scholarly journals Longitudinal assessment of an anti-stigma campaign related to common mental disorders in rural India

2018 ◽  
Vol 214 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Pallab K. Maulik ◽  
Siddhardha Devarapalli ◽  
Sudha Kallakuri ◽  
Anadya Prakash Tripathi ◽  
Mirja Koschorke ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Mental Illnesses ◽  
Rural India ◽  
Time Points ◽  
Positive Effects ◽  
Services Delivery

BackgroundStigma related to mental health and lack of trained mental health professionals is a major cause for an increased treatment gap, particularly in rural India. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health project delivered a complex intervention involving task sharing, an anti-stigma campaign and use of technology-based, decision-support tools to empower primary care workers to identify and manage depression, anxiety, stress and suicide risk.AimsThe aim of this article is to report changes in stigma perceptions over three time points in the rural communities where the anti-stigma campaign was conducted.MethodA multimedia-based anti-stigma campaign was conducted over a 3-month period in the West Godavari district of Andhra Pradesh, India. Following that, the primary care-based mental health service was delivered for 1 year. The anti-stigma campaign was evaluated in two villages and data were captured at three time points over a 24-month period (N = 1417): before and after delivery of the campaign and after completion of the health services delivery intervention. Standardised tools captured data on knowledge, attitude and behaviour towards mental health as well as perceptions related to help seeking for mental illnesses.ResultsMost knowledge, attitude and behaviour scores improved over the three time points. Overall mean scores on stigma perceptions related to help seeking improved by −0.375 (minimum/maximum of −2.7/2.4, s.d. 0.519, P < 0.001) during this time. Loss to follow-up was 10%.ConclusionsThe data highlight the positive effects of an anti-stigma campaign over a 2-year period.Declaration of interestNone.

scholarly journals Undergraduate Education in Psychiatry in India

2020 ◽  
Vol 3 (1) ◽  
pp. 9-16
Author(s):  
Roy Abraham Kallivayalil ◽  
Arun Enara
Keyword(s):  
Mental Health ◽  
Medical Education ◽  
Help Seeking ◽  
Medical Training ◽  
Common Mental Disorders ◽  
Well Being ◽  
Mental Illnesses ◽  
Treatment Gap ◽  
The World ◽  
Education In India

AbstractMedical education curricula, from around the world, have often neglected psychiatry as a subject of importance in undergraduate medical training.In India, the scenario has not been different from the rest of the world. The National Mental Health Survey done in India, recently, estimates a treatment gap of around 80–85% for various mental illnesses. This provides a strong case to strengthen the undergraduate psychiatry curricula since it would help tackle the treatment gap of common mental disorders in the community.Further, a strong educational foundation with meaningful inclusion of mental health and well-being, will also make the trainee aware of their own mental well-being and better help seeking behaviour in the medical student. In this article, we look to review the evolution of undergraduate medical education in India.

scholarly journals Common Mental Disorders

2012 ◽  
Vol 9 (3) ◽  
pp. 213-217
Author(s):  
A Risal
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Common Mental Disorders ◽  
Economic Status ◽  
Pathways To Care ◽  
Middle Income

Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms typically encountered in community and primary care settings. Risk factors for these disorders are mainly lower socio-economic status, psychological illnesses, poor reproductive health, gender disadvantage and physical ill-health. WHO has recommended that treatment of all these disorders should be based in primary care to be more effective and accessible to all the community people. The structure of mental health care in primary care is generally understood in terms of the “pathways to care” model and it plays a major role in countries like ours where community-based mental health services do not exist. Both the psychological and pharmacological therapies are found to be equally effective for treating these disorders. Integration of mental health into primary care can be considered as the stepping stone in the way forward to tackle the barriers and problems in effective management of common mental disorders in the community. The acute shortage of mental health professionals and the relatively low levels of awareness about mental disorders make it mandatory that primary health care should remain the single largest sector for mental health care in low and middle income countries like ours.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6308 Kathmandu Univ Med J 2011;9(3):213-7  

Revisiting goa's mental health

2011 ◽  
Vol 26 (S2) ◽  
pp. 573-573
Author(s):  
A.E. Ribeiro ◽  
M. Santos
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Physical Symptoms ◽  
Mental Illnesses ◽  
Health Issue ◽  
Public Health Issue ◽  
Care Providers ◽  
Major Public Health Issue

