Mental Health Awareness

OrganizationOrganization- Sowmanasya Hospital and Institute of Psychiatry, Trichy

Group 6 Swaroop Bala Teja Ketan Sawarmale Subhajit Das Mohd Pervez Nitesh Kumar Das

Contents
Objectives.................................................................................................................................................... 3 Introduction- Why Mental Health Awareness?...................................................................................... 4 Mental Health in India ............................................................................................................................ 6 Community Mental Health Care services in Trichy............................................................................... 9 Situation in Trichy ................................................................................................................................... 11 Common mental Disorders and Reasons ................................................................................................ 12 Recommendations for Mental Health Awareness ...................................................................................... 13

Objectives
To understand the challenges in current situation of mental health awareness awarene programs in India. To study mental health awareness programs conducted by Sowmanasya Hospital and Institute of Psychiatry, Trichy Trichy. Spread knowledge about mental health and encourage its practices in Trichy. Recommending the solutions in order to increase mental health awareness.

IntroductionIntroduction- Why Mental Health Awareness?

Mental health refers to a wide array of activities directly or indirectly related to the mental well-being. WHO has defined health as; "A state of complete physical, mental and social well-being, and not merely the absence of disease". It is related to promoting the well-being, the prevention of mental disorders, and the treatment and rehabilitation of people who are affected by mental disorders. Mental illness is not a case of personal failure. It doesnt happen only to other people. There was a time and that not too long ago when we couldnt openly speak about cancer. That remained as a family secret. Today, many of us still do not want to talk about AIDS. These barriers are slowly and gradually being broken down. There is no justification for excluding people with a mental illness or brain disorder from our communities there is a room for everyone. Yet many of us still shy away from mental ill people, or feign ignorance of such individuals as if we do not dare to understand and care. There is a new understanding that can offer real hope to the mentally ill people. Understanding how inseparable mental and physical health is in reality, and how their influence on each other is complex and profound. Mental health has been neglected for far too long but it is crucial to the overall well-being of individuals, societies and countries and must be globally regarded in a new light. There are some principles which need to be followed so that things can be made better for mentally challenged people. The first of these principles is that people should not discriminate on the grounds of mental illness. Another is that as far as possible, every patient shall have the right of being treated and should be cared for in his or her own community. And a third is that every patient shall have the right to be treated in a very light environment, with the least restrictive or intrusive treatment. One in every four person has a chance to be get affected by a mental disorder at some stage of life. The risk of certain disorders, such as Alzheimers disease, increases with age. The conclusions are really obvious for the worlds ageing population. The social and economic burden of mental illness is huge. Today we know that most illnesses, mental or physical, are influenced by a combination of biological, psychological and

social factors. Our understanding of the relationship between mental and physical health is increasing rapidly as technology is advancing. We know that mental disorders are the outcome of many factors and have a physical base in the brain. We know they can affect anyone, anywhere. And we know that more often than not, that can be treated with effectiveness. Mental, physical and social health is vital and important strands of life connected to each other. In an effort to make improvements in any one of these strands, the others must also be addressed. To improve the mental wellness of individuals and communities, it is important to understand about the determinants of health, how they are interconnected and influence mental health. We should also consider promotional activities to enhance the wellbeing of the remainder of the population. Mental health promotion can be seen as an important new task for public mental health. The main reason for this new task is that the absence of mental illness does not necessarily imply the presence of flourishing mental health. As a result, traditional public mental health interventions that are effective in alleviating mental illness do not necessarily promote mental health. Furthermore, mental health does have important individual, societal, and economic consequences. Even when one try to control the symptoms of mental illness, mental health has an independent relation with psychosocial adaptation, work productivity, physical disease, and utilization of health care and even mortality. An important challenge for the coming time is, therefore, to study whether and how mental health can be effectively promoted or not.

Mental Health Promotion seeks to strengthen individual competencies, resources, and psychological strengths, and to strengthen community assets to prevent mental disorder and enhance wellbeing and quality of life for people and communities.

