Table 2. Content summary of the selected studies.

S. No	Author(s) & Year of publication	Aims/Purpose	Study Design	Target Sample and sample size	Study Setting and Origin	Mental Health Condition / domains under study	Intervention Type and Details	Outcomes	Key Findings
1	Chinnayya et al., 1990	To examine the attitudes of paramedical health workers towards different mental health problems, before and a short training in mental healthcare. To understand the relationship between change in attitudes and characteristics of health workers. To examine the characteristics of health workers with relatively favourable attitudes even prior to mental health training, To examine the items which do not register a favourable attitudinal change, or even show a change in the unfavourable direction.	Pre Post study/Before and after	150 primary care paramedical health workers (multipurpose workers) who are working at the PHC and are involved in providing mental health care	Mental health unit of NIMHANS (psychiatric and neurological hospital), Bangalore, Karnataka in South India	Attitudes toward mental health care	Each month, a batch of 8 to 10 MPWs are deputed to undergo the training, which is of one week’s duration. The Training consists of lectures, case demonstrations, and role play. The training is facilitated by a manual of mental health developed in-house.	Significant changes in attitudes of paramedical health workers towards different mental health problems.	The results of the present study indicate that the mental health training of paramedical workers has been effective in bringing about a change of attitudes towards mental illness. Attitude change has been uniform for the different disorders.
2.	Joel et al., 2006	To test the effect of a biomedical intervention on explanatory models (EMs) of community health workers.	Cross-sectional intervention	80 Community health workers from The Rural Unit for Health and Social Affairs (RUHSA).	RUHSA, a community health programme of the Christian Medical College Hospital, Vellore, South India. The programme operates in all 84 villages in the chosen district.	Chronic Psychosis	The community health workers were divided into two groups depending on the geographical location of their villages and peripheral health centres. Forty workers were taught about the biomedical aspects of schizophrenia. The training programme discussed local beliefs about mental illness, elicited by the SEMI interview. The health workers were encouraged to discuss their beliefs and their implications. The structured teaching programme, of 2 -h duration, then described the symptoms, causes, treatment and referral. The training was given in batches of 6-7 workers. The 40 workers of the control group were not educated during the study period.	Not mentioned.	A variety of indigenous beliefs, which contradicted the biomedical model, were elicited at the baseline evaluation. Seeking biomedical help at follow up was significantly related to receiving education about the biomedical aspects of chronic psychosis (OR 17.2; 95% CI: 18.75, 15.65; p < 0.001). This remained statistically significant (OR 9.7; 95% CI: 82.28, 1.14; p < 0.04) after using logistic regression to adjust for baseline variables
3.	Armstrong et al., 2011	To provide a mental health training intervention to community health workers and to evaluate the impact of this training on mental health literacy.	Pre test post test	63 community health workers sourced through Gramina Abrudaya Seva Samstha (GASS), an NGO operating locally. The types of community health workers included Junior Health Assistants, Village Rehabilitation Workers, and ASHA workers.	Community setting in the rural district of Doddaballapur, Bangalore, South India.	Mental Health Literacy (MHL) is defined as ‘knowledge and beliefs about mental disorders which aid their recognition, management and prevention of mental illnesses.	The mental health training program is a four-day course that aims to increase recognition of mental disorders, enhance appropriate response and referral, support people with mental disorders and their families, and improve mental health promotion in communities.	Changes in the participants’ level of MHL, we adapted a MHL at three time points; i. e. baseline, completion of the training and three months follow up.	The training course improved participants’ ability to recognize a mental disorder in a vignette, and reduced participants’ faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants’ faith in recovery following treatment.
4.	Balaji et al., 2012	To develop a lay health worker delivered community based intervention in three sites in India.	The intervention was designed into three phases with a structured format to suit the design of the RCT.	Participants suffering with schizophrenia and their primary caregivers from 30 families.	Goa, Satara, Kanchipuram in West and South India	Schizophrenia	The intervention comprised of five components (psychoeducation; adherence management; rehabilitation; referral to community agencies; and health promotion) which were delivered by trained lay health workers supervised by specialists.	To address myths about the illness, To discuss ways to cope with or respond to negative reactions from others, Lay health workers to act as positive role models in their interactions with the family. To be able to disclose one’s illness to others and make informed choices.	The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge about the subject matter. Some had expectations regarding their demographic and personal characteristics, for example, preferring only females or those who are understanding/friendly.
5.	Mindlis et al., 2015	To evaluate the impact that community interventions in mental health through a grassroots approach had on the knowledge and attitudes towards depression in a non-psychiatric population in rural Gujarat, India.	Cross sectional	333 community member from 6 villages of Gujarat, Western India (intervention arm = 146 and control arm = 187	The local study partner was the MINDS Foundation (www.mindsfoundation.org) located in Vadodara, Gujarat. Villages were selected for their accessibility from the SVU campus.	knowledge and attitudes towards depression	Series of interventions: -Organizing mental health education workshops for each village -Free-of-charge program for individuals with mental illness and their families to receive transportation to and from the Psychiatry Team who will formally diagnose, counsel and provide appropriate treatment -Community mental health workers training -Community Reintegration through social and vocational rehabilitation programs for Patients.	Significant changes in mean scores on knowledge and attitudes towards depression	The intervention villages showed higher levels of literacy regarding depression and lower levels of stigma, after adjusting for all other sociodemographic variables.
