BRiCs: Improving the quality of life for adolescents with mental health problems in Colombia

INTERVENTION: Adolescents and clinicians will be recruited from at least three primary care/community health centres in the Bogota and Duitama municipalities. The unit of randomisation will be the clinicians, who will be randomised in a 2:1 ratio to either the intervention (DIALOG‐A once per month over 6 months) or to the usual care control group (routine care, without DIALOG). The researchers will also collect data on effect estimates, variability, and recruitment and retention rates that would be required for a fully powered, definitive, efficacy trial. In the intervention group, clinicians and adolescents will use the repurposed DIALOG‐A once per month over a 6‐month period. Thereafter, they can use DIALOG‐A flexibly depending on need. This will be documented and considered in the analysis. The intervention will be compared to a usual care control group. Clinicians in the active control will ask individuals to rate their quality of life on a tablet. This however will occur at the end of their meeting and will not involve a discussion of the ratings or the four‐step solution‐focused approach. CONDITION: Adolescents with anxiety and/or depression ; Mental and Behavioural Disorders PRIMARY OUTCOME: ; Primary outcomes will be collected at baseline and 6 months:; 1. Symptoms of depression measured using the Patient Health Questionnaire (PHQ‐ 8) at 6 months; 2. Symptoms of anxiety measured using Generalised Anxiety Disorder assessment (GAD‐7) at 6 months; SECONDARY OUTCOME: ; All secondary outcomes are collected at baseline, 6 and 9 months (unless otherwise stated), for the 108 patient participants:; 1. Depression on the PHQ‐8 (at 9 months); 2. Anxiety on the GAD‐7 (at 9 months); 3. Quality of life will be measured using Manchester Short Assessment Quality of Life (MANSA); 4. Mental health symptom levels (YP‐CORE); 5. Social Support measured using the Multidimensional Scale of perceived Social Support; 6. Empowerment measured using the Youth Efficacy/Empowerment scale; 7. Self‐esteem measured using the Rosenberg self‐esteem scale; 8. Economic outcomes measured using a modified Client Service Receipt Inventory (CSRI); INCLUSION CRITERIA: Clinicians: 1. Aged 18 years or over 2. Regularly sees adolescents with anxiety and/or depression 3. Experience of working with adolescents for at least three months 4. No plans to leave the current post within the next six months. Patients: 5. Aged 13‐16 years old 6. Currently experiencing depression or anxiety (defined as a score =7 on the Self‐Reporting Questionnaire) 7. Capacity to provide informed assent and consent is provided by a parent/guardian