Taking Mental Health Care to Remote Villages

Bharat Dogra

While the importance of mental health care is now increasingly recognized, in many remote villages facilities of mental health are not accessible at all. Due to a diversity of reasons mental health problems have been increasing in many of these villages. However due to proper medical care, the first resort is invariably to local superstition based practices.

 Having exhausted their meager resources and efforts in this, most of the households do not venture beyond this for medical care. Hence mental health patients who can be cured remain unattended for a long time and perhaps for the entire lifetime, imposing much avoidable suffering and burden on patients as well as on their family members.

In recent years a leading voluntary organization, the Nav Bharat Jagriti Kendra ( NBJK ) implemented, in collaboration with some associated organizations, a project for taking mental health care to several remote villages of Jharkhand and Bihar. As a part of this project some surveys were also conducted to identify the mental health patients and find out about their sufferings.

In several villages people said that it is for the first time that someone is inquiring about this. People told about mental health patients who were leading a life of complete loss of hope and their carers and family members also suffered from a very heavy burden.

In fact it was found on the basis of door to door visits that several mental health patients who were prone to violent or embarrassing behavior were more or less always kept tied to chains. Others were locked up in small rooms.

 Despite all the obvious misery, people found it very difficult to go to distant hospitals for care. In addition there was a widespread feeling that a family who got a member admitted to a mental hospital would be stigmatized. Due to both these factors, perhaps more the first factor than the second one, going to a distant hospital or institution for mental health care was not even considered as an option by most families whose member suffered from this health problem.

Hence the NBJK and associate organizations  explored the option of organizing a significant number of mental health camps from time to time with continuity for several years in selected places so that people could bring patients to a place which was close to their village and was reasonably well known to them. The patient was examined by a well-qualified doctor and could generally go back to his village in the same evening with medicines and with a date fixed for the next check-up.

 It was realized that this was considered a routine treatment and was not stigmatized. It was also not expensive for most villagers to come to a nearby place for just one day in a month or so.

Hence a large number of rural mental health patients who would have been deprived of treatment otherwise were able to access treatment and this led to very encouraging recovery in many cases. These cases of good recovery in turn  encouraged others to come forward for treatment.

In several of these villages these voluntary organizations have good contacts and this helped them to get more support for the suffering patients. A community based treatment and recovery was emphasized in which family members, neighbors and community members were all encouraged to play a supportive role in the treatment and recovery of mental health patients, including those suffering from quite serious and long persisting problems.

Yet another encouraging aspect of this project was that there was also provision in it for providing livelihood support to recovering patients. This help came in very handy for recovering persons to get busy in livelihood related work and this was certainly helpful in return to normalcy.

In addition there was a very thoughtful provision for extending some help to carers also. Carers of various patients were encouraged to meet each other at regular intervals so that they could exchange ideas and information with each other. Efforts were also made to improve their livelihood conditions to some extent.

When the project period ended its financial support stopped. However as many people continued to need this effort, the NBJK dug into its internal resources to continue some of the camps.

This work has important lessons for all those concerned with taking mental health care to remote villages, which has been an area of neglect in most parts of the country.

The writer is a freelance journalist who has been involved with several social movements.    

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Nov 28, 2020

Bharat Dogra

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