Using Financial Incentives and Screening to Increase Engagement With Mental Health Services Among College Students in Chennai, India

This study will evaluate the effectiveness of interventions to increase engagement with mental health services among a sample of college students in Chennai, India. The study is being conducted in partnership with an arts and science college for women in Chennai. The sample will be recruited within classrooms, during college hours. All students present in the classroom per the allotted time will be introduced to the study. The research team will obtain consent from those interested after screening them for age eligibility (between the ages of 18 and 30 years). Study participants will then complete a baseline survey including questions around demographics, perceptions of their own mental health, mental health treatment history, and the PHQ-ADS, a standardized composite screening tool for depression and anxiety. The experimental design is an RCT with 4 groups, randomized at the individual level: (1) a control group, which will watch a video with information about mental health and be able to access therapy in college and at SCARF, a mental health center in Chennai, at no cost for the duration of the study; (2) a screening group, in which, in addition to the interventions in the control group, students will be informed whether their responses to the PHQ-ADS questions fit in the standard risk categories of no, mild, moderate, or severe distress and corresponding recommendations for whether to make an appointment with a counselor/therapist; (3) a rewards group, in which, in addition to the interventions in the control group, students will be provided with a cash payment for attending their first therapy session; and (4) a combined screening and rewards group. The investigators will measure interest in, and take-up of, therapy at the individual level.

Study Overview

• Status: Completed
• Conditions: Depression/Anxiety
• Intervention / Treatment: Behavioral: Screening; Behavioral: Rewards

• Study Type: Interventional
• Enrollment (Actual): 340
• Phase: Not Applicable

Contacts and Locations

Study Locations

• India
  • Tamil Nadu
    • Chennai, Tamil Nadu, India
      • College campus

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion criteria:

• aged 18-30
• are present in the classrooms,
• consent to participate in the study

Exclusion criteria: None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Information about mental health and therapy and free access to therapy
Experimental: Screening; Information about screening for depression and anxiety. Information about mental health and therapy and free access to therapy	Behavioral: Screening; Information about screening for depression and anxiety
Experimental: Rewards; Financial rewards for attending therapy. Information about mental health and therapy and free access to therapy	Behavioral: Rewards; Financial rewards for attending therapy
Experimental: Screening + Rewards; Information about screening for depression and anxiety, and financial rewards for attending therapy (combination of previous two treatments). Information about mental health and therapy and free access to therapy	Behavioral: Screening; Information about screening for depression and anxiety; Behavioral: Rewards; Financial rewards for attending therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of participants expressing interest in therapy	Student stating interest in the participant survey in booking an appointment with a study counselor, or asking to be contacted by a study counselor to discuss mental health and therapy	Immediately after treatment (Day 1)
Proportion of participants making an appointment	student completing the process to make an appointment for therapy with a study counselor, through the participant survey or otherwise	From enrolment until two months after enrolment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of participants taking-up of a mental health care app	This is measured in two ways: participants expressing interest in accessing a mental-healthcare app in the survey, and participants actually clicking a link to download the app.	Immediately after treatment (Day 1)
Proportion of participants demanding for information about mental health	This is measured in two ways: participants expressing interest in receiving more information about mental health, and participants actually clicking a link to access the information	Immediately after treatment (Day 1)
Proportion of participants attending therapy sessions	Data will be collected from the administrative records of the counselling office on whether participants actually attended a therapy session, as well as the number of sessions attended.	From enrolment until two months after enrolment

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of participants reporting they would consider seeking therapy in future	Participants are asked whether they would consider seeking therapy in future	Immediately after treatment (Day 1)
Proportion of participants reporting specific steps they would take to take care of their mental health	Participants are asked what steps they would take in order to take care of their psychological well-being (for example, spending time with family, or going to a counselor)	Immediately after treatment (Day 1)
Proportion of participants reporting specific motivating/inhibiting factors for taking up therapy	Participants are asked to select what factors are motivating or inhibiting them in taking up therapy.	Immediately after treatment (Day 1)

Collaborators and Investigators

• Sponsor: Massachusetts Institute of Technology
• Collaborators: University of California, Berkeley; University of Michigan; Harvard University; Abdul Latif Jameel Poverty Action Lab; Institute for Financial Management and Research; Schizophrenia Research Foundation (SCARF India), Chennai, India

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2025
• Primary Completion (Actual): May 25, 2025
• Study Completion (Actual): May 25, 2025

Study Registration Dates

• First Submitted: March 6, 2025
• First Submitted That Met QC Criteria: March 13, 2025
• First Posted (Actual): March 20, 2025

Study Record Updates

• Last Update Posted (Estimated): September 25, 2025
• Last Update Submitted That Met QC Criteria: September 24, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Behavior; Anxiety Disorders; Depression; Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Diagnostic Techniques and Procedures; Diagnosis; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Health Services; Health Care Facilities Workforce and Services; Preventive Health Services; Diagnostic Services; Health Surveys; Surveys and Questionnaires; Public Health Practice; Mass Screening
• Other Study ID Numbers: 2206000666

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual-level data will be posted online

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No