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 Table of Contents    
LETTERS TO EDITOR  
Year : 2021  |  Volume : 63  |  Issue : 3  |  Page : 307-308
Challenges faced by community-level workers in delivering mental health services for a rural community in South India


Schizophrenia Research Foundation, Chennai, Tamil Nadu, India

Click here for correspondence address and email

Date of Submission06-Aug-2020
Date of Acceptance06-Aug-2020
Date of Web Publication17-Jun-2021
 

How to cite this article:
Raghavan V, Kulandesu A, Karthick S, Senthilkumar S, Gunaselvi T, Rao K, John S, Thara R. Challenges faced by community-level workers in delivering mental health services for a rural community in South India. Indian J Psychiatry 2021;63:307-8

How to cite this URL:
Raghavan V, Kulandesu A, Karthick S, Senthilkumar S, Gunaselvi T, Rao K, John S, Thara R. Challenges faced by community-level workers in delivering mental health services for a rural community in South India. Indian J Psychiatry [serial online] 2021 [cited 2021 Sep 26];63:307-8. Available from: https://www.indianjpsychiatry.org/text.asp?2021/63/3/307/318731




Sir,

Community mental health in India is still in its infancy. Most of the mental health services in India are largely urban and restricted to medical college psychiatry units, hospitals, and private clinics. The only exceptions are the services offered by the District Mental Health Programme.[1] However, factors such as lack of political will, inadequate utilization of allotted funds, sparse and scattered infrastructure, and very few trained mental health professionals in some of the states prove detrimental to the growth of community mental health in India.[2]

Community-level health workers (CLWs) form a very important component of community health services.[3] They play multiple roles such as delivering care at the doorstep of persons, increasing awareness, helping reduce stigma, facilitation of help seeking to the appropriate medical sources, ensuring follow-up, and liaising with various government departments for facilitating benefits to their clients. In this process, they also face innumerable and varied challenges.[4] It is important to understand the challenges faced by the CLWs from their perspective and include them in the development of an action plan to address their issues and community mental health as a whole.

The Schizophrenia Research Foundation (SCARF) has been running a community outreach program called SCARF TElepsychiatry in Pudukottai, funded by Tata Education Trust for persons with mental health disorders at Pudukkottai district, Tamil Nadu, from 2010.[5] In this program, with the help of CLWs, persons with mental health disorders were identified from the community and treatment initiated through telepsychiatry. The CLWs also made regular monthly visits to the homes of patients to deliver psychoeducation and rehabilitation measures.

In the current study, three community project coordinators and six community-level mental health workers were individually interviewed using a semistructured pro forma to understand the challenges faced by them in delivering mental health services to the people in the community. The results [Table 1] indicate that they face different challenges at different points in time from different people, for example, during identification and referral for treatment, home visits, and facilitation of welfare schemes for persons with severe mental disorders.
Table 1: Challenges faced by community mental health workers when delivering mental health services for a rural community

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A wider coordinated effect from different sectors such as governmental departments, nongovernmental organizations, and general public and leveraging technology could facilitate the activities of community-level workers. Thus, as it is imperative to bring changes at the policy level in implementing mental health services at the community, the challenges faced by community-level workers in the day-to-day basis must also be understood and acted upon. Without that, even a well-planned policy will not effectively reach the persons to whom they are primarily addressed.

Financial support and sponsorship

SCARF TElepsychiatry in Pudukottai Program was funded by Tata Education Trust of the Sir Dorabji Tata Trust and the Allied Trusts.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Chadda RK, Patra BN, Gupta N. Recent developments in community mental health: Relevance and relationship with the mental health care bill. Indian J Soc Psychiatry 2015;31:153.  Back to cited text no. 1
  [Full text]  
2.
Thornicroft G, Tansella M, Law A. Steps, challenges and lessons in developing community mental health care. World Psychiatry 2008;7:87-92. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408397/. [Last accessed on 2018 Jun 05].  Back to cited text no. 2
    
3.
Thara R, John S, Chatterjee S. Community mental health teams in low- and middle-income countries. Epidemiol Psychiatr Sci 2014;23:119-22.  Back to cited text no. 3
    
4.
Mutamba BB, van Ginneken N, Smith Paintain L, Wandiembe S, Schellenberg D. Roles and effectiveness of lay community health workers in the prevention of mental, neurological and substance use disorders in low and middle income countries: A systematic review. BMC Health Serv Res 2013;13:412.  Back to cited text no. 4
    
5.
Thara R, John S, Chatterjee S. Comprehensive care for patients in the developing world: Lessons in facing challenges. Int J Ment Health 2013;42:77-90.  Back to cited text no. 5
    

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Correspondence Address:
Vijaya Raghavan
Schizophrenia Research Foundation, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_907_20

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