Research In India -Serious Mental Illness-

...a commonsense care setting.


‘People selected on the basis of high motivation can work wonders can be seen from the excellent study carried out by Chatterjee S, Patel V, Chatterjee A, Weiss HA. The study used a three-tier model for the delivery of mental health services. The first tier was for the out-patient programme. The second tier employed mental health workers drawn from the local community. The third tier consisted of family members. The shared cultural idiom prompted greater adherence to treatment which was much higher compared to another group which used only out -patient services. This particular experiment can become a model not only for the treatment for mental disorders but also for primary healthcare in general.’ –stated - The story of Community Health in India, The National Mental Health Programme, Ministry of Health and Family Welfare. Government of India.
 
This study was deemed as a model study of community-based rehabilitation for chronic schizophrenia in rural India referred to as -‘The Barwani Experiment’ which was inclusive of ‘family caregivers’.

This study was also published in the British Journal of Psychiatry 2003 entitled –‘Evaluation of a community-based rehabilitation model for chronic schizophrenia in rural India.’
 
Some Observations:
1. The 'family caregivers' in India continue to play a key and crucial role in the care giving process of their family members with serious mental illness. This was  exemplified in the research study in Barwani in rural India. Yet 'family caregivers' are strangely missing from the Mental Health Care Bill.

2. But then the Mental Health Care Bill pending before parliament in India has ‘establishments’ which are purportedly  the community care centres.

References:

1. The story of Community Health in India, The National Mental Health Programme, Ministry of Health and Family Welfare. Government of India

2. The Mental Health Care Bill, as tabled in the Rajya Sabha in 2013

PUBLIC HEALTH AWARENESS CAMPAIGNS MENTAL HEALTH, HUMAN RIGHTS - Government of India

"There is a need for Public Mental Health Education and awareness campaigns on Mental Health to be launched. The main goal is to reduce barriers to treatment and care by increasing awareness of the frequency of mental disorders, their treatability the recovery process and the human rights of people with mental disorders."

‘National Mental Health Programme Progress and Problems’ -2003, Ministry of Health and Family Welfare.Government of India

"SERIOUS MENTAL ILLNESS" NOT EVEN DEFINED in the Mental Health Care Bill 2013

When -> The National Commission on Macroeconomics and Health, Ministry of Health & Family Welfare, Government of India, New Delhi in August 2005 states, ‘there are 65 million Indians with serious mental illnesses like Schizophrenia, Bipolar disorder, Major depression…’
 
When-> Mental health An Indian perspective 1946-2003’ by the Directorate General Health Services, Ministry of Health and Family Welfare states that –‘It is suggested that the community health programme should divert a significant part of their funds to the care of the chronically ill because ultimately it is the State which has a moral duty to look after the weak and dependent population.’

When->The World Health Organization (WHO) states, ‘Schizophrenia: Youth’s greatest disabler’. 

When->India is demographically a youthful country. 

When-> Mental health An Indian perspective 1946-2003’ by the Directorate General Health Services, Ministry of Health and Family Welfare states that –‘Although the prevalence of chronic psychotic illnesses such as Schizophrenia and Bipolar disorder in women may be less than that of Depression, Anxiety they pose an immense problem in management and rehabilitation.’ 

When-> To be in consonance with the UN Convention Rights Persons with Disabilities which has stated-‘Recognizing further the diversity of persons with disabilities’
‘Recognizing the need to promote and protect the human rights of all persons with disabilities including those who require more intensive support.’
 
Yet -‘SERIOUS MENTAL ILLNESS’ - Schizophrenia, Bipolar Disorder, Major Depression – NOT EVEN DEFINED in the Mental Health Care Bill 2013 

A community-based rehabilitation model - the Barwani study in rural India

comprising of family members of loved ones with a serious mental illness, chronic schizophrenia

Due to lack of opportunities in the rural areas in India many families are left behind when the heads of the household leave their families in the villages seeking employment in distant towns. When a family member has a serious mental illness the 'family caregiver' takes on the responsibility in keeping the rest of the family together whilst giving care. With serious mental illness it is like a cyclone hitting the family. 

Mothers, fathers, brothers, sisters, grandparents; even children give care to their family members with mental illness in the harshest conditions. These 'family caregivers' are invisible for they are never written about- who knit the social fabric of the family, giving care, support and protection for their loved ones with mental illness.

'The Barwani Experiment’ using a three tier model for the delivery of mental health services had the third tier comprising of family members can become a model not only for the treatment of mental disorders but also for primary healthcare in general state.'- Evaluation of a community-based model in rural India

'Family caregivers' who  have the knowledge and experience in giving care have not even been defined in the Mental Health Care Bill, Bill No. LIV of 2013 as introduced in the Rajya Sabha.

References:

1.National Mental Health Programme. Ministry of Health and Family Welfare. Government of India.

2.As Introduced in the Rajya Sabha Bill No. LIV of 2013-The Mental Health Care Bill