Csr Pmee Group 6

7/27/2019 Csr Pmee Group 6

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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


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ObjectivesObjectivesObjectivesObjectives

To understand the challeprograms in India.

To study mental healthmental healthmental healthmental healthHospital and Institute oHospital and Institute oHospital and Institute oHospital and Institute o

Spread knowledge abou Recommending the solu

nges in current situation of mental health a

wareness programswareness programswareness programswareness programs conducted by SowSowSowSow

f Psychiatry, Trichyf Psychiatry, Trichyf Psychiatry, Trichyf Psychiatry, Trichy.

mental health and encourage its practice

ions in order to increase mental health aw

wareness

anasyaanasyaanasyaanasya

in Trichy.

reness.


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IntroductionIntroductionIntroductionIntroduction---- Why Mental Health Awareness?Why Mental Health Awareness?Why Mental Health Awareness?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 nojustification 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


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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.


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Mental HealthMental HealthMental HealthMental Health inininin IndiaIndiaIndiaIndia

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 %.About60 to 70 million Indians suffer from

SMDsandCMDs mental disorders. Nearly 6% of Keralas population has mental

disorders. One in5 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 positivelycorrelated 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 1529-

year 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.


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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.


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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.


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Community Mental Health Care servicesCommunity Mental Health Care servicesCommunity Mental Health Care servicesCommunity Mental Health Care services in Trichyin Trichyin Trichyin Trichy

Sowmanasya Hospital and Institute of Psychiatry,Sowmanasya Hospital and Institute of Psychiatry,Sowmanasya Hospital and Institute of Psychiatry,Sowmanasya Hospital and Institute of Psychiatry,

TrichyTrichyTrichyTrichy

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 ANAFFORDABLE 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 ;


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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 GunaseelamMusiri 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


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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 alsopatients 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

SowmanSowmanSowmanSowmanasyaasyaasyaasya 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.


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Common mental Disorders and Reasons

During Our Conversation with Dr. Arun Kumar V we found out that general mentalillnesses 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.


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Recommendations for Mental Health Awareness

1. EDUCATEEDUCATEEDUCATEEDUCATE THETHETHETHE AAM ADMIAAM ADMIAAM ADMIAAM 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 POLICIESESTABLISH NATIONAL POLICIESESTABLISH NATIONAL POLICIESESTABLISH NATIONAL POLICIES, PROGRAMMES AND LEGISLATION, PROGRAMMES AND LEGISLATION, PROGRAMMES AND LEGISLATION, 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 RESOURCESDEVELOP HUMAN RESOURCESDEVELOP HUMAN RESOURCESDEVELOP 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


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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 USINGAWARENESS USINGAWARENESS USINGAWARENESS USING MASS MEDIAMASS MEDIAMASS MEDIAMASS 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 thepublic 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.


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Csr Pmee Group 6