Carlin Carr, Bangalore Community Manager
This year marks an important turning point in mental healthcare in India. The landmark Mental Healthcare Bill 2013 has been introduced and is under review to be passed as law. The new bill decriminalizes suicide and protects the rights of the mentally ill from inhumane treatment. It also “aims to ensure that proper medical treatment is provided to mentally ill patients” and “seeks to regulate the public and private mental health sectors and establish a mental health system integrated into all levels of general health care,” says an article in the Indian Express. Gaps in care have been filled by NGOs that not only work to provide treatment but to increase public awareness around issues of mental illness that have added to stigmatization of these patients.
In Bangalore, the Richmond Fellowship Society has been operating services since 1986, though it is part of the world’s largest global charity network focusing on mental illness. The organization says that over 10 million people in India suffer from schizophrenia, “while the figure for those suffering bipolar affective disorder, depression and anxiety disorders stands at a colossal 150 million.” While the numbers cut across socio-economic status, the poor, especially the homeless, are inordinately affected. Experts estimate that by 2020, mental health disorders will be the second leading cause of disability and death. The World Health Organization (WHO) has created a comprehensive Mental Health Action Plan 2013-2020 to increase awareness and services.
The Fellowship focuses on a Therapeutic Community approach which emphasizes using skill and compassion to enable the mentally ill to rebuild their lives with dignity. Outreach services include halfway homes, long-term stays, and public awareness campaigns as well as development, research and advocacy on related issues. Importantly, the Richmond Fellowship has also launched a training program for care providers to improve services on the ground. The Fellowship runs Asia’s only M.S. degree in psychosocial rehabilitation and counseling “to address the paucity of trained manpower” in the field. The degree is affiliated with the Rajiv Gandhi University of Health Sciences in Bangalore.
While organizations such as the Richmond Fellowship are working to fill the gap in services to the mentally ill, the 2013 bill marks an important step in integrating effective steps for mental illness care into community health centers. The biggest challenge will be training care providers to be aware of symptoms and to create a chain of intervention points so that more serious cases can be referred outside. After all, NGOs such as the Richmond Fellowship are few and far between across the country, and a tiered approach — as the Fellowship uses, depending on the length and seriousness of care needed — is essential in providing long-term rehabilitation for healthier and happier people.
Photo credit: Huw Thomas