Strengthening Nonspecialist Health Care Providers' Capacity to Address Mental Health in the Context of Domestic Violence in Nepal: Pre-Post Mixed Methods Training Evaluation.

Nearly 90% of nonspecialist health care providers had not received any prior formal mental health training at baseline.

• Study conducted in Madhesh Province, Nepal, a low- and middle-income country setting
• Total of 46 nonspecialist HCPs participated, randomized into two groups
• This baseline finding underscores the gap in mental health training for frontline health workers in public health facilities

Both training groups demonstrated significant improvements in mental health knowledge, with greater gains observed in the group receiving the longer 10-day training.

• Group 1 (n=24, 10-day comprehensive training) showed mean knowledge score increase from 41.33 to 48.41
• Group 2 (n=22, 3-day focused training) showed mean knowledge score increase from 41.18 to 44.27
• Improvements were assessed at baseline, immediately post-training, and at 3-month follow-up
• The 10-day training was based on the WHO's Problem Management Plus model with augmented modules on safety planning and psychosocial support

Attitudes toward individuals with mental health problems improved in both training groups.

• Improvements were reflected in reductions in social distance scores and perceived dangerousness scores in both groups
• Changes were measured at baseline, immediately post-training, and at 3-month follow-up
• Both the 10-day and 3-day training formats produced attitudinal improvements

Thematic analysis of in-depth interviews with group 1 participants indicated enhanced confidence and psychosocial support skills following training.

• In-depth interviews were conducted with participants from group 1 (10-day comprehensive training)
• Qualitative findings were thematically analyzed
• Enhanced skills were particularly noted in managing mental health concerns among women experiencing intimate partner violence or domestic violence
• Participants reported increased confidence in addressing common mental health concerns

The study used a mixed methods, pre-post intervention design with a comparison group nested within a larger domestic violence intervention trial.

• 46 nonspecialist HCPs were randomized into 2 groups in Madhesh Province, Nepal
• Group 1 (n=24) received 10-day comprehensive mental health and violence prevention training; Group 2 (n=22) received 3-day training focused on ethical considerations, the IPV/DV-mental health link, and referral services
• Training was based on the WHO's Problem Management Plus model with augmented modules on safety planning and psychosocial support
• Quantitative changes in knowledge and attitude scores were combined with qualitative in-depth interviews

The training model was assessed as having potential for scale-up in other resource-limited settings to build frontline capacity in managing mental health problems and supporting women experiencing IPV or DV.

• The authors identified this as a scalable approach for low- and middle-income countries
• The model addresses a noted gap in nonspecialist HCP capacity in public health facilities
• Both a shorter (3-day) and longer (10-day) version of the training produced measurable improvements