Despite Goa's privileged economic and environmental position, research has demonstrated that mental health is in fact a major public health issue in this Indian state.Besides learning difficulties, child abuse, and high suicide rates, depression and anxiety seem to affect more than one third of the patients in primary care attenders. Medically unexplained physical symptoms are common clinical features, frequently misdiagnosed by the primary care physicians. Alcohol consumption has always been an integral part of Goan lifestyle, with alcohol dependence being a major public health issue. Drug abuse, in particular heroin and more recently LSD and ecstasy, are of concern in the coastal areas, and foreign influence might not be the only explanation for this fact.Goa has one of the most extensive health systems in India. Private psychiatry is also relatively well represented, and fortunately there are some NGOs working in this field, providing care in areas where government services have been inadequate.Despite those facts, the majority of persons with mental health disorders have never come in contact with mental health care providers. Persons prefer to consult non-mental health professionals, and frequently continue to seek help from Religious and Spiritual Leaders, Informal Counsellors, priests and Gurus with healing powers. Many of such practices are unregulated, expensive and potentially dangerous.Priority mental health issues in Goa include sensitizing health workers to mental illnesses, and improving access to care in existing health services.

scholarly journals Lived Experience, Transparency, Help, and Humility: Four Characteristics of Clergy Responding to Mental and Emotional Problems

2020 ◽  
Vol 74 (1) ◽  
pp. 4-11
Author(s):  
Krystal Hays ◽  
Jennifer Shepard Payne
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Help Seeking ◽  
Emotional Problems ◽  
Individual Characteristics ◽  
Mental Illnesses ◽  
The Individual

Many individuals who experience mental and emotional problems prefer support from clergy instead of formal mental health services. Because clergy are often sought out by those with mental illnesses, it is essential to understand their perspectives about mental and emotional problems and identify the individual characteristics that influence these perspectives. This study utilized qualitative data from a conversation among pastors in an online social networking group to examine the characteristics of clergy who held affirming attitudes toward professional mental health services. Thirty-five pastors participated in the discussion, generating more than 140 comments over 13 days in response to the question: “If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?” Thematic analysis was conducted, and results suggest four characteristics common among clergy: personal experiences with mental and emotional problems, transparency in sharing their stories, personal help-seeking, and humility. These four characteristics may influence clergy members’ present-day understanding and responses to mental and emotional problems. Implications for spiritual care professionals and mental health professionals are presented.

The Bridge Program: A Model for Delivering Mental Health Services to Asian Americans through Primary Care

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Asian Americans ◽  
Mental Health Professionals ◽  
Primary Care Providers ◽  
Care Providers ◽  
Bridge Program ◽  
Community Awareness

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.

scholarly journals VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

2019 ◽  
Vol 12 (2) ◽  
pp. 71 ◽  
Author(s):  
Madhukar Trivedi ◽  
Manish Jha ◽  
Farra Kahalnik ◽  
Ronny Pipes ◽  
Sara Levinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Universal Screening ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Similar Treatment ◽  
Measurement Based Care

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

Uninsured Children With Psychosocial Problems: Primary Care Management

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 930-936 ◽  
Author(s):  
Thomas K. McInerny ◽  
Peter G. Szilagyi ◽  
George E. Childs ◽  
Richard C. Wasserman ◽  
Kelly J. Kelleher
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Psychosocial Problems ◽  
The United States ◽  
Behavior Study ◽  
Care Practices ◽  
Uninsured Children ◽  
Primary Care Practices

Objective. Nearly 14% of children in the United States are uninsured. We compared the prevalence of psychosocial problems and mental health services received by insured and uninsured children in primary care practices. Methods. The Child Behavior Study was a cohort study conducted by Pediatric Research in Office Settings and the Ambulatory Sentinel Practice Network. Four hundred one primary care clinicians enrolled an average sample of 55 consecutive children (4–15 years old) per clinician. Results. Of the 13 401 visits to clinicians with 3 or more uninsured patients, 12 518 were by insured children (93.4%) and 883 were by uninsured children (6.6%). A higher percentage of adolescents, Hispanic children, those with unmarried parents, and those with less educated parents were uninsured. According to clinicians, uninsured children and insured children had similar rates of psychosocial problems (19%) and severe psychosocial problems (2%). For children with a clinician-identified psychosocial problem, we found no differences in clinician-reported counseling, medication use, or referral to mental health professionals. Conclusions. Among children served in primary care practices, uninsured children have similar prevalence of clinician-identified psychosocial and mental health problems compared with insured children. Within their practices, clinicians managed uninsured children much the same way as insured children.psychosocial problems, uninsured children, pediatrics, family medicine, primary care.

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