Inclusion of people with mental health disorders

Aditi Hastak, Bangalore Community Manager
Bangalore, 3 March 2016

Disability is an umbrella term for impairments, activity limitations and participation restrictions either due to physical, mental, intellectual or sensory deficiencies, of which mental illness is the most challenging. Association of People with Disabilities (APD) engages with slums in Bengaluru and other small towns to identify, build capacity and attempt social integration of people with mental health disability.

In the state of Karnataka, it is estimated that over five million people are suffering from mental illness. "Considering that a considerable part of the population is affected by mental illness in varying degrees, our main objective should be to end the stigma attached to the condition. The next step is to advocate for treatment, recovery, and rehabilitation of the affected individuals," mentions the APD website.

The APD India works across several verticals of livelihoods, education, healthcare and advocacy to empower the people with disabilities (PWD). In the vertical of health care, mental health is an integral component. This type of disability is laden with stigma, neglect, isolation, abuse and, in some cases, traditional forms of treatment. On the other hand, the provision of healthcare services is minimal, with less than 700 healthcare professionals, doctors and social workers in Karnataka dealing with such type of disabilities.

Keeping in tandem with this gap, APD commenced a community mental health program in 2004. The program has been operational for more than 10 years now. The program started with 19 slums in Bangalore and then expanded to other districts within Karnataka like Davangere, Kolar, Chikballapur and Bijapur. Recent stats record that 1,137 people with mental disorders were identified and involved in the health program in 2013-14 and 947 in 2014-15.

The program operates at multiple levels, starting from identification. A primary survey of the location for at least four to five months to understand common problems and identify people with mental illness is conducted. The identified people are then directed to a suitable healthcare facility. Though it sounds straightforward, in reality the process is an arduous task of breaking barriers of traditional healers, stigmas and sometimes lack of willingness to receive treatment.

While working with individuals to improve the situation is on-going, engagement with communities and government agencies for capacity building is also happening. Social awareness through various means of plays, exhibitions and monthly meetings to interact with parents, caregivers and residential camps are just a few of the activities that APD conducts. The final phase is rehabilitation and social integration through regular counselling and appropriate livelihood training after their condition stabilizes.

The concern of livelihood opportunity is the last issue one thinks of, and the most difficult part is to identify people with such illness, make them and their families to accept this not as a "bad" thing but a disorder which can be corrected like any other. Another major factor that needs attention is the availability of experienced and specialized professionals in taking care of such cases. An article cites that out of the five years of Bachelor of Medicine and Bachelor of Surgery (MBBS) education in India, only two weeks of clinical postings are dedicated to psychiatry. Both have to improve to adequately address mental illness issues.

Photo credit: APD India

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