A Lancet study in 2017 estimated that nearly 14 per cent of India’s population suffers from some form of mental health ailment. Post the coronavirus pandemic, another 20 per cent has been added to that number. The concerning fact is that only a small percentage of people with mental health issues seek professional help and the majority of them are from urban areas. Compared to their urban counterparts, people in rural areas of the country are still widely unaware of mental health issues and often don’t get the help they require.
Community-led rehabilitation programs aim to bring mental health awareness, accessibility and training to villages in rural India. Tapping into the strong sense of community that still exists in villages, community-based mental rehabilitation programs can contribute towards capacity building and training more people to stimulate efforts towards improving the quality of mental healthcare in villages.
Significant Challenges to Mental Healthcare in Rural India
There are significant barriers to proper mental healthcare in rural areas and villages in India which include:
Lack of Awareness
Lack of awareness and knowledge in mental health leads to delay in care-seeking. Most of the time, those with mental health issues are not able to accept their mental illness, even though their family members can trace the symptoms of mental disorder.
The majority of people in rural areas are of the belief that if they went to a mental hospital, society would treat them like mad people. It becomes difficult for their children to get married and even to live in a society with others. This factor leads them to seek care from unrecognized faith healers. Most of them have blind beliefs and prefers weapons of prayers and magic to cure mental disorder.
Lack of Availability of Resources
The unavailability of specialized services and providers is also an obstacle for seeking appropriate mental health care at facilities in rural areas. The majority of mental health doctors are present only at district hospitals. People usually have to travel long distances to reach district hospitals.
How Community Based Rehabilitation Programs can help
Mental health professionals in various low-income countries are actively promoting Community Mental Health (CMH) and are attempting to influence their governments to initiate measures to bring mental health into the primary health care system. Community-based rehabilitation programs can work with mental health professionals, local health centre staff and users of mental health services to promote mental health services in the community. Several mental health problems can be resolved by working together with people who experience mental illness in their own homes and communities, using resources and support networks that are available to them. Awareness-raising campaigns and large-scale dissemination of knowledge and skills can help in reducing the stigma attached to the illness. Building knowledge and awareness among families can also make a real difference, in ensuring that people with mental health issues are integral members of the family and community, participating in all social and cultural activities.
Advantages of Community-Led Rehabilitation programmes:
1. Meeting the needs of the most disadvantaged group.
2. Promotes faster integration of people with mental health issues into mainstream societal activities.
3. Promotes good mental health in the community and leads to early identification.
4. Inclusion of people with mental health disorders in community-based programs also proves to be cost-effective.
6. Encourages innovative use of the resources that already exist (for example advocacy groups, street theatre troops, etc.)
8. Mental health problems of people with disabilities are addressed, which adds value to an existing program.
9. An environment can be built wherein all disadvantaged groups including people with mental health issues fully participate in their development and the community in which they live.
It has been observed that the inclusion of mental health issues in community-based rehabilitation programs can help build an environment wherein people with mental health issues can access their entitlements and enjoy equal opportunities for full participation in their own communities. A different and better world for all people can be created through community based mental health services.
The author is the Managing Trustee of the Poddar Foundation