Community mental health in India: A rethink

<p>Abstract</p> <p>Background</p> <p>Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the coun...

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Main Authors: Aynkran Jothy R, Padmavati Ramachandran, Thara Rangawsamy, John Sujit
Format: Article
Language:English
Published: BMC 2008-07-01
Series:International Journal of Mental Health Systems
Online Access:http://www.ijmhs.com/content/2/1/11
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author Aynkran Jothy R
Padmavati Ramachandran
Thara Rangawsamy
John Sujit
author_facet Aynkran Jothy R
Padmavati Ramachandran
Thara Rangawsamy
John Sujit
author_sort Aynkran Jothy R
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF), an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes.</p> <p>Methods</p> <p>One hundred and eighty five patients with chronic mental illness were followed up and their present treatment status determined using a modified version of the Psychiatric and Personal History Schedule (PPHS). The resources created earlier were assessed and qualitative information was gathered during interviews with patient and families and other stakeholders to identify the reasons behind the sustenance or failure of these initiatives.</p> <p>Results</p> <p>Of the 185 patients followed up, 15% had continued treatment, 35% had stopped treatment, 21% had died, 12% had wandered away from home and 17% were untraceable. Of the patients who had discontinued treatment 25% were asymptomatic while 75% were acutely psychotic.</p> <p>The referral service was used by only 15% of the patients and mental health services provided by the PHC stopped within a year. The Citizen's group was functional for only a year and apart from chicken rearing, all other self-employment schemes were discontinued within a period of 6 months to 3 years.</p> <p>There were multiple factors contributing to the failure, the primary reasons being the limited access and associated expenses entailed in seeking treatment, inadequate knowledge about the illness, lack of support from the family and community and continued dependence by the family on the service provider to provide solutions.</p> <p>Conclusion</p> <p>Community based initiatives in the management of mental disorders however well intentioned will not be sustainable unless the family and the community are involved in the intervention program with support being provided regularly by mental health professionals.</p>
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spelling doaj.art-4532f39e9d94465ab9751016115a8cd32022-12-22T02:58:31ZengBMCInternational Journal of Mental Health Systems1752-44582008-07-01211110.1186/1752-4458-2-11Community mental health in India: A rethinkAynkran Jothy RPadmavati RamachandranThara RangawsamyJohn Sujit<p>Abstract</p> <p>Background</p> <p>Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF), an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes.</p> <p>Methods</p> <p>One hundred and eighty five patients with chronic mental illness were followed up and their present treatment status determined using a modified version of the Psychiatric and Personal History Schedule (PPHS). The resources created earlier were assessed and qualitative information was gathered during interviews with patient and families and other stakeholders to identify the reasons behind the sustenance or failure of these initiatives.</p> <p>Results</p> <p>Of the 185 patients followed up, 15% had continued treatment, 35% had stopped treatment, 21% had died, 12% had wandered away from home and 17% were untraceable. Of the patients who had discontinued treatment 25% were asymptomatic while 75% were acutely psychotic.</p> <p>The referral service was used by only 15% of the patients and mental health services provided by the PHC stopped within a year. The Citizen's group was functional for only a year and apart from chicken rearing, all other self-employment schemes were discontinued within a period of 6 months to 3 years.</p> <p>There were multiple factors contributing to the failure, the primary reasons being the limited access and associated expenses entailed in seeking treatment, inadequate knowledge about the illness, lack of support from the family and community and continued dependence by the family on the service provider to provide solutions.</p> <p>Conclusion</p> <p>Community based initiatives in the management of mental disorders however well intentioned will not be sustainable unless the family and the community are involved in the intervention program with support being provided regularly by mental health professionals.</p>http://www.ijmhs.com/content/2/1/11
spellingShingle Aynkran Jothy R
Padmavati Ramachandran
Thara Rangawsamy
John Sujit
Community mental health in India: A rethink
International Journal of Mental Health Systems
title Community mental health in India: A rethink
title_full Community mental health in India: A rethink
title_fullStr Community mental health in India: A rethink
title_full_unstemmed Community mental health in India: A rethink
title_short Community mental health in India: A rethink
title_sort community mental health in india a rethink
url http://www.ijmhs.com/content/2/1/11
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