Depression and Individual Poverty

We will collect household income and food and non-food consumption. We will elicit the 7-day recall of food consumption from 20 major food items or groups commonly consumed in the study area. We will measure quantity consumed, whether it was purchased, home-grown, or received as a payment or gift, and monetary values of all purchased food. We will elicit the 30-day, 2-month and 6-month recall of other household expenditures. In addition, we will measure the following private assignable goods: respondents' food consumption the evening prior the interview, and food and clothing expenditure for adult males, adult females, and children.

We will also use a new elicitation method that we developed to measure private assignable goods.

2016-11-01

2018-11-01

individual resource shares and poverty indicators

household total, food, and non-food consumption; household income; household poverty

We conducted our prior study between 2016 and 2018, in a peri-urban region northwest of Bangalore, Karnataka. Our study area comprises 506 villages and wards (urban jurisdictions) with at least 40 households within the catchment area of our partner NGO in the Doddaballapur, Korategere, and Gauribidanur districts. In 2017, 24 percent of local adults aged 18 to 50 had some depression symptoms and 10 percent had symptoms of at least moderate depression.

We provided psychiatric care (PC) and livelihoods assistance (LA). The psychiatric care (PC) intervention consisted of eight months of free psychiatric care through the Shridevi Institute of Medical Sciences and Research Hospital. The initial visit included a diagnosis, an explanation of the significance of mental illness, and an individualized course of medical treatment. Patients returned for monthly follow-up visits. The most commonly prescribed anti-depressants were Selective Serotonin Reuptake Inhibitors (SSRIs). These drugs are generally not under patent and are available inexpensively in India. They are widely used and have relatively few well-tolerated side effects.

The livelihoods assistance (LA) intervention provided two group meetings and personalized livelihoods assistance during the first two months of the study.

We used a cluster-randomized design to cross-randomize PC and LA by locality. Before starting recruitment, we stratified the randomization by district and terciles of a locality socioeconomic index based on the 2011 Census of India. We screened about forty households per locality, with the target of selecting 1-2 participants per locality. Both the modal and median number of participants per locality is 2. This design minimized spillovers and cross-arm contamination. Treating few people per locality limited information leakages, protecting patient confidentiality.

We studied the effects of the intervention for about 20 months after depression treatment concluded. We found that pharmacotherapy reduced symptoms of depression, with stronger and more prolonged effects when paired with LA, despite having no independent effect on mental health . Thus, the LA intervention is not the focus of the current study.

randomization done in office by a computer

locality

Yes

506

Up to 1,000

In the original survey, we enrolled 395 participants (from 204 localities) in the control arm, 207 participants (from 99 localities) in the PC arm, 205 participants (from 102 localities) in the LA arm, and 193 participants (from 101 localities) in the PC/LA arm.

Assuming a 10% attrition rate for each arm in the follow-up survey, the minimum detectable effect (MDE) for the comparison of any of the intervention arms with the control arm (e.g., PC/LA vs. control) is 0.20 SD. This calculation is based on the assumptions of 80 percent power and 95 percent confidence. For a comparison of pooled PC arms with the control arm (e.g., PC/LA and PC vs. control), the MDE is 0.17 SD. With 20% attrition, the two MDEs are 0.21 SD and 0.17 SD. With 30% attrition, the two MDEs are 0.23 SD and 0.19 SD.