{"title":"Community Street Play Versus Facility-based Screening for Mental Health Literacy in Rural India: A Mixed-methods Quasi-experimental Study.","authors":"Abhishek Ghosh, Pragyapti Malav, Blessy B George, Manya Shukla, Nagma Imam, Kashish Ranchan, Manju Mehra, Renjith R Pillai, Kshitiz Sharma, Shankar Prinja, Sandeep Bhola, Preet Mohan Singh, Alakjot Kaur, Debasish Basu, Neha Dahiya, Ashoo Grover","doi":"10.1177/02537176261472529","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Community-based approaches to mental health literacy (MHL), including street theatre, remain underrepresented. No study has compared street play with primary care facility-based screening as parallel MHL strategies. This study evaluated the effectiveness and acceptability of structured street play compared with facility-based screening in rural Punjab, India.</p><p><strong>Methods: </strong>A mixed-methods quasi-experimental study with two non-randomized arms was conducted across ten primary care facilities in Mohali district. Adults in one block received a single 30-min street play (<i>N</i> = 102); those in the adjacent block underwent structured screening for depression, anxiety, and substance use by a non-specialist nurse using a validated mobile application (<i>N</i> = 100). Mental health knowledge schedule and attitudes to mental illness questionnaire were assessed at baseline and 1-month follow-up. Acceptability was measured using the theoretical framework of acceptability scale. Twelve qualitative interviews guided by the health belief model (HBM) explored participants' experiences.</p><p><strong>Results: </strong>Both arms showed significant improvements in knowledge (<i>F</i> = 9.788, <i>p</i> = .002) and attitudes (<i>F</i> = 4.841, <i>p</i> = .029) at follow-up, with no significant between-arm difference. A significant time × gender interaction (<i>F</i> = 12.262, <i>p</i> = .01) indicated that females who held more stigmatizing views at baseline showed greater attitudinal improvement than males. Post-intervention condition recognition was uniformly high, and acceptability exceeded 90%. Qualitatively, participants recognized susceptibility, severity, and benefits of help-seeking across all six HBM domains, with stigma, structural barriers, and increased self-efficacy reported.</p><p><strong>Conclusions: </strong>A single-session street play and facility-based screening produce comparable short-term improvements in MHL, supporting their integration as complementary demand-generation and case-identification strategies within the primary care mental health framework.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176261472529"},"PeriodicalIF":1.8000,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13486401/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Psychological Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/02537176261472529","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Community-based approaches to mental health literacy (MHL), including street theatre, remain underrepresented. No study has compared street play with primary care facility-based screening as parallel MHL strategies. This study evaluated the effectiveness and acceptability of structured street play compared with facility-based screening in rural Punjab, India.
Methods: A mixed-methods quasi-experimental study with two non-randomized arms was conducted across ten primary care facilities in Mohali district. Adults in one block received a single 30-min street play (N = 102); those in the adjacent block underwent structured screening for depression, anxiety, and substance use by a non-specialist nurse using a validated mobile application (N = 100). Mental health knowledge schedule and attitudes to mental illness questionnaire were assessed at baseline and 1-month follow-up. Acceptability was measured using the theoretical framework of acceptability scale. Twelve qualitative interviews guided by the health belief model (HBM) explored participants' experiences.
Results: Both arms showed significant improvements in knowledge (F = 9.788, p = .002) and attitudes (F = 4.841, p = .029) at follow-up, with no significant between-arm difference. A significant time × gender interaction (F = 12.262, p = .01) indicated that females who held more stigmatizing views at baseline showed greater attitudinal improvement than males. Post-intervention condition recognition was uniformly high, and acceptability exceeded 90%. Qualitatively, participants recognized susceptibility, severity, and benefits of help-seeking across all six HBM domains, with stigma, structural barriers, and increased self-efficacy reported.
Conclusions: A single-session street play and facility-based screening produce comparable short-term improvements in MHL, supporting their integration as complementary demand-generation and case-identification strategies within the primary care mental health framework.
期刊介绍：
The Indian Journal of Psychological Medicine (ISSN 0253-7176) was started in 1978 as the official publication of the Indian Psychiatric Society South Zonal Branch. The journal allows free access (Open Access) and is published Bimonthly. The Journal includes but is not limited to review articles, original research, opinions, and letters. The Editor and publisher accept no legal responsibility for any opinions, omissions or errors by the authors, nor do they approve of any product advertised within the journal.
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