24 December, 2016

Lay counselling needs govt attention

Two studies published recently in the medical journal, The Lancet, confirm that lay counselling in primary healthcare can help tackle symptoms of severe depression and reduce harmful drinking. This should convince the government to roll out at the earliest lay counselling services in primary healthcare facilities across the country. Depression and alcoholism are the two most common mental health problems in India. According to the National Mental Health Survey, one in 20 adults suffers from depression and one in 10 adult men indulges in harmful drinking. Around 65 million adults are affected by the two disorders. Daily life is a living hell for those suffering from depression and alcoholism. These disorders have an immense social impact and the economic burden they impose on the individual, his family and society is enormous. Yet, most people suffering from depression and harmful drinking do not receive treatment. The treatment gap for both disorders is a shocking 85%. Social stigma attached to the two disorders is partly to blame.

However, an important reason is that medical expertise and infrastructure for treatment of mental health problems is extremely limited in India. For instance, there are only 0.3 psychiatrists per 100,000 people in India. Most of them are located in the major cities. India has 443 government-run mental hospitals which are concentrated in the western and southern states. Six states, mainly in the northern and eastern regions with a combined population of 56 million people, are without a single mental hospital. The majority of mental health patients have to travel long distances to avail treatment in district or state capitals. This lack of easy access to facilities deters patients from seeking help. While it is important to increase the number of psychiatrists, nurses and professional counsellors in primary healthcare facilities, this is a big challenge in terms of costs. Not to mention, ramping up these numbers over a short period is difficult.

It is in this context that the findings of the studies on lay counselling provide hope. They provide evidence that lay counselling works. It has resulted in remission in depression, decrease in suicidal thoughts and domestic violence among those who received the counselling. Additionally, it is a cost-effective intervention. The training is provided to the community workers over a period of a few weeks, which means it would be possible to staff primary healthcare facilities with trained counsellors in a short time. The government and NGOs working in the field of community and mental health should collaborate to train community workers. Once the system is in place, monitoring the work and updating the skills of lay counsellors is necessary.

Source: www.deccanherald.com      

24.12.2016

Lose as if you like it; win as if you were used to it

Tommy Hitchcock