Gantt Chart of the ICMR MINDS.

Non-Communicable Diseases (NCDs) are now a leading cause of mortality and morbidity globally, and mental illness is a significant part of it. In India, the treatment gap for common mental disorders is over 80%. In order to bridge this gap, mental health treatment models recommend task-shifting to non-specialists and integration of mental health care into general healthcare services. Other NCDs are being managed effectively by non-specialist healthcare workers (HCWs) at primary care, and mental illness and substance misuse are highly comorbid with other NCDs; hence, integrating mental health care within the NCD services and care framework seems logically feasible and effective. However, country-specific characteristics pose a significant challenge to the implementation of integrated care for mental disorders and NCDs. The primary objective of this study includes the development and implementation of a service delivery model that would result in at least 70% coverage of screening, linkage to care, and management of common mental disorders and substance use disorders (MSUD) among persons seeking care for NCDs at public health facilities. Secondary objectives include assessment of the feasibility of adoption of the implementation model by the health care system and to evaluate the cost of the mental health service strengthening intervention package from the health system’s and the patient’s perspectives. It will be a multi-site implementation research study, employing a mixed-methods quasi-experimental, within-site, three-phase, single-arm, interrupted time series design. The implementation model comprises screening, treatment, and linkage of mental health services integrated into NCD care in at least three blocks in each of the seven selected districts of the seven selected states of India, which are geographically far apart. The expected outcome would be to increase the proportion of patients screened and managed for MSUDs among persons seeking care for NCDs at the public health facilities. The results of this implementation research will provide a roadmap for scaling up of integrated MSUDs services within general healthcare.Trial registrationClinicalTrials.gov CTRI/2024/08/072748.非传染性疾病（Non-Communicable Diseases, NCDs）现已成为全球范围内主要的死亡与发病诱因，精神疾病是其中的重要组成部分。在印度，常见精神障碍的治疗缺口超过80%。为缩小这一缺口，精神卫生治疗模型倡导将相关任务下放至非专科医护人员，并推动精神卫生服务整合至常规医疗服务体系之中。 基层医疗场景下，非专科医护人员（healthcare workers, HCWs）可有效管理其他非传染性疾病；且精神疾病与物质滥用和其他非传染性疾病存在高度共病性，因此将精神卫生服务整合至非传染性疾病服务与照护框架内，在逻辑上具备可行性与有效性。然而，各国本土特征为精神障碍与非传染性疾病整合照护的实施带来了显著挑战。 本研究的主要目标为开发并实施一套服务提供模型，使印度公立卫生机构中因非传染性疾病就诊的人群中，常见精神障碍与物质使用障碍（Mental and Substance Use Disorders, MSUD）的筛查、诊疗衔接与管理覆盖率至少达到70%。次要目标包括评估卫生体系对该实施模型的采纳可行性，并从卫生体系与患者双视角，评估精神卫生服务强化干预方案的成本。 本研究属于多中心实施研究，采用混合方法类实验设计，具体为站点内三阶段单臂间断时间序列设计。该实施模型将精神卫生服务整合至非传染性疾病照护流程中，涵盖筛查、治疗与诊疗衔接环节，覆盖印度7个地理分布相距较远的选定邦下辖的7个选定区县中各至少3个行政区块。 预期成果为提升公立卫生机构中因非传染性疾病就诊人群的物质使用障碍筛查率与管理率占比。本实施研究的结果将为在常规医疗体系内推广整合式物质使用障碍服务提供路线图。 试验注册：ClinicalTrials.gov CTRI/2024/08/072748。