4. Discussion
depression, disability, anxiety
DISORDERS
To our knowledge, this is the first study to systematically evaluate the large-scale implementation of a trained community volunteer-led intervention for common mental disorders using a pragmatic implementation research design in a low and middle-income country. Our findings show that the Our data shows that improvements in the primary outcome are enhanced over time, as indicated by the odds of improvement of depression and anxiety symptoms at 8 months follow-up being higher than at 3-month follow-up. Counseling sessions were completed before the 3-month follow-up data collection and no additional sessions were delivered afterward. This may suggest the intervention’s benefits continue even after the counseling sessions end. As expected, improvement in social functioning and reduction in disability is seen at 8 months but absent at 3 months, suggesting a lag between symptomatic improvement and functional improvement.The There are several challenges to implementing an intervention using community volunteers. First, any training or capacity building needs to emphasize the need to maintain confidentiality, especially when such volunteers are drawn from the same community where they are likely to have more than a passing acquaintance with those seeking help. Other challenges include identifying suitable volunteers and maintaining their motivation over time. The 