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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO406

Development and validation of a district mental health system assessment tool for programme evaluation in India

DEVELOPMENT AND VALIDATION OF A DISTRICT MENTAL HEALTH SYSTEM ASSESSMENT TOOL FOR PROGRAM EVALUATION IN INDIA

The DARPAN tool, developed to assess mental health systems at the district level, was found to be valid and reliable. Field testing revealed critical gaps, including the disconnect between training and competence, medication supply shortages, and limited integration into primary care.

The study aimed to develop and validate a contextually appropriate, valid, and operationally sensitive assessment tool to monitor the implementation of the District Mental Health Programme (DMHP), which is central to mental health service delivery in India. Conducted between April 2022 and March 2024 in Kolar district, Karnataka, India, the study followed a five-stage sequential development process: framework development, item generation, expert validation, face validity assessment, and field testing; 160 draft indicators were reduced to 138 items across 15 domains through the revision of 35 items and the removal of 22. The process involved 8 experts, 10 stakeholders for face validity assessment, and 57 participants in field testing; validity was assessed using the Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI), while internal consistency was assessed using Cronbach's alpha. The tool demonstrated adequate psychometric properties: I-CVI values ranged from 0.78 to 1.00, S-CVI/Ave was 0.94, and Cronbach's alpha was 0.87. Field testing identified critical implementation gaps: although 81.6% of physicians had received DMHP training, only 40% reported confidence in independently diagnosing and treating patients; psychotropic medications were available for an average of only 5.3 months per year; 0% of the primary health centres (PHCs) assessed had independently initiated psychiatric treatment; implementation of the Mental Health Act was partial; and community awareness activities were concentrated at the district and taluk levels, failing to reach peripheral facilities. In conclusion, DARPAN was found to be suitable for assessing district-level DMHP implementation, identifying implementation gaps, supporting evidence-based programme planning, and monitoring service delivery. Multicentre validation across different districts in India was recommended as the next step to establish broader applicability. Note: the conference abstract reported 12 domains and 105 items, an S-CVI of 0.93, a Cronbach's alpha of 0.86, and 89 key informants across 10 health facilities; the values presented in the poster were used here.

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