Individuals with severe mental illness have long been segregated from living in communities and participating in socio-cultural life. In recent years, owing to progressive legislations and declarations (in India and globally), there has been a growing movement towards promoting social inclusion and community participation, with emphasis on the need to develop alternative and inclusive care paradigms for persons with severe mental illness. However, transitions from inpatient care to community settings is a complex process involving implications at multiple levels involving diverse stakeholders such as mental health service users, care providers, local communities and policy makers. This article studies how the transition from a hospital setting to a community-based recovery model for personals with severe mental illness can be facilitated. It reflects on the innovative process of creating a Supported Housing model in South India, where 11 MH Service users transitioned from a psychiatric ECRC to independent living facilities. Experiences in various phases of the project development, including care provider-and community level responses and feedback were scrutinised to understand the strategies that were employed in enabling the transition. Qualitative methods (including in-depth interviews and naturalistic observations) were used with residents and staff members to explore the challenges they encountered in stabilizing the model, as well as the psychosocial benefits experienced by residents in the last phase. These were complemented with a Brief Psychiatric Rating Scale (BPRS) and WHO Quality of Life scale to compare baseline and post-assessment results and an increase of quality of life. Results display a significant reduction of psychiatric symptoms in patients (p< 0.5). It also describes the challenges encountered in the current context, and strategies that were used to respond and adapt the model to address these concerns effectively. Positive behavioural and psychoemotional changes were observed amongst the residents, significant amongst those being enhanced in their mobility and participation. The article concludes by discussing the
Youth suicide is a public health problem in India, and young people in school, particularly adolescents, experience heavy psychological burden. Prevention programs, involving peer educators (PEs), have proved useful strategies to address this problem, but their impact on the PEs is less understood, particularly in India. This qualitative study aims to explore the changes observed in PE students who were involved in a ‘mindfulness’ and ‘Support-Appreciate-Listen–Team’ (SALT)-based peer education program to address suicidal behavior in Indian school students. One hundred and fourteen students were trained as PEs in six high schools in Pune to identify and respond to the needs of students in distress. By listening to the narratives of the PEs, their parents, school authorities, and the associated NGO team, we reflect on perceived social, emotional, behavioral, and cognitive changes in PEs. The PEs demonstrated enhanced caring for those in distress both inside and outside school by improved listening skills, self-awareness, care, and empathy. Furthermore, the program had a positive impact on their broad emotional intelligence and PEs expressed increased ownership of life, taking action, and seeking support where needed. The study concludes that mindfulness and SALT-based peer education (PE) programs are valuable for the PEs. This could be used to motivate PEs to volunteer in such programs. Other results are discussed and further research areas are suggested.
PurposeThe COVID-19 pandemic is certain to have an unprecedented impact on the global population, but marginalized and vulnerable groups in low-income countries (LICs) are predicted to carry the largest burden. This study focuses on the implications of COVID-19-related measures on three population groups in India, including (1) migrant laborers (of which a majority come from Scheduled Castes (SCs) and Scheduled Tribes (STs), as well as Other Backward Classes (OBCs)), (2) children from low-income families and, (3) refugees and internally displaced persons (IDPs).Design/methodology/approachThis study adopts a sequential mixed-method research design. A desk-based study of a selection of government reports was undertaken on the COVID-19-related mitigation measures. The desk study was followed by in-depth interviews with purposively recruited high-ranking experts in specific sectors of policy implementation and service delivery across the country.FindingsThe outcomes of this study shed light on (1) the most urgent needs that need to be addressed per population group, (2) the variety of state-level responses as well as best practices observed to deal with mitigation issues and (3) opportunities for quick relief as well as more long-term solutions.Practical implicationsThe COVID-19 pandemic has not only reduced people's means of maintaining a livelihood but has simultaneously revealed some of India's long-standing problems with infrastructure and resource distribution in a range of sectors, including nutrition and health, education, etc. There is an urgent need to construct effective pathways to trace and respond to those people who are desolate, and to learn from – and support – good practices at the grassroot level.Originality/valueThe current study contributes to the discussion on how inclusive public health might be reached.
Rapid developments in the last few decades have brought about dramatic changes in Indian social life, particularly affecting new middle-class families. Inter-generational conflicts, high academic pressures, and modern anxieties lead to stress both in parents and in children. There is a need for parenting programmes that respond to these specific concerns, in order to reduce parenting stress and improve family well-being. This study aimed to develop and evaluate a parenting programme in Pune, India, based on a ‘theory of change’. In this pilot programme, parents were encouraged to learn in a group format about fostering autonomy in children, promoting academic potential in a stress-free manner and remaining in connection with adolescents. Facilitated by a psychologist, parents participated in four sessions involving ‘creativity and play’, ‘self-awareness and bonding’, and ‘communication’. The intervention was based on validated psychotherapeutic approaches and parenting methods to support parents in their learning. Some 16 in-depth interviews were conducted with parents before and eight interviews after the intervention to understand their learning experiences. Additional feedback was gathered from observation notes and debriefings after each session. The results show that the attention for playful quality time helped parents to (re)gain a more creative and flexible attitude towards spending time with their children. Second, parents learned to reflect on their frameworks of meaning (rooted in their own upbringing), listen attentively and communicate more mindful with their children. Furthermore, this study shows that an activity-based approach, connecting parents in co-creating new parenting paradigms, while supporting them with stress-reducing tools, is a useful way of engaging this target group. The study concludes by offering new perspectives for counsellors working with families in countries undergoing rapid change.
Mental health problems among youth have become important public health concern for many low & middleincome countries. As part of a research program to improve mental wellbeing in Pune, India, a university-based intervention was developed for students of two educational institutes. In one month, 33 students (age 18-22) participated in a series of 2-hour sessions in which they were stimulated to learn better coping skills to deal with stress and anxiety. The interactive sessions were facilitated by a psychologist and volunteers of a suicide prevention NGO. Rational Emotive Behaviour Therapy (REBT) approaches were used to help students identify stressors and find alternative thought patterns towards the stressor. Playful exercises, such as theatre, dance and poetry, were used to develop self-esteem, self-expression and a better sense of control in students. Throughout the program, relaxation methods, such as Emotional Freedom Technique (EFT), were practiced to help reduce stress in students. To study the impact of the intervention, data were collected, before-and after the intervention and in an eight month follow-up with the Perceived Stress Scale (PSS), in combination with open questionnaires and field notes. Preliminary results show a significant decrease in average stress scores in students after the program in comparison to before the intervention (p-value is 0.044 < 0.05). Students reflect upon the program as helpful and specifically emphasize the role of poetry, dance & EFT as main contributors. In follow-up tests perceived stress scores remained lower than at base-line, although not significant. Booster sessions are suggested to sustain the benefits. Overall, the results of this pilot study show that low threshold, university-based interventions, could be useful in stimulating psychosocial well-being in youth.
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