We open with some major and significant randomised controlled trials exploring interventions in resource-poor societies. Two papers by the same team writing in the Lancet explore the use of non-specialist ‘lay counsellor’ health workers to deliver brief psychological interventions for excessive alcohol consumption and depression in India. Male harmful drinkers in ten primary health centres were randomised to receive either enhanced usual care (EUC), or EUC and Counselling for Alcohol Problems (CAP). The active intervention produced significantly greater remission and abstinence rates, with an incremental cost per additional remission of $217. A Healthy Activity Program (HAP) for moderately to severely depressed men and women was evaluated in a different cohort, with a parallel design of EUC compared with EUC plus therapy. Once again, the active intervention produced significant improvements, with reductions in depression symptomatology and remission, as well as decreased illness consequences such as days out of work and intimate partner violence. Both interventions were reported to be acceptable to patients and practical for delivery in primary care settings.
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