6	Nimgaonkar and Menon (2015)	To identify and manage psychiatric disorders rapidly, comprehensively and sustainably, with an emphasis on task-shifting and community participation.	Cross sectional, mixed methods, Pre-post design	2759 families comprising of village leaders, other members of the community, medical psychiatric social worker, health animators and health volunteers at a public space in total 184 villages of Tamilnadu as part of ASHWINI program	The study was conducted in the Gudalur and Pandalur Taluks of the Nilgiris District located within the Nilgiri mountain ranges in the state of Tamil Nadu, in South India. The ASHWINI program serves five tribal peoples residing in 184 villages, comprising 2759 families	knowledge and attitudes toward mental illness. Acceptance of mental illnesses within the community.	Health workers were trained to provide community education and to identify and refer individuals with psychiatric problems to a community hospital. A combination of education, supportive counseling and pharmacotherapy provided by doctors, health animators and village health workers formed the key components of the treatment that was offered to participants.	Changes in the healthcare delivery as well services utilization; Change in knowledge and attitudes towards mental illness	Treated patients experienced significant improvement in daily function (p = 0.01). Mean treatment adherence scores remained stable at the beginning and end of treatment, overall. The proportion of selfreferrals increased from 27% to 57% over three years. Surveys conducted before and after program initiation also suggested improved knowledge, attitudes and acceptance of mental illness by the community.
7.	Shidhaye et al., 2017	To assess whether implementation of VISHRAM intervention was associated with an increase in the proportion of people with depression who sought treatment (contact coverage).	Cross-sectional, Before and after intervention	1457 and 1887 adult community members from voter list of 30 villages surveyed at baseline and 18 months respectively.	30 villages in the Amravati district in Vidarbha, central India.	Depression and mental health literacy	Vishram was a collaborative care model which was delivered by community health workers, village based lay counselors, primary health care physicians and visiting psychiatrists. Awareness about mental disorders was carried out by lay health workers in the community. They referred individuals identified with depression to health counselors and provided first aid. Health counselors offered Health Activity Program (HAP). Those who dint respond to HAP were offered help at health facilities.	The primary outcome was change in contact coverage with VISHRAM, defined as the difference in the proportion of individuals with depression (PHQ-9 score >9) who sought treatment for symptoms of depression between the baseline and the 18-month survey population. Secondary outcomes were whether the distribution of coverage was equitable, the type of services sought, and mental health literacy.	The contact coverage for current depression was six-times higher in the 18month survey population (27·2%, 95% CI 21·4–331·7) than in the baseline survey population (4·3%, 1·5-7·1). Contact coverage was equitably distributed across sex, education, income, religion, and caste. Most providers consulted for care were general physicians. They observed significant improvements in a range of mental health literacy indicators, for example, conceptualisation of depression as a mental health problem and the intention to seek care for depression.
8.	Garfin et al. 2019	To explore predictors of improved QOL over time in Women Living with HIV/AIDS (WLH/A) in India	RCT with a factorial design	600 WLH/A in Andhra Pradesh, in Southern India enrolled in a larger nurse-led- Asha-support randomized control trial (RCT).	one Community Health Center and 1-2 Primary Care Centers (PHCs) in rural Andhra Pradesh near one of four high-HIV- prevalence sites.	Depression and stigma amongst WLH/A	4 group based modules: keeping healthy, caregiving, staying upbeat, and healthy eating for self and family. A minimum of six group sessions (three modules with two sessions each) were delivered by experts in a large room at the research site.	Analyses examined whether psychosocial variables measured at baseline could help classify subgroups of WLH/A enrolled in an Asha- supported intervention and whether subgroup membership predicted QOL at baseline, change over time, and at 6-month followup.	At follow-up, the sample as a whole exhibited lower depression (M = 0.05, SD = 0.32), internalized stigma, (M = 0.004, SD = 0.03), and stigma fears (M = 0.01, SD = 0.13) and improved social support (M = 4.96, SD = 0.09) compared to baseline (for paired t tests comparing baseline to followup scores all p-values < .001).
9.	Maulik et al., 2019	To report changes in stigma perceptions over three time points in the rural	Pre test and post test study design followed by a post communities where the antistigma campaign was conducted.	1417 Community member ≥18 years old intervention evaluation at end of 3Months	Community setting, in two villages of west Godavari district of Andhra Pradesh, South India. This was part of the larger study named Smart Mental Health.	Stigma perceptions in seeking mental health care	A multimediabased anti-stigma campaign was conducted over a 3-month period in the West Godavari district of Andhra Pradesh, India. Following that, the primary carebased mental health service was delivered for 1 year. The antistigma campaign was evaluated in two villages and data were captured at three time points over a 24-month period before and after delivery of the campaign and after completion of the health services delivery intervention. Standardised tools captured data on knowledge, attitude and behaviour towards mental health as well as perceptions related to help seeking for mental illnesses	Significant changes in mean scores of each item of KAB and BACE-TS across three time points.	Most knowledge, attitude and behaviour scores improved over the three time points. Overall mean scores on stigma perceptions related to help seeking improved by – 0.375 (minimum/maximum of – 2.7/2.4, s.d. 0.519, P < 0.001) during this time.