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Mental health

Is technology the way forward for addressing mental health among youth?

Varalakshmi Vemuru's picture
After an accident at his workplace, Bhoomi, a 26-year-old from rural Tamil Nadu, India, lost interest in work and isolated himself from everyone. His neighbors were at a loss to understand the change in his behavior. He was labeled a “lunatic,” which worried his parents and propelled them to seek help.
 
Mental illness or disability can be a debilitating experience for an individual as well as his or her family. People not only have to deal with the physical and biological impacts of an illness, but also with the social and cultural stigma that accompanies it.
 
This was what Bhoomi and his family went through before they benefited from the Tamil Nadu government’s Mental Health Program (TNMHP).

The unheard voices of women caregivers for people with mental illness

Varalakshmi Vemuru's picture
SHG meeting of people with mental illness and caregivers. (Photo: TNMHP)

Thirty-year old Vijaya (name changed) spent 10 years of her life not talking to anybody. Her parents were daily wage laborers, scraping together a sparse living in India’s southern state of Tamil Nadu. Unaware of any treatment, and afraid of being stigmatized or shunned by their community, they did not disclose their daughter’s illness to anyone. Instead, Vijaya suffered in silence, confined to the house, and hidden from public view.
 
It was only when the Tamil Nadu government’s Mental Health Program (TNMHP) reached out to their community that Vijaya’s life underwent a dramatic change. After six months of working with the program’s community facilitators, Vijaya’s parents took her for treatment, and within a year, the young woman began interacting with others more frequently.
 
Poor mental health places a huge burden on individuals, families, and society. From developed countries to emerging market economies, mental disability – ranging from common mental disorders such as depression to severe mental illnesses and retardation – has profound impacts on people’s economic and social well-being.
 
As cited in “Out of the Shadows: Making mental health a global development priority” in 2010 alone, depression cost an estimated US$800 billion in lost economic output. What’s worse, these costs are expected to double by 2030.
 

Dawa-Dua: How medical treatment complements prayer for people with mental illness in India

Varalakshmi Vemuru's picture
Devotees at Erwadi Dargah (Photo by DMPH Erwadi)
Devotees at the Erwadi Dargah in Tamil Nadu, India. (Photo: DMPH Erwadi)
Last month I blogged about how mental illness is curable, treatable, and preventable. Today, let me take you to a town in Tamil Nadu called Erwadi, where faith and medicine now go hand in hand to address mental illness.
 
Erwadi is known for its 550-year-old Badusha Nayagam Dargah—“Erwadi Dargah,” one of the biggest shrines in India. Every day, numerous devotees of different faiths visit the shrine from surrounding villages, states, and countries. Among these visitors is a large number of people who suffer from mental illness and have come to pray for a cure. Some of them see the Dargah as their first and only hope—guided by the magico-religious belief that illness is caused by the possession of evil spirits or the performance of wicked magic—while others have turned to the shrine as a last resort after receiving ineffective treatment.
 
When I visited Erwadi Dargah in 2013 and met with a team working on a local program called District Mental Health Project (DMHP), an important partner of the World Bank-supported Tamil Nadu Mental Health Project, they expressed an urgent need to help the devotees affected by mental illness. Their subsequent discussions with representatives of the shrine revealed a lack of information on potential treatment options and strong resistance to medical interventions among the devotees. At that time, the team knew of a similar circumstance in another part of India—the state of Gujarat—so they invited the representatives of Erwadi’s religious community to learn from peers in Gujarat about complementing religious rituals with medical treatment.
 
And thus started a unique experiment called “Dawa-Dua,” or prayer-treatment.

Mental illness is curable, treatable, and preventable: a story of hope from India

Varalakshmi Vemuru's picture
On World Mental Health Day, here’s a fact to reflect on: people with mental illness are among the socially excluded and marginalized groups in society. They are often misunderstood, ignored, or simply invisible.
 
In India alone, an estimated 70 million people—or 5% of the population—suffer from mental illness. The southern state of Tamil Nadu, for instance, has one million people living mental disorders—about 3-5 cases per village. Meanwhile, the country faces a severe shortage of psychiatrists and psychiatrist nurses, and clinical care is scarce in rural India. Due to deep social stigma related to mental illness, such serious issues are largely invisible at the community level.

That’s why, in 2012, we launched a comprehensive social and clinical care program with the government of Tamil Nadu to inform and educate local communities on mental health issues, as well as to encourage families and people affected by mental illness to seek treatment. Working with leading local health practitioners, we based the campaign on a core message that was simple, powerful, and resonated with the community:
   
Through a poster on do’s and don’ts of addressing mental illness, the campaign advised the community to
1) seek help from a psychiatrist, 2) start medication, 3) attend counseling sessions, and 4) join self-help groups. (Image: TNEPRP / World Bank)

Capitalizing on the Demographic Transition

Michael Engelgau's picture

For decades, the leading causes of mortality have differed between low income countries and high income countries. Those who have worked their careers in health and development probably never thought they would see the day when maternal/child health and communicable diseases would not be the leading health burden in many low income countries.

The new actor is non-communicable diseases (NCDs), which are characterized by chronic diseases (cardiovascular disease, diabetes, cancer, and chronic respiratory disease), along with injury and mental health which are now responsible for half the health burden in South Asia. Thus, the challenge now is how best to juggle this “double burden”.

Currently, many compelling reasons are pushing countries toward starting to tackle NCDs. From both a social and political standpoint, South Asians are 6 years younger than those in the rest of the world at their first heart attack. This type of trend threatens a country’s ability to fully capitalize on the demographic dividend from a larger mature working force because healthy aging is necessary, which in turn, requires tackling NCDs.