Mental health care goes to the grassroots in State

The Health Department has launched an initiative to assess the true burden of mental health disorders in the community by involving health workers in the detection and follow-up of cases.

These newly detected cases will be integrated into the primary-care system through the nearest family health centres (FHCs) so that the treatment is more accessible. The Sampoorna Manasikarogyam or comprehensive mental healthcare programme is being implemented in all 170 FHCs as part of the Aardram Mission.

Sampoorna Manasikarogyam envisages using trained health workers to make house visits at the ward level, talk to families and understand if there are any mental health issues amongst the kin that they are concerned about.

“This is an initiative we had successfully experimented with in 14 grama panchayats at Kallikkad in Thiruvananthapuram in 2012. The aim is to treat the patient within the community and ensure that he/she remains on follow-up care,” says P.S. Kiran, State Nodal Officer, Mental Health.

Reducing dropout rate

“Patients dropping out of treatment when they begin to experience symptomatic relief is a major issue. Many with chronic illnesses can lead normal lives within their families if regular follow-up and adherence to medication can be ensured. But they end up in hospitals again and again and are marked as mentally ill for life. Sampoorna Manasikaarogyam aims at reducing the treatment dropout rate and the stigma associated with mental disorders,” he says.

Training is given to Accredited Social Health Activists (ASHAs) in every ward on mental health issues, awareness creation, and stigma reduction. They are also trained to administer a 13-point structured questionnaire or case detection form. The forms brought back by ASHAs after home visits are evaluated by a team of psychiatrists at the District Mental Health Programme (DMHP).

ASHAs then follow up the newly detected cases and encourage them to attend the medical camps – at least three -- which will be conducted by the DMHP team and the team at the FHCs.

Stable cases are then handed over to the FHC medical team, so that a weekly/monthly mental health clinic can be conducted for them.