Mental Health in India

Mental disorders affect all the sections and strata of the society. Epidemiological studies suggest that 6-7% of the population of India suffer from mental disorders. Treatment gap in even Severe Mental Disorders is approx. 50%. In case of Common Mental Disorders it is over 90 %. About 60 to 70 million Indians suffer from SMDs and CMDs mental disorders. Nearly 6% of Keralas population has mental disorders. One in 5 has some sort of emotional and behavioral problems which translate into mental illness. Neuropsychiatry disorders account for 12% of the Global Disease, burden of these disorders is likely to increase to 15% by 2020 (World Health Report, 2001) Above statistics shows that there is a severe problem of mental health in India and also compared to the western countries and Europe we have very less resources to tackle this situation. Considering the population of India, the ratio of doctors and nurses for the mental patients is very less compared to the other western countries ratios. Due to lack of proper education about mental health, people in India prefer to ignore mentally ill individuals due to societal pressures and therefore people suffering from some mental health issues does not prefer to come out and accept the illness. Data from surveys in India show that common mental disorders are about twice as frequent among the poor as among the rich. Suicidal tendencies are one of the mental health issues and it is among the top three causes of death of the people aged 1534 years. Easy access to alcohol and other toxic substances in India seem to be positively correlated with number of suicides. Over 95000 Indians killed themselves in 1997, equal to one suicide every six minutes. One in every three people was in the 1529year age group. Between 1987 and 1997, the suicide rate rose from 7.5 to 10.03 per 100000 persons. Out of Indias four major cities, Chennais suicide rate of 17.23/100000 is the highest. India has no national policy or program for suicide prevention, and for a population of over a billion people there are only 3500 psychiatrists.

Its not that only poor people in India suffers from the mental health issues but researches have shown that people living in metro cities having very fast life and stressful work are also facing mental health issues like depression, anxiety etc. As shown in the figure below Bangalore which is known for its IT culture is ranked third in terms of mental and behavioral disorders which have a large impact on individuals, families and communities.

In addition to all the challenges there is no significant attention given by the government to form better policies in order to help mentally ill people. There is a lack of awareness for the importance of mental health and also people are ignorant about the same. Lack of resources such as mental hospitals, nurses, psychiatrists is making things worse to spread awareness about the mental health. There are nearly negligible promotional activities to promote the mental health attention and at this juncture of time India needs to take significant steps to create awareness for this.

Community Mental Health Care services in Trichy

Sowmanasya Hospital and Institute of Psychiatry, Trichy

Sowmanasya Hospitals and Institute of Psychiatry is an exclusive mental health care in Tiruchirapalli, Tamilnadu. The name Sowmanasya is derived from Sanskrit meaning harmony of the mind. It is situated on the banks of Cauvery .The founder Dr.G. Gopalakrishnan is a psychiatrist churned out of Post Graduate Institute of Medical Education and Research , Chandigarh . He started this Hospital as an outpatient clinic on 14th Sep 1980. Sowmanasya holds the licence issued by Tamil Nadu Government valid till 2011. It has been accredited by the National Broad Of Examinations, New Delhi , for training of 4 DNB ( Diplomate in National Board) candidates each year in the specialty of psychiatry inclusive of post diploma candidates. Sowmanasya also accredited by Dr.M.G.R. Medical University as a research institution for the purposes of Ph.D programmes in psychiatrist and Psychiatric social work. Institution attached to the hospital has been training doctors for specializing in psychiatry since 1992 till dated. Many doctor hare qualified since then. Apart from all these functions hospital staff works towards improving the awareness about the mental health care by conducting seminars and personal consulting.

Their Mission statement is

DEDICATION TOWARDS PROVIDING QUALITY MENTAL HEALTH CARE SERVICES THROUGH COMMITMENT AND FAITH IN EVERY PERSON IN NEED, AT AN AFFORDABLE COST. Which can be accounted to the fact that their Consultation fee is only Rs. for the first time and Rs. 80 for repeated visits they Qualified Doctors reside inside and near the campus. There have 4 Consultants, 4 resident doctors, a psychologist, 2 Social workers occupational therapist. In-patients accommodation - single rooms 9 ;

common wards -4,patients are allowed to stay with their family members .

They also have a standing panel of consultants & work with other hospitals any other clinical services specially needed. Generally detailed work-up of the patients are done by social workers, resident doctors, consultants & then the treatments and drugs are advised accordingly. In December 2003 they had started first licensed community-based rehabilitation center Gunaseelam Musiri Taulk, Trichy. The Hospital is provides all professional services to the Temple Trust like a 15-bedded psychiatric residential rehabilitation facilities including amenities such as bed, lunch, treatment and a small kitchenette with gas, The rehabilitation center is attached to a Hindu temple named after its presiding diety Prasanna Venkatachalapathy Perumal. The site is a known place for religious healing of the mentally ill for the past 200 years. Out-patient service is available on alternative days weekly thrice ( Monday, Wednesday, and Friday). Drugs and consultation are free for all the patients. It site is unique in its approach of using a blend of traditional temple rituals and modern psychiatric intervention involving pharmacotherapy and psychosocial therapies. The treatment follows an integrated approach which includes pharmacotherapy, psycho education and spiritual therapy. This centre has 12 beds, and provides inpatient services exclusively for schizophrenia patients.

