2018; Volume 19, No 8, August
Featured Article
Recently, we asked IAHPC Board Members to address one topic. Here is Dr. Chitra Venkateswaran’s response to ‘What I learned this past year that helped transform me professionally.’
Diversification & Partnerships Improve Mental Health Care
By Chitra Venkateswaran
Dr. Chitra Venkateswaran (4th from left), Clinical Director of Mehac Foundation, with staff.
Learning, as we know, has no end. When we set up the not-for-profit Mehac Foundation nearly a decade ago, our initial focus was to evolve long-term care models for mental health based on the widespread community-oriented palliative care movement in the South Indian State of Kerala. Kerala is known for its impressive social indices and social awareness, so the initiatives have many stakeholders.
We incorporated mental health care pathways in existing palliative care services and sought to build robust clinical services structures. This past year, we recorded significant growth not only in our clinical services but in other, diverse directions, in keeping with the dynamism that stakeholders demanded from us.
Enhancing mental health literacy
These included initiatives to enhance mental health literacy in the community. Though still evolving, mental health literacy is known to have positive health outcomes. We realized that along with clinical models, which were the priority, we needed to initiate specific awareness sessions directed to certain sectors of the community to increase general knowledge of mental illness, and how to access community-based services. This was needed to help close the gap between the prevalence of need and access to care, which remains huge, in part because of the stigma of having a mental illness.
Empowering long-term caregivers
Training the staff of government and quasi-government health systems, social work bodies, and volunteers working in the health sector was done with specific modules for each group, in interactive formats using narratives and the discussion of cases. This was integrated with palliative care training, the aim being to empower these people to provide long-term care to people with chronic illnesses, including mental illness.
We were able to address important social indicators, like suicide, through programs in schools for students (Kerala’s suicide rate is very high among young people), where we also raised student awareness regarding social responsibility.
Helping vulnerable women help themselves
A social enterprise for vulnerable women with mental health needs was also begun early this year, with volunteer participation. People disempowered by their experience of mental illness and poverty are empowered, through community-based, self-help support, to lead productive, positive lives. The result is opportunities for income generation or participation in productive work, thereby enabling the women to recover and reintegrate into society.
Partnerships + collaboration = sustainability
What I learned from all this is that, in the present socio-political scenario, sustainability and scaling up can be catalyzed by partnerships and collaboration. Our main agenda, to establish partnerships, led to positive outcomes influencing fundraising, networking, and programs with a range of partners: not-for-profit bodies; corporations; government agencies, such as Panchayats (local councils); the National Health Mission; health volunteers; and community-based social bodies, such as Kudumbhasree and Anganwadi.
A success story
For example, we teamed up with both a corporate and a governmental agency to facilitate raising funds to train doctors, nurses, and accredited social activists (ASHA) of the National Health Mission. Our success led to the next phase, empowering ASHA volunteers to visit 25,000 homes to deliver mental health information, including how to identify people with issues. A third phase followed — the training of Anganwadi (a type of rural mother-and-child care center in India) staff. Anganwadi centers, part of the national health care system, typically provide basic health care in villages, including contraceptive counseling and supply, nutrition education and supplementation, and preschool activities. Staff members then educated 25,000 mothers about mental illnesses in children and post-partum disorders. The fourth phase, now being planned, is to create a network of volunteers who will learn about palliative care and mental health.
These new developments meant growing not only in areas of our primary goals, but also in terms of sustaining our clinical work with collaborations that advance research and education. These partnerships have enabled others to learn about the philosophy of palliative care philosophy, and work collaboratively in an environment of mutual learning and mutual respect. Together, we strengthen efforts to strive together to help people who suffer in our communities.