Capacity Building in Mental Health for Bihar: Overview of the 1-Year Blended Training Program for Nonspecialist Medical Officers.

 The aim of this study is to give an experiential overview of a 1-year blended training program for nonspecialist medical officers (primary care doctors; PCDs) of Bihar State of India. The training program was aimed to enable PCDs identify, diagnose, and treat commonly presenting psychiatric disorders in primary care  PCDs had a brief onsite orientation program to psychiatric practice at National Institute of Mental Health and Neuro-Sciences (NIMHANS), followed by 10 months of online blended training. The online program followed the NIMHANS Virtual Knowledge- Extension for Community Healthcare Outcomes (ECHO) model, that is, a hub and spokes model of training  Twenty-two PCDs participated in this program. Eleven of them got accredited at the end. The onsite orientation consisted of exposure to various psychiatry facilities at NIMHANS, in addition to learning psychiatric history taking and mental status examination. The ECHO model of online learning consisted of fortnightly sessions, lasting 2 hours each. There were 20 such sessions. Each session consisted of a didactic lecture by the psychiatrist followed by a case discussion. The cases were presented by PCDs, moderated by the hub specialists (NIMHANS). At the end of the training, participants rated an average of 4.5/5 on the mode, content and relevance of training and increase in knowledge due to the training. Around 23,000 patients were cared for during the said 1 year by the trained PCDs.  Training PCDs in a manner that enables retaining the learnt skills is feasible. However, rigorous evaluation protocols are needed in order to test this in a systematic fashion.