quick reads

The big news: BJP says Bihar governor is their pick for president, and nine other top stories

Other headlines: One dead and several injured after van runs over pedestrians in London, and GJM asked Centre to withdraw security forces from Darjeeling.

A look at the headlines right now:

  1. BJP picks Bihar Governor Ram Nath Kovind to be presidential candidate: The election will be held on July 17, and current President Pranab Mukherjee finishes his term on July 24.
  2. One killed, eight injured after van runs over pedestrians near two mosques in London: The police are trying to verify whether it was a deliberate act or an accident, while Prime Minister Theresa May called it a ‘potential terror attack’.
  3. Withdraw security forces from Darjeeling, hold tripartite talks, GJM tells Modi government: MLA Amar Singh Rai said the GJM did not want to be ‘pawns’ in Centre-state politics, and that the party would not hold talks with Mamata Banerjee.
  4. Australia announces online visa applications for Indians from July 1, says will make process faster: The online procedure will offer benefits like 24/7 accessibility, e-payment of the visa application charge and the ability to check the status of applications.
  5. Donald Trump is not under investigation, says his lawyer, though the president had claimed otherwise: Jay Sekulow said Trump had merely been reacting to news report when he said he was being probed for obstruction of justice in the Russia scandal.
  6. Rs 10-crore deal helped ex-UP minister Gayatri Prajapati get bail in gangrape case, finds inquiry: A probe ordered by the Allahabad High Court found that then Posco judge OP Mishra, a district judge and three lawyers were the beneficiaries of the sum.
  7. CBI team at Delhi minister Satyendar Jain’s house, questions his wife about alleged money laundering: The agency had registered a preliminary inquiry against Jain in April on the allegations that he had laundered Rs 4.63 crore in 2015-16.
  8. US aircraft shot down Syrian fighter jet, says Pentagon: Iran launched missiles targeting the Islamic State group in East Syria in retaliation to the June 7 attacks in Tehran.
  9. Ramakrishna Mission head Swami Atmasthananda dead at 98: Prime Minister Narendra Modi, who considered him his guru, called it a ‘personal loss’.
  10. Delhi social welfare minister to visit 80-year-old Urdu poet incorrectly declared dead in 2013: Scroll.in had reported that Asar Jamayee, who lives alone, had been deprived of his monthly pension since the department made the error.
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Removing the layers of complexity that weigh down mental health in rural India

Patients in rural areas of the country face several obstacles to get to treatment.

Two individuals, with sombre faces, are immersed in conversation in a sunlit classroom. This image is the theme across WHO’s 2017 campaign ‘Depression: let’s talk’ that aims to encourage people suffering from depression or anxiety to seek help and get assistance. The fact that depression is the theme of World Health Day 2017 indicates the growing global awareness of mental health. This intensification of the discourse on mental health unfortunately coincides with the global rise in mental illness. According to the latest estimates from WHO, more than 300 million people across the globe are suffering from depression, an increase of 18% between 2005 and 2015.

In India, the National Mental Health Survey of India, 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed the prevalence of mental disorders in 13.7% of the surveyed population. The survey also highlighted that common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. Perhaps the most crucial finding from this survey is the disclosure of a huge treatment gap that remains very high in our country and even worse in rural areas.

According to the National Mental Health Programme, basic psychiatric care is mandated to be provided in every primary health centre – the state run rural healthcare clinics that are the most basic units of India’s public health system. The government provides basic training for all primary health centre doctors, and pays for psychiatric medication to be stocked and available to patients. Despite this mandate, the implementation of mental health services in rural parts of the country continues to be riddled with difficulties:

Attitudinal barriers

In some rural parts of the country, a heavy social stigma exists against mental illness – this has been documented in many studies including the NIMHANS study mentioned earlier. Mental illness is considered to be the “possession of an evil spirit in an individual”. To rid the individual of this evil spirit, patients or family members rely on traditional healers or religious practitioners. Lack of awareness on mental disorders has led to further strengthening of this stigma. Most families refuse to acknowledge the presence of a mental disorder to save themselves from the discrimination in the community.

Lack of healthcare services

The average national deficit of trained psychiatrists in India is estimated to be 77% (0.2 psychiatrists per 1,00,000 population) – this shows the scale of the problem across rural and urban India. The absence of mental healthcare infrastructure compounds the public health problem as many individuals living with mental disorders remain untreated.

Economic burden

The scarcity of healthcare services also means that poor families have to travel great distances to get good mental healthcare. They are often unable to afford the cost of transportation to medical centres that provide treatment.

After focussed efforts towards awareness building on mental health in India, The Live Love Laugh Foundation (TLLLF), founded by Deepika Padukone, is steering its cause towards understanding mental health of rural India. TLLLF has joined forces with The Association of People with Disability (APD), a non-governmental organisation working in the field of disability for the last 57 years to work towards ensuring quality treatment for the rural population living with mental disorders.

APD’s intervention strategy starts with surveys to identify individuals suffering from mental illnesses. The identified individuals and families are then directed to the local Primary Healthcare Centres. In the background, APD capacity building programs work simultaneously to create awareness about mental illnesses amongst community workers (ASHA workers, Village Rehabilitation Workers and General Physicians) in the area. The whole complex process involves creating the social acceptance of mental health conditions and motivating them to approach healthcare specialists.

Participants of the program.
Participants of the program.

When mental health patients are finally free of social barriers and seeking help, APD also mobilises its network to make treatments accessible and affordable. The organisation coordinates psychiatrists’ visits to camps and local healthcare centres and ensures that the necessary medicines are well stocked and free medicines are available to the patients.

We spent a lot of money for treatment and travel. We visited Shivamogha Manasa and Dharwad Hospital for getting treatment. We were not able to continue the treatment for long as we are poor. We suffered economic burden because of the long- distance travel required for the treatment. Now we are getting quality psychiatric service near our village. We are getting free medication in taluk and Primary Healthcare Centres resulting in less economic stress.

— A parent's experience at an APD treatment camp.

In the two years TLLLF has partnered with APD, 892 and individuals with mental health concerns have been treated in the districts of Kolar, Davangere, Chikkaballapur and Bijapur in Karnataka. Over 4620 students participated in awareness building sessions. TLLLF and APD have also secured the participation of 810 community health workers including ASHA workers in the mental health awareness projects - a crucial victory as these workers play an important role in spreading awareness about health. Post treatment, 155 patients have resumed their previous occupations.

To mark World Mental Health Day, 2017, a team from TLLLF lead by Deepika Padukone visited program participants in the Davengere district.

Sessions on World Mental Health Day, 2017.
Sessions on World Mental Health Day, 2017.

In the face of a mental health crisis, it is essential to overcome the treatment gap present across the country, rural and urban. While awareness campaigns attempt to destigmatise mental disorders, policymakers need to make treatment accessible and cost effective. Until then, organisations like TLLLF and APD are doing what they can to create an environment that acknowledges and supports people who live with mental disorders. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.