Community workers help to bridge treatment gap in mental health | Rosalind Miller

Training

lay people can play a crucial role in helping to provide effective care for depression and anxiety in low-income, primary care

A report in The Lancet last year concluded that improving access to effective mental health could help alleviate poverty. Mental health is seen as a "priority development." But access to health care remains a major obstacle for many people in poor countries. While in Europe a third of people with mental illness are not treated in developing countries, the situation is much worse. In some countries, primary care is beyond nine in 10 people in need.

But the biggest test of psychiatry that occurred in the developing world, the intervention of Manas, shows unequivocally that the formation of the laity can play a crucial role in helping to provide care effective for depression and anxiety in disadvantaged areas of primary health care.

community health programs are not uncommon, and the judgment of Manas has applied similar principles, training people to provide basic care in their own communities -. A mental health

The randomized controlled trial was conducted in Goa, India, and has involved over 2,700 participants. After consultation with the community about the program (which led to some changes in how the issue was discussed - for example, depression is explained as a stress-related illness), local people, mostly women attended four weeks of training sessions to help manage depression, with an additional two weeks to cover specific disorders such as alcohol abuse. They are usually college graduates, although it is expected that community members with low educational level is used if the program develops.

After training, the community worker is based on the center of primary health care and works with a primary care physician, under the supervision of a psychiatrist. There are only 4000 psychiatrists in India, serving a population of 1.3 million. Change some aspects of care to non-specialists allows specialists to achieve higher population coverage. Centers of primary health care are also easily accessible and are far from the old psychiatric institutions are strongly imbued with stigma.

Professor Vikram Patel, a clinical psychiatrist and former Rhodes scholar, set the trial, which found that patients receiving care fell from 30% in common mental disorders and were less likely to attempt suicide. There was also a substantial reduction in the number of working days due to illness. Patel insists armies of mental health professionals are not required to provide care. Instead, he believes in "mental health for all and all."

"We need to train everyone to be able to understand the ways of common sense in which the former can promote their own mental health," mental health literacy, "he says." In Second, to provide mental health care when someone close to them is in a crisis, "with the mental health first," and, thirdly, the level of professionalism, use of workers Health to provide health care for people with minds of mental illness.

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