After the introduction of the Mental Healthcare Bill in India, we thought the moment of reckoning has arrived.
The bill promised lot of ground level action by putting clinical resources in place. More than that, a mental healthcare bill meant that there should be, or is already, deeper recognition of the prevailing problem in India.
At least, it marked the beginning of a formal recognition of what we commonly associate with stigmatisation, family neglect, lack of treatment accessibility and so forth.
Bill overlooks many ground facts
The fact that institutional based care is now available, at least in the papers, is unfortunately not good enough. Because, only if mentally ill patients are sent for clinical treatment, will the unthinkable happen. The problem is deep-rooted in India, agreed; however, by providing access to doctors, when the near and dear ones of the patient don’t identify with the basic facts of mental health disorders, is like giving doctors an empty space to live-in.
Conveniently assumes we know ‘everything’
The government should have identified the need to encapsulate a plan to influence the mindset of people first. And no, we are not talking about the minds of the diseased here, rather the focus is on the family, the society, the caretakers of such patients, who need to be influenced first and made aware of-what mental disease is, that there is a vast variety of it and that, it can be then cured. What use is the cure grant without diagnosing the disease?
So, Is there a solution in sight?
Fortunately, Yes. Empathy or soft care before the institutional care is the answer to the ignored mental status of those suffering. And, there is a need to influence the minds of attached family or society members to deliver the first level of healthcare to the mentally-suffering.
Who will do it? The community will do.
The official term is community-based care.
The de-institutionalisation of mental healthcare
The first solution to the vast problem finds ground in community mental health workers. These workers are a part of the community and know the people closely. They also know people in thecontext of their mental illnesses. It happens so because they are trained to do so. It works in a way of voluntary system.
Community members volunteer for training to help the deceived in the society. Through this looped human chain of volunteers, a very dependable diagnosis or care system works to benefit the society. Such volunteer services are both affordable and approachable in more realistic way. Since the community workers are a part of their lives, the rural people, relate to them empathetically. There is no trust deficit.
How do these front-line workers deliver?
The fact that they deliver is evident. There have been noted thereduction in the treatment gap as thecontinued supply of community health workers made a difference. These set of volunteers collaborate with the physicians and the psychiatrists in the facilities, creating a considerable ground-level administration impact.
Today, many NGOs offer the mental health training programme for the community healthcare workers. It is a short course to educate them about mental disorders and improve personal ability to recognise the symptoms and suggest an appropriate course of action or referral case to the doctor.
How Does It Really Work?
The bigger fact is that these community members mingle with the family members, making them more aware of the mental condition of their loved ones and thus providing the much-needed family support for the suffering.
The whole society or the community works towards building awareness and improving the health condition of ‘those’ perceived to be abnormal or detached from the society, pushed to a corner when all they need is timely care and medicinal help to treat their mental problem.
Once people are aware, it is easier to recognise the initial signs and symptoms, identify patients and give them adequate care which includes counselling.
The community care system is a smart initiative to pool local resources, to do timely diagnosis, provide cheaper access to clinical help and more importantly, influence the social mindset towards the mentally-ill. It is important to let the surrounding people of the diseased know- that there is an accessible cure. Before approaching a doctor, a realisation should be made.