There has been a six-fold rise in the proportion of people who sought treatment for depression across 30 villages in Amravati district of Vidarbha, which has been at the epicentre of farmer suicides, a study has revealed.
The study published on Wednesday in The Lancet Psychiatry has reported findings of Vidarbha Stress and Health Programme (VISHRAM) to address mental health risk factors for suicide. It has also reported that in the past 12 months, the prevalence of depression fell from 14.6 per cent to 11.3 per cent, while suicidal thoughts came down from 5.2 per cent to 2.5 per cent.
According to Dr Vikram Patel, psychiatrist and principal investigator of VISHRAM, this is the first programme in the region that has shown an impact not only on the increasing demand for care for depression, but also a reduction in suicidal behaviour. “This community mental health programme showed a six-fold increase in the proportion of people seeking care for depression,” Patel told The Indian Express.
Fourteen districts, which accounted for the most farmer suicides, are located in Vidarbha and Marathwada regions of Maharashtra. According to official data, the Vidarbha region reported 1541 farmer suicides in 2015, the highest in the state. In Vidarbha, Amravati district accounted for the highest number of farmer suicides, 1,179.
The mental health programme was implemented over a period of 18 months by NGOs Prakriti and Sangath. It was evaluated by the Public Health Foundation of India and funded by Tata Trusts. Before VISHRAM was introduced on a population of one lakh in 30 villages across Chandur Bazaar and Dhamangaon talukas of Amravati, researchers did a baseline survey from Dec 25, 2013, to March 10, 2014. They randomly selected 1,456 adults from the electoral roll and measured depression using the Patient Health Questionnaire (PHQ]-9). Eighteen months later, after VISHRAM was implemented, the survey was repeated on another 1,887 participants from September 18, 2015, to October 8, 2015.
According to lead author of the study Dr Rahul Shidaye, the programme’s implementation was led by community-based workers and non-specialist counsellors and done in collaboration with facility-based general physicians and psychiatrists. More than 1,000 small group meetings were held over the 18 months. First aid for mental health was provided to 1441 individuals with psychosocial distress. More than half of these people (793) were referred to counsellors.
“When the baseline survey was done before VISHRAM’s implementation, the proportion of people who sought care was 4.3 per cent. This rose 27.2 per cent in the 18 months,” Patel said. The number of suicides came down from 28 to 22, he said.
Despite the small numbers, the pilot study provides the first evidence of how a massive treatment gap can be reduced, Patel said. He further pointed out that the findings are significant in view of the findings of a recent national mental health survey that showed that nearly 20 million adults were living with depression and at least 90 per cent of them had not received any care in the previous 12 months.
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