Innovation details
This innovation works with community mobilizers and change agents to facilitate access to both mental health and social care which has the potential to:
- Reduce the treatment gap
- Increase the overall livelihood of the individual and family/caregivers
- Contribute to a higher quality of life
Methodology
This innovation adopts a quasi-experimental field trial approach; it is implemented in 41 villages in a rural area of Maharashtra through trained community mobilizers from community based organizations such as self help groups (SHG) and farmers clubs (FC).
Formative Research
15 in-depth interviews and 10 focus group discussions with the community will inform the needs of the population. This will serve as a way to grasp the constructs, lexicon and patterns of wellbeing, mental health and social determinants of health, resulting in a culturally appropriate needs-based intervention.
Training
Self Help Groups and Farmer’s Club leaders
The training programme will be similar in content to Australia’s Mental Health First Aid, in that it mobilizes community members to identify and detect mental illness, and equips SHGs with the ability to differentiate common mental health disorders (CMHD) from serious mental illness (SMI). All training will be delivered in the local language (Marathi).
The training provides skills on:
- Counselling for someone with a mental health problem (basic supportive counselling skills)
- Facilitating access to social care benefits
- Referral and follow-up techniques
The training takes a rights based approach by enabling the leaders to understand and recognise the right to health, inclusion in the community and access to community based services; in addition to the right to freedom from abuse and human rights violations. As access and entitlement to social benefits for people with mental health problems is a major and crucial part of the program, community mobilizers will aid in ensuring that all people consulted are empowered to access the benefits.
These community mobilizers are voluntary workers; most of them are leaders of self help groups or farmer’s clubs and we call them ‘champions’.
NGO and PHC staff (Doctors and Social Workers)
Doctors and social workers posted at the NGO (BAIF) centre in Peth will also receive training on identification, referral and social care benefit. PHC staff will receive training for the identification and treatment of CMHDs, as well as follow up for SMIs and referral to the district hospital.
Use of Technology
ATMIYATA utilizes high-impact emerging technologies (mobile IT) as a training tool. All the main information that the community mobilizers require will be uploaded on the smartphones for use during training and identifying mental health problems. Content will include information on wellbeing, detection, referral and follow up with several films, including:
- A ‘role model’ film showing local community members accessing care and support
- A community-oriented film on acceptance and support for people coping with mental distress and illness, detection and referral; and includes myth-busting in the form of frequently asked questions (FAQ’s) with a psychiatrist in the local language
- A film asking “what can you do?”
Target Population
The ATMIYATA intervention targets three populations experiencing varying levels of mental distress through community based organizations supported, referred, and followed up by trained community mobilizers:
- People with emotional distress and stress
Identified community mobilizers will support people with emotional distress and stress so they (and their families) can better cope with stress. This level of intervention is necessary as a prevention measure for the development of CMHD and SMI.
- People with common mental health disorders
The community mobilizers in 41 villages will be trained to detect, refer and follow-up with people with CMHDs. Basic supportive counselling and active listening skills will be provided.
- People with serious mental illness
Access to treatment for SMI at both the primary healthcare centre and district hospital levels will be facilitated.
The care and referral pathway is based on a stepped care approach, stepping up care as a client has a need for more intensive services. Community mobilizers provide basic community-care, and specialist care is provided by the government-funded public health system.
Community Activities
Awareness activities in the community will include role play, posters, events at local colleges, and community addresses. NGO staff and community mobilizers will lead these activities. The purpose of these activities is to raise the awareness of mental illness within the community.
