Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study
Ankita Mukherjee, Mercian Daniel, Sudha Kallakuri, Siddhardha Devarapalli, Sandhya Kanaka Yatirajula, Amanpreet Kaur, Praveen Devarsetty, Usha Raman, Beverley M Essue, Rajesh Sagar, Shashi Kant, Shekhar Saxena, Graham Thornicroft, Anushka Patel, David Peiris, Pallab K Maulik, John Torous, Abiodun O · 2026
Read Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study by Ankita Mukherjee, Mercian Daniel, Sudha Kallakuri, Siddhardha Devarapalli, Sandhya Kanaka Yatirajula, Amanpreet Kaur, Praveen Devarsetty, Usha Raman, Beverley M Essue, Rajesh Sagar, Shashi Kant, Shekhar Saxena, Graham Thornicroft, Anushka Patel, David Peiris, Pallab K Maulik, John Torous, Abiodun O (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13195372.txt.
Description
Ankita Mukherjee and a large team of co-authors dissect what helped and what hindered a digital mental health program in rural India, in this 2026 study. The SMART Mental Health trial gave primary care doctors and community health workers a phone-based decision tool to find and treat depression, anxiety, and self-harm risk, alongside a community anti-stigma campaign. The trial improved remission and cut stigma; this study asks how.
The evaluators mixed program data with thirty-eight focus groups and thirty-seven interviews. Delivery was faithful: nearly every participant got at least one follow-up visit, and most saw the anti-stigma videos. Referrals onward were the weak point, with only about a quarter of referred patients reaching a psychiatrist. Cultural reluctance and patients' competing demands blocked care, while health workers' closeness to their villages, plus training and mentoring, pulled the other way.
Catalog record
| CREATOR | Ankita Mukherjee, Mercian Daniel, Sudha Kallakuri, Siddhardha Devarapalli, Sandhya Kanaka Yatirajula, Amanpreet Kaur, Praveen Devarsetty, Usha Raman, Beverley M Essue, Rajesh Sagar, Shashi Kant, Shekhar Saxena, Graham Thornicroft, Anushka Patel, David Peiris, Pallab K Maulik, John Torous, Abiodun O |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 77 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |