The evident lack of psychiatrists in Madhya Pradesh, along with an increase in the prevalence of mental illnesses post-COVID-19 have broadened the pre-exisitng treatment gap. Lack of financial support, coupled with the higher prevalence of mental illnesses in lower socio-economic populations, along with a high economic burden for the affected families indicate a dire need for the development of cost-effective and accessible methods to provide mental health care to all. OptimizeD aims to provide a bottom-up approach to mental healthcare in Bhopal, Madhya Pradesh, integrating the basic structures of Indian healthcare systems into the delivery of mental health services.

Main Trial:

1500 patients will be randomized to either HAP or ADM and treated for 3 months to achieve remission. Those who achieve remission enter a 9-month follow-up phase, during which HAP is gradually phased out while ADM continues, as is typical for each treatment. Patients in the HAP arm receive weekly sessions for 3 months and then discontinue, whereas patients in the ADM arm receive medication for the full 12 months. Patients who do not achieve remission or experience subsequent relapse (the return of the treated episode) are referred to specialist care.