Reimagining Community Mental Health Care Services: Case Study of a Need Based Biopsychosocial Response Initiated During Pandemic

Abstract

Community mental health systems worldwide have undergone transformation in order to accommodate enormous demands of the pandemic and its mitigation efforts. The pandemic created unprecedented challenges that required Mehac Foundation (further referred as Mehac), a not for profit organization based in Kerala, to reassess our care delivery model. The aim of this report is to present a flexible, need-based biopsychosocial response; a case study effectuated by the Non-Governmental Organization (NGO) with a focus on minimizing the impact of COVID 19 on vulnerable communities, while adhering to timely regulations issued by the government. The key aspect of our biopsychosocial response was implementation of a phased approach that was rooted in real time need identification. The strategies will be described under broad headings of (i) adaptations for maintaining continuity of care, (ii) identifying vulnerable subgroups and need based psychological response, (iii) exploring social dimensions of the pandemic and implementing strategies to address them, (iv) ensuring team well-being and enhancing skills to effectively respond to the challenges.

Commentary: Reimagining Community Mental Health Care Services: Case Study of a Need Based Biopsychosocial Response Initiated During Pandemic

“…Sunder et al ( 1 ) have acknowledged that a formal evaluation of Mehac's approach has yet to be conducted, and we look forward to that possibility. Until then, I commend my Indian colleagues for their exemplary leadership in addressing the social dimension of the biopsychosocial model.…”

“…With limited healthcare resources, Kerala's Mehac Foundation undertook a novel and highly efficient approach to care delivery that required broad and active community participation. Borrowing from the field of palliative care, the foundation implemented a flexible model of service delivery based on Public-Private-People Partnership ( 1 ). This approach utilized existing community resources including public governance organizations (e.g., panchayats), private organizations (e.g., non-governmental and corporate organizations), and—most notably—people (e.g., family members and volunteers).…”

“…Also, I work at the University of Rochester Medical Center (URMC), which gave birth to the biopsychosocial model and is the focus of this special issue. With these standpoints in mind, I offer the following commentary on Sunder's et al recent article ( 1 ). I'll begin with some background about URMC followed by discussion of the coronavirus pandemic to provide context.…”

Community mental health interventions for people with major depressive disorder: A scoping review

“…In India, the continuity of mental healthcare amidst the nation's lockdown was achieved through the engagement of community health workers, volunteers and neighbours to set up improvised zone‐based mental health facilities, providing medication delivery services and psychological first‐aid (Sunder et al . 2021). Similarly, when the community mental health clinics in the United States of America (USA) could not support post‐hospital transitional care for patients with psychiatric illness due to lockdown, mental healthcare protocols were restructured to integrate generic community crisis teams and community mental health teams to ease the transition process (Smith et al .…”

“…CMHIs were broadly described in the WHO Mental Health Action Plan 2013-2030, as the adoption of recovery-based approaches that provide integrative and holistic mental healthcare through prevention, promotion, rehabilitation and treatment across various community organizations for people with mental health conditions (World Health Organization 2013). In India, the continuity of mental healthcare amidst the nation's lockdown was achieved through the engagement of community health workers, volunteers and neighbours to set up improvised zone-based mental health facilities, providing medication delivery services and psychological first-aid (Sunder et al 2021). Similarly, when the community mental health clinics in the United States of America (USA) could not support posthospital transitional care for patients with psychiatric illness due to lockdown, mental healthcare protocols were restructured to integrate generic community crisis teams and community mental health teams to ease the transition process (Smith et al 2021).…”