Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series

There is a scarcity of psychological interventions for self-harm in young people, either developed or adapted for use in low and middle-income countries (LMICs). ATMAN is a psychological intervention developed in India for youth with three key modules: problem-solving, emotion regulation and social...

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Main Authors: Shilpa Aggarwal, Michael Berk, Nilesh Shah, Anokhi Shah, Dimple Kondal, George Patton, Vikram Patel
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Cambridge Prisms: Global Mental Health
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Online Access:https://www.cambridge.org/core/product/identifier/S2054425125000263/type/journal_article
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author Shilpa Aggarwal
Michael Berk
Nilesh Shah
Anokhi Shah
Dimple Kondal
George Patton
Vikram Patel
author_facet Shilpa Aggarwal
Michael Berk
Nilesh Shah
Anokhi Shah
Dimple Kondal
George Patton
Vikram Patel
author_sort Shilpa Aggarwal
collection DOAJ
description There is a scarcity of psychological interventions for self-harm in young people, either developed or adapted for use in low and middle-income countries (LMICs). ATMAN is a psychological intervention developed in India for youth with three key modules: problem-solving, emotion regulation and social network strengthening skills in addition to crisis management. ATMAN was delivered in 27 youth with a history of self-harm (14–24 years old) sequentially by a specialist and it a non-specialist counsellor. Out of 27, 18 youth who started the ATMAN intervention completed it, and 13 completed the 10-month follow-up. There was a significant reduction in post-intervention scores on Beck’s Scale for Suicidal Ideation (BSI) (mean difference [confidence interval]: 14.1 [17.2, 10.9]) and Patient Health Questionnaire (PHQ-9) (9.6 [12.8, 6.4]) from the baseline scores, irrespective of who delivered the intervention (non-specialist vs. specialist). The difference remained significant at the 10-month follow-up (BSI: 17.0 [20.5, 13.6] and PHQ-9: 10.5 [14.5, 6.6]). Themes such as improved understanding of self-harm acting as a deterrent, using ATMAN strategies to deal with daily life distress, and the importance of addressing stigma in self-harm emerged during the qualitative interviews. Although requiring further evaluation, ATMAN shows promise as a scalable intervention that can be used in LMICs to reduce the burden of suicide in young people.
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spelling doaj-art-6f2cbbda5c064cd4a7f8a980e5f6a3c92025-08-20T02:16:18ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512025-01-011210.1017/gmh.2025.26Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case seriesShilpa Aggarwal0https://orcid.org/0000-0002-8590-0846Michael Berk1Nilesh Shah2Anokhi Shah3Dimple Kondal4George Patton5Vikram Patel6https://orcid.org/0000-0003-1066-8584IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia Child and Youth Mental Health, Mental Health Speciality Services, Gold Coast, Australia Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, AustraliaIMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, AustraliaLokmanya Tilak Municipal Medical College & General Hospital Municipal Corporation, Mumbai, IndiaPublic Health Foundation of India, New Delhi, IndiaCentre for Chronic Disease Control, New Delhi, IndiaCentre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, VIC, AustraliaGlobal Health and Social Medicine, Harvard T H Chan School of Public Health, Boston, MA, USAThere is a scarcity of psychological interventions for self-harm in young people, either developed or adapted for use in low and middle-income countries (LMICs). ATMAN is a psychological intervention developed in India for youth with three key modules: problem-solving, emotion regulation and social network strengthening skills in addition to crisis management. ATMAN was delivered in 27 youth with a history of self-harm (14–24 years old) sequentially by a specialist and it a non-specialist counsellor. Out of 27, 18 youth who started the ATMAN intervention completed it, and 13 completed the 10-month follow-up. There was a significant reduction in post-intervention scores on Beck’s Scale for Suicidal Ideation (BSI) (mean difference [confidence interval]: 14.1 [17.2, 10.9]) and Patient Health Questionnaire (PHQ-9) (9.6 [12.8, 6.4]) from the baseline scores, irrespective of who delivered the intervention (non-specialist vs. specialist). The difference remained significant at the 10-month follow-up (BSI: 17.0 [20.5, 13.6] and PHQ-9: 10.5 [14.5, 6.6]). Themes such as improved understanding of self-harm acting as a deterrent, using ATMAN strategies to deal with daily life distress, and the importance of addressing stigma in self-harm emerged during the qualitative interviews. Although requiring further evaluation, ATMAN shows promise as a scalable intervention that can be used in LMICs to reduce the burden of suicide in young people.https://www.cambridge.org/core/product/identifier/S2054425125000263/type/journal_articleself-harmsuicideinterventionscounsellinglow- and middle-income
spellingShingle Shilpa Aggarwal
Michael Berk
Nilesh Shah
Anokhi Shah
Dimple Kondal
George Patton
Vikram Patel
Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
Cambridge Prisms: Global Mental Health
self-harm
suicide
interventions
counselling
low- and middle-income
title Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
title_full Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
title_fullStr Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
title_full_unstemmed Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
title_short Effectiveness of ATMAN psychological intervention in reducing self-harm in young people in India: a mixed method case series
title_sort effectiveness of atman psychological intervention in reducing self harm in young people in india a mixed method case series
topic self-harm
suicide
interventions
counselling
low- and middle-income
url https://www.cambridge.org/core/product/identifier/S2054425125000263/type/journal_article
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