Short films loaded on a basic android app to enable a bunch of villagers identify mental health disorders in their community may come across as a simplistic idea to address major mental health conditions. However, it has emerged as a successful model where trained tais and dadas in 41 villages of Nashik have detected mild and major mental health conditions among residents over a period of two years. These had never been identified or treated earlier.
Devised by the Pune-based Centre for Mental Health Law and Policy (CMHLP) at the Indian Law Society, the Atmiyata (Compassion) project was rolled out in Peth block of Nashik district in December 2013 – making mental healthcare accessible to many in this part for the first time.
But the idea behind the project — which is now all set to get replicated in Gujarat’s Mehsana district once it clears the funding hurdle — wasn’t limited to addressing mental health problems alone.
It pertinently included helping people access government social welfare schemes.
“If you look at data, you will find that poverty and mental health problems are linked. So our programme was comprehensive in that it addressed both at the same time. Tais and dadas helped people who were eligible, and had mental health problems, access various social welfare benefits such as widow pension scheme, Indira Gandhi Awas Yojana, disability pension and MNREGA cards,” said psychiatrist Dr. Soumitra Pathare, coordinator, CMHLP.
Dr. Pathare, who has assisted the Union Ministry of Health in drafting new mental health legislation and is also part of the policy group drafting the new national mental health policy, said Atimyata addressed one of the biggest roadblocks in mental health treatment — lack of trained human resources.
In Maharashtra, only 20 of the 89 psychiatrist positions are filled. “People can’t access services. Besides, whatever existing services are there, people try to avoid them fearing social stigma,” Dr. Pathare told The Hindu .
In many cases, she added, like anxiety and depression, counselling is enough and the trained tais and dadas were a good resource as they were trained to counsel and take the more severe cases to the district general hospital. “You don’t see a cardiologist for blood pressure, similarly you don't need to see a psychiatrist or a psychologist for every mental health problem,” he reasoned.
Nearly two years after its launch, by August 2015, the trained volunteers identified 1,150 people suffering from common mental disorders and another 180 with severe mental disorders such as schizophrenia, more than half of whom are now undergoing treatment.
The project steered clear of preachy classroom sessions. The therapy sessions were through scripting and filming seven-minute movies which covered issues of alcoholism, domestic violence and unemployment, among others, that were uploaded on a mobile app. By the time the project was wrapped up in November 2015, a total of 7,622 people had seen the films — the app downloaded and films transferred from one handset to another via Bluetooth. Another set of training videos were also uploaded that were used to train the Atmiyata aais and dadas .
The project, funded by Grand Challenges Canada, was executed without any fuss or frills. “We tied up with BAIF, an NGO active in Peth and piggy-backed our mental health intervention on their development intervention. BAIF works on developing sustainable agriculture and micro credit groups,” said Dr. Pathare, adding that community leaders anchoring these programmes were trained for Atmiyata as well.
And the project’s achievement?
“When we started, there was a huge treatment gap. Almost 60 per cent of the people with mental health disorders now have access to treatment as against the 2 to 3 per cent earlier. This is a huge achievement. The Atmiyata intervention is a low-cost, low-intensity, but high-impact intervention,” said psychiatrist Dr. Kaustubh Joag, principal investigator of Atmiyata project.
“Besides, the beauty of the project is its sustainability. It ended last December, but the work continues,” said Dr. Pathare.
The idea behind the Atmiyata project is also
to help people get access to the government’s social welfare schemes
