New Delhi: Maharashtra’s Vidarbha, a region known for farmers ending their lives in epidemic proportions, is now experiencing a fall in depression thanks to Vishram (the Vidarbha Stress and Health Programme), a grass-root community mental health programme designed to address the mental health risk factors for suicide, including depression and alcohol use disorders in a predominantly rural population of 100,555 people in 30 villages in the Amravati district of Vidarbha.
According to the recent evaluation of the progamme, the prevalence of depression has fallen from 14.6 per cent to 11.3 per cent. The findings have been published in Lancet Psychiatry.
The programme, implemented over 18 months, was delivered by two NGOs (Prakriti, with technical support by Sangath), was evaluated by the Public Health Foundation of India (PHFI) and was funded by the Tata Trusts.
It was evaluated through a survey done and found that the prevalence of depression fell from 14.6 per cent to 11.3 per cent.
Significantly, there was a remarkable increase in the proportion of people seeking care. According to the lancet, the proportion of those with depression who sought care rose from just 4.3 per cent to 27·2 per cent, a six fold increase.
Importantly, the treatment access was equitably increased across caste, gender and social class. Even prevalence of suicidal thoughts in the past 12 months also fell from 5·2 per cent to 2·5 per cent. “A range of mental health literacy indicators showed significant improvement,” said the lancet.
The intervention-VISHRAM led by Indian psychiatrist Professor Vikram Patel. Professor Patel, winner of the Pardes Humanitarian Prize-involved three sectors: the community, existing front-line workers -ASHA workers, and worked with community to raise mental health literacy and provided psychological first-aid. The programme also included counsellors who provided psychological treatments in the community and even in the primary health care centers (PHCs). To further help those with suicidal tendencies, the experts indulged psychiatrists from the government’s District Mental Health Program and private sector, providing medication for serious mental disorders at the primary health care centres and rural hospital.
In previous years, the Vidarbha region of Maharashtra has reported a high prevalence of suicides in agricultural communities. A 2015 study conducted by VISHRAM found that 5.2 per cent of the population interviewed had thought of taking their life in the last 12 months. Out of these, nearly half (45.3%) also had depression. “VISHRAM is the first program in the region to have shown an impact not only on the increasing demand for care for depression but also a concomitant reduction in suicidal behaviour,” it further added.
Shockingly, one third of the global burden of mental illness falls on India and China, which is more than all high-income countries combined. Yet in both countries less than 1 per cent of the