Age of the patients staying at this centre ranged from 21 to 50. The majority of them were female and were unmarried and had availed of school education. Most of them

were not employed while the remaining were earning and had a mean income of less than Rs1000/month. The majority of them hailed from nuclear families and had a mean family size of 3.8. It was seen that majority of them manifested the disorder before the age of 22 and 60% reported being under treatment for more than 5 yrs. The majority had been through irregular treatment and had a history of multiple hospitalizations prior to their admission at Gunaseelam. While there were also patients for whom this was the first instance of hospitalization.

Situation in Trichy
South India is one of the most liberal states in India due to higher state GDP India and higher literacy rate, of this Tamil Nadu is one of the state with higher recognition of mental disorders. In Trichy , there are four mental hospitals other than Sowmanasya Sowmanasya Hospital , this can be attributed to two reason, Firstly Trichy is one of the best connected cities in TamilNadu, hence it getting a lot of visitation of patients from the nearby cities and villages. Secondly, on speaking with the doctor we came to know that the awareness of Mental Disorders in common within Trichy and the social stigma associated with is very less.

Common mental Disorders and Reasons

During Our Conversation with Dr. Arun Kumar V we found out that general mental illnesses were Depression, Anxiety/ Phobias caused mainly due to Stress, while major illness were Schizophrenia, Bipolar disorder, Clinical depression or Personality disorder .On Speaking with the doctors be found that major ailments that affected the people in this area varied with their age as in Children ADHD was a common ailment, While In adults the depression was the most common ailment. The reason for this mental disorders varied from some having genetic predisposition towards some ailments like schizophrenia while some were due to environmental factors or personal lifestyle choices like depression.

The biggest issue faced by these patients is the social stigma associated with mental illness as majority of Indians even educated ones still believe that t only mad people saw counselors. While talking to us doctors told us it difficult for a person to voluntarily ask for help for mental illnesses, to his family members. On the other hand these ailments are so common that it is at times impossible for an person to differentiate between a stressful life and a mental illness. The stigma attached to mental health issues will take time to disappear.

Recommendations for Mental Health Awareness

1. EDUCATE THE AAM ADMI ADMI Public education and awareness campaigns on mental health should be launched in all parts of the country. The main goal of such programs should be to reduce barriers to social discomfort in dealing with mental disorders and care by increasing awareness of the frequency of mental disorders, their treatability, the recovery process and the human rights of people having some kind of mental disorders.The focus should be on normalization or acceptance of Mental disorders similar to normal diseases without any ailments The care choices available and their benefits should be widely brought into focus so that responses from the general population, professionals, media, policy-makers and politicians reflect the best available knowledge. Well-planned education and public awareness campaigns can reduce social stigma and discrimination, can increase the use of mental health services, and bring mental and physical health care closer to each other. 2. ESTABLISH NATIONAL POLICIES, POLICIES, PROGRAMMES AND LEGISLATION Mental health policy, programs and legislation are the steps that are necessary for significant and sustainable action. We need to stop treating it as an afterthought. Presently in India there is a severe shortage of mental health professionals and facilities in India. The Mental health act of 1987 An Act to consolidate and amend the law relating to the treatment and care of mentally ill persons, to make better provision with respect to their properly and affairs and for matters connected therewith or incidental thereto. Defines the mental health act in its redefining act in 2013 it tries to decriminalize suicide, it seeks to provide for mental health care for persons with mental illnesses and to protect, promote and fulfill the rights of such persons during the delivery of mental health care and services. Most states need to increase their budgets for mental health programs from existing low levels. Some states that have recently developed or revised their policy and legislation have made progress in implementing their mental health care programs. Mental health reforms should be part of the larger health system reforms. 3. DEVELOP HUMAN RESOURCES Increase and improve training of mental health experts in all circles of life who can be messenger of against this social stigma on the fore front of this awareness revolution. This individuals can be social workers or other professionals like teachers, who will help identify cases of mental illness provide specialized care as well as support for the benign primary health care programs. India lacks in adequate number of such specialists to staff mental health services. Specialist mental health care teams ideally should include medical and non-medical people including

members from administration like municipality and Gram panchayats, who can work together towards the total care and integration of patients in the community.

4. AWARENESS USING MASS MEDIA The various forms of the mass media can be used to strengthen more positive community attitudes and behaviors towards people having mental disorders. Action can be taken to monitor, remove or prevent the use of images, messages or stories in the media that potentially would have negative consequences for persons suffering from mental and behavioral disorders. The media can also be used to inform the public, to persuade or motivate individual attitude and behavioral change, and to advocate for change in social, structural and economic factors that influence mental and behavioral disorders. Advertising, although expensive, is useful for increasing awareness of issues and events and for neutralizing misperceptions. Publicity is a relatively cheaper way to create news to attract the attention of the public and to frame issues and actions to achieve advocacy. The placement of educational health or social messages in the entertainment media (so-called edutainment), is useful for promoting change in attitudes, beliefs and behaviors.