THRIVE

Overview

The THRIVE trial aims to evaluate the clinical effectiveness, economic benefits and mechanisms of action of a cash-plus program on clinical, functional and economic outcomes in adults with severe depression

in rural India. The study addresses the link between depression and poverty by evaluating an intersectoral cash-plus program that combines evidence-based interventions for depression with economic empowerment. Through a cluster randomized controlled trial among adults with severe depression, it provides increased access to mental health care in deprived region(s) of India while simultaneously addressing depression and poverty as key social determinants.

Rationale

Depression is one of the biggest contributors to the global mental health burden of disease and is closely linked with poverty. Depression substantially impairs social functioning and is associated with reduced workforce participation, contributing to poverty, while poverty itself is an important social determinant of depression through insecure employment, volatile incomes, and increased stress. In India, this negative cycle is particularly pronounced due to high baseline poverty, limited governmental financial risk protection, and high out-of-pocket health care expenditures, placing people with depression at risk of impoverishment.

Partners

• Centre for Mental Health Law & Policy, Pune, India

• University of Lucerne, Switzerland