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These studies were proof that depression could be treated in poor countries by lay people. Now these researchers are trying to figure out how to streamline these interventions to the minimum outlay of resources needed to maintain excellent results. Many models are being tried, which integrate mental health care into primary care, employ community health workers or piggyback therapy on to other kinds of services. But one very promising strategy is to rely on peers as therapists. “The idea is to really make it go viral,” said Vikram Patel, a psychiatrist at the London School of Hygiene and Tropical Medicine and the leader of the Goa study.
In Rawalpindi and Goa, researchers are shifting the Thinking Healthy Program from community health workers to minimally trained peers. These projects are part of the South Asia hub of a major project financed by the N.I.M.H. to support and link global research on delivering mental health care in poor countries. The study is in its early days — results won’t come out for several years.