FIVE YEARS after 1,168 teachers from 650 schools in Satara were trained in using “psychological” first aid and drop boxes were set up to help prevent student suicides, Parivartan Trust — a mental health NGO led by Dr Hamid Dabholkar along with the District Mental Health Programme — have incorporated art and drama at three of their primary health centres to identify people with severe mental illnesses. Over two years, they have identified 1,500 such persons with schizophrenia, bipolar disorder and anxiety.
“Psychological first aid” is the theme for this year’s World Mental Health Day on October 10. According to Dabholkar, however, their project of reaching out to communities in distress had begun several years ago. “Initially, we set up the Umang project to help prevent student suicides. The focus of this new project, set up along with the Tata Trust and taken up at three primary health centres (PHC) in Satara, has been to offer basic pragmatic psychological support to people in the communities,” said Hamid, son of slain activist Narendra Dabholkar.
Engaging the community is important in this project and 15 Accredited Social Health Activists (ASHA) workers have been trained along with five other community health workers to get patients enrolled for treatment. Sunita Bhosale, community health worker at Chinchaner PHC, said workers visit people’s homes daily, asking them to fill up a General Satisfaction Questionnaire (GSQ). “Questions like constantly feeling sad, no desire to work, lack of sleep or feel like dying are asked. Initially, there was resistance among people who would shut their doors when ASHA workers contacted them. But we conducted poster exhibitions and even performed skits to talk about depression and anxiety. Slowly people started opening up and talking to us about their problems,” Bhosale said. Two other PHCs at Limb and Nagthane are also involved in this project.
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“For instance, only last month, we were able to identify 182 new patients with mental illness out of which 66 were men, 66 were women and 50 were children,” Bhosale said, adding that by and large anxiety, stress, epilepsy and depression were the main problems. Children who were mentally challenged had behavioural problems and were also brought to the PHC for consultations. The main chunk of patients, however, are referred to the district civil hospital which has only one psychiatrist. Dr Abhijeet Ghorpade, programme coordinator of the District Mental Health Programme, said they had partnered with Dabholkar and the Tata Trust to reach out to the communities by training ASHA workers in identifying symptoms of mentally ill patients and then assisting the caregivers at home to help their relatives. Out of 1,300 mentally ill patients, at least 350-400 suffer from schizophrenia and psychosis while others have epilepsy and depression, Ghorpade said.
Mental health problems are easy to identify from external behavioural disturbances. If one has scientific knowledge about the nature of the stress and its impact on life then it is not difficult identify its symptoms through a focused conversation. There is ample evidence globally and even in India about the effective use of mental health workers for counselling, researchers with the project said. “Parivartan Trust has developed a psychological first aid kit under the Jan Man Swasth programme and uses art and drama as a method of community engagement. The Manasrang (Colours of mind) platform developed with help of noted director Atul Pethe, includes use of poster slogans, dance and drama as part of the community engagement, thereby providing psychological first aid.