JMIR Publications

ABSTRACT

Background:

Depression and poverty are intertwined, yet most interventions tackle them separately. Livelihood Integration for Effective Depression Management (LIFE-DM) is an innovative intervention that combines group-based depression psychotherapy with microfinance service. We will evaluate the effectiveness of LIFE-DM on mental health, psychosocial outcomes, and economic well-being among economically disadvantaged women with depression in Vietnam.

Methods:

A match-paired cluster non-randomized controlled trial (n=166) will compare the effectiveness of LIFE-DM to enhanced treatment as usual (E-TAU) for low-income women with depression in four commune health stations in Danang, Vietnam. LIFE-DM participants will receive group behavioral activation treatment and were offered microfinance loans, vocational training, and personal finance support. E-TAU participants will be offered free antidepressant treatment and referral as usual to Women’s Union for livelihood support. Primary outcomes are severity of depression symptoms and remission rates at 6- and 12-month follow-up. Secondary outcomes include economic variables such as income, employment status, as well as functioning, quality of life, self-efficacy, behavior activation, and treatment participation. Discussion: We hypothesize that LIFE-DM participants will show greater treatment participation and improvement in mental health, psychosocial and economic outcomes. If this hypothesis is supported, this study will be one of the first to demonstrate the effectiveness of integrating psychotherapy with livelihood support to break the cycle between mental illness and economic hardship. This combined approach may offer a scalable and sustainable approach for low-resource settings like Vietnam and could inform mental health and social policy across similar global contexts. Trial registration: ClinicalTrials.gov: NCT02069301