Indian paradise takes novel approach to mental health.

News Indian women in the popular tourist destination of Goa, where the project to treat mental health disorders was launched. Beyond the paradise and prosperity of the internationally known tourist destination of Goa is another story – a high prevalence of mental health problems. Goa, a tiny state on India's western coastline, is one of the country's most affluent and literate, but recent studies have highlighted a high prevalence of depression and stress-related problems, affecting 5–10% of young adults and 15–25% of people who visit primary health centres. The state launched a pilot project in October 2005 that takes an innovative approach to addressing depres-sive and anxiety disorders which are a major cause of mental health disability worldwide. The project integrates evidence-based mental health treatments – including antidepressants, psychological treatments and yoga – into routine primary health care, using existing primary care staff plus locally-recruited staff. It is called Manas, which is short for mana shanti sudhar shodh meaning " search for mental peace " in Konkani, a local language in Goa, and draws on an approach developed by the World Health Organization (WHO) that is based on findings from studies in Chile, India and Uganda and on guidelines of the UK National Institute of Clinical Excellence. It relies on Sangath, a non-governmental organization (NGO), to train local counsellors. " Sangath's training of locally-recruited counsellors through the project is meeting an important need for psychological support and effective treatment among Goa's population and may provide a model which can be applied across India and other developing countries , " said psychiatrist Dr Vikram Patel, who is leading the programme and based at the Sangath office in Porvorim near the Goan capital of Panjim. Sangath is implementing the project in collaboration with the Goa state government's Directorate of Health Services and the London School of Hygiene and Tropical Medicine, with funding from the Wellcome Trust. The project was piloted at four primary health centres and four general practitioner clinics in Goa in 2006. The intervention was extended to more primary health centres in March this year, when a randomized controlled trial to evaluate its clinical benefits and affordability also began. In its first phase, a total of 12 primary health centres are involved, with half receiving the full intervention. The second phase will be to evaluate general practitioners' practices that are also involved. Patel, who is also the principal investigator, said …