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WHAT IS “THINKING HEALTHY"

Thinking Healthy manual is a supplement to the World Health Organization’s mhGAP Intervention Guide (mhGAP-IG). The mhGAP-IG was developed for use in non-specialized health-care settings. It includes guidance on evidence-based interventions to identify and manage a number of priority mental health conditions. One of the priority conditions is Depression in the perinatal period. The mhGAP-IG describes in detail what to do but does not go into descriptions of how to do. Training materials have been developed on how to use mhGAP-IG. The purpose of the Thinking Healthy Manual is to provide detailed instructions on how to implement the evidence-based guidelines contained in the mhGAP-IG for the management of perinatal Depression. 

The mhGAP-IG guidelines for management of perinatal Depression include the following:

• Psychosocial interventions should be the first-line of management of depression during pregnancy and breastfeeding. Antidepressant medication should be avoided as much as possible in this population – The Thinking Healthy is an evidence-based psychosocial intervention for Depression tailored to the perinatal period.

• Incorporate general principles of care – The Thinking Healthy approach provides instructions for empathic, clear and sensitive communication with women and their families, and mobilizing and providing social support.

• Provide psycho-education – The Thinking Healthy approach provides psycho-education in a way that avoids over-medicalization. Commonly understood terms such as stress and burden are used instead of depressive disorder or illness to avoid stigma.

• Provide cognitive behavior therapy (CBT) if available – The Thinking Healthy approach uses pictures and structured activities to deliver a simplified form of therapy based on principles of Cognitive Behaviour Therapy.

• Provide adjunct treatments such as structured physical activity, relaxation, and problem-solving if available – The Thinking Healthy approach integrates these activities into the daily routine of the mother.

• Reactivate social networks – The Thinking Healthy approach emphasizes the importance of social support throughout the intervention.

• Give attention to overall well-being. The Thinking Healthy approach attends to the physical as well as psychological health of the mother, in addition to emphasizing the importance of the mother-infant relationship in this period.

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