University Institute, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rangawsamy","family":"Thara","sequence":"additional","affiliation":[{"name":"Schizophrenia Research Foundation (SCARF), Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huda","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Supporting Always Wholeheartedly All Broken-hearted (SAWAB), Kashmir, India"},{"name":"Consultant Clinical Psychology Research Unit, Advanced Institute of Management of Stress and life style related Problems (AIMS), Nigeen Hazratbal, Srinagar, Kashmir, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4060-5739","authenticated-orcid":false,"given":"Bilal Issaoui","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Douglas Hospital Research Centre, McGill University, Montr\u00e9al, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"bibr1-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.119164"},{"key":"bibr2-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1038\/475027a"},{"key":"bibr3-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012373960-5.00335-X"},{"key":"bibr4-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61263-X"},{"key":"bibr5-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61240-9"},{"key":"bibr6-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030442"},{"issue":"1","key":"bibr7-0706743719839318","first-page":"S14","volume":"13","author":"Margoob MA","year":"2006","journal-title":"JK Practitioner"},{"issue":"1","key":"bibr8-0706743719839318","first-page":"S18","volume":"13","author":"Margoob 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Mental Health GAP: Kashmir Project Nominated As Best In World. Rising Kashmir October 20, 2015. Available from: http:\/\/risingkashmir.com\/news\/mental-health-gap-kashmir-project-nominated-as-best-in-world. [Cited December 22, 2018]."},{"key":"bibr32-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600464"},{"key":"bibr33-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.153668"},{"key":"bibr34-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-015-0630-9"},{"key":"bibr35-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1097\/WTF.0000000000000105"},{"key":"bibr36-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-016-0163-2"},{"key":"bibr37-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.111.092155"},{"key":"bibr38-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-42"},{"key":"bibr39-0706743719839318","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-412"},{"key":"bibr40-0706743719839318","unstructured":"Center for Theory of Change. 2017 June 5 How Does Theory of Change Work? Center for Theory of Change. 2017. 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