Manthan - Promoting the mental health and wellbeing of transgender persons in the national capital region of Delhi using a peer support approach: A pre-post mixed method study

Introduction Transgender individuals face a heightened risk of psychiatric illness due to the stigma to which they are subjected. Peer support has been shown to improve service uptake within the transgender community in HIV programmes. It has also been associated with positive impacts on the mental health of people with lived experience of mental illness, as well as individuals from vulnerable populations such as sex workers. Methods This pre-post study employed mixed methods to conduct a preliminary evaluation of a trans peer support model, examining its effects on anxiety, depression, suicidality/self-harm, and psychological wellbeing. The study also sought to assess the acceptability of the peer support model and to identify facilitating and impeding factors. Results The findings demonstrate significant reductions in both depression (13.1 [SD 4.9] to 7.0 [SD 5.1], mean difference = −6.1 [95% CI = −7.61, −4.6], p<0.001) and anxiety (11.2 [SD 4.5] to 6.0 [SD 4.8], mean difference = −5.36 [95% CI = −6.69, −4.04], p<0.001) from baseline to endline. These reductions were found to be clinically significant for 60.3% and 58.6% of participants, respectively, at endline. An improvement in mental wellbeing was also observed at the conclusion of the intervention. Furthermore, participants’ knowledge, attitudes, and behaviours related to mental health improved from baseline to endline, alongside a reduction in stigma perceptions associated with seeking mental health care. The intervention demonstrated high acceptability, with a median session attendance rate of 91.7% (95% CI = 70.8, 95.8). The primary barrier to participation was the time required for travel. Conclusion This study highlights the importance of psychotherapeutic interventions that harness peer support and inclusive social environments to promote the mental health of transgender individuals, and demonstrates that such interventions can be effectively delivered by non-mental health professionals.