Stigma, taboo deter people from approaching experts for help
Tamil Nadu is way ahead of other states when it comes to creating the infrastructure for mental healthcare, but lack of awareness and discrimination against such patients stop them from accessing these facilities
By : migrator
Update: 2018-06-18 18:00 GMT
Chennai
A little over a tenth of Tamil Nadu’s population have some kind of mental health matter, revealed the recently conducted National Mental Health Survey, and the state has been taking efforts to address the issue.
However, ignorance and stigma remain even now, rendering the existing psychiatric services underutilised. Pointing out how the incidence of psychological morbidity is rising drastically by the day, senior psychiatrist Dr C Ramasubramanian said psychiatrists have been appointed in almost all the 32 districts.
“We, as a state, are taking up various initiatives to check mental health,” he said. In terms of the facilities, there are 10-bedded psychiatric wards in all district headquarter hospitals. In addition, there is a psychiatric wing at all medical college hospitals.
To increase the number of professionals, the state government has also announced plans to set up ‘satellite clinics’ by creating psychiatric posts to provide treatment to the mentally ill patients based on Advanced Tour Programme to the specific hospitals on specified dates.
The state has been implementing the District Mental Health Programme – which comes under the National Mental Health Programme – in all districts.
“Under the programme, the state government has appointed a psychiatrist, a psychologist and a social worker in each district. These workers have also been given a vehicle with which they are running mobile psychiatric clinics,” said Ramasubramanian. But, even though Tamil Nadu is far ahead in the field of mental health when compared to other states, people continue to refrain from approaching psychiatrists due to various factors including stigma and lack of awareness.
Ramasubramanian said the government has been encouraging private sector to start psychology courses, besides increasing the number of courses in psychiatry MD and diploma in state-run medical colleges.
“We started giving training on basic psychiatry to doctors in all Primary Health Centres on how to identify psychiatric illnesses and also how to start the treatment,” he added.
According to a Health department official, they have understood the importance of creating awareness on mental illness and the importance of treating it.
“When the public is able to understand the nature of the illness, they will be able to immediately take the case to the PHC, where the doctors are already trained in basic psychiatry. They will administer basic psychiatric treatment and then refer the case to the district psychiatrist, who conducts the mobile clinic in the Taluk Headquarter Hospital. This makes matters easier for the patient and family, as they would not have to travel,” said the official.
However, P Nilam, a psychologist, noted that it was important to address the stigma surrounding mental health which is seen not only in rural areas but also in Chennai city as well.
He said, “The few patients who even come for check-ups are very worried about the society finding out. While the public is aware of mental illness as an issue, they are unaware of whom to approach in what situation.”
She added, “This has led to a number of quacks sprouting up in various parts of the state who take families of mentally ill patients on a ride. Not only should the taboos surrounding mental illness be cleared, the government should also check the mushrooming of quacks.”
INADEQUATE RESOURCES, FACILITIES
- There are only 6,500 psychiatrists, 3,000 psychologists and around 2,500 socialworkers in the country
- There are only about 42 mental hospitals in the country
- In the private sector, there are only 40,000 psychiatric beds in the country
- High cost of treatment
- Having to travel long distances to meet a psychiatrist
- Most psychiatric treatments are long-term
- Lack of community-oriented mental health care
- Lack of integration within primary care
- Lack of public mental health leadership
- The absence of mental health from the public health agenda and the implications for funding
Govt officials mull community-based rehabilitation options
Looking at ways to address the gaps in delivery of mental healthcare in the state, experts and government officials here are looking at community psychiatry or community-based rehabilitation as an option to treat cases of mental illness.
Reluctant to approach a psychiatrist and thus let the society know about their mental illness, many have been seeking the help of priests and religious leaders for treatment. The dargah at Erwadi is one such shrine that has been attracting a large number of persons with mental illness.
“Popular belief is that one develops mental illness due to the presence of evil spirits. Therefore, we have decided to look into the combination of religion and mental health as a way forward in treating mental illness. The project we have undertaken is known as the Da wa-dua (medicine and prayers) project,” said Dr C Ramasubramanian, a senior psychiatrist.
“It is already being followed at Erwadi Dargah and at Gunaseelam in Tiruchy. We are planning to initiate steps to start a similar programme at the Puliyampatti church very soon. Ultimately, our aim is to involve religious people in the promotion of mental health,” he added.
With an aim to address the non-utilisation of existing services, psychiatrists have decided to take up the age-old faith, as many tend to approach religious places to get healed.
“People consider priests as an ambassador to the almighty. Any advice given to them by the priests will be taken well,” he said. The plan is to encourage those facing such illnesses to go to religious places to offer prayers, and then the priests and other religious persons would refer specific cases to psychiatrists at the institute nearby, he added. Any path a person wants to follow while working towards getting treated was acceptable, noted Dr Preethi M, a psychiatrist.
“In most cases, persons refrain from returning for a follow up. If the Da wa-dua method helps treat the cases successfully, then other states too should follow the model.”
Visit news.dtnext.in to explore our interactive epaper!
Download the DT Next app for more exciting features!
Click here for iOS
Click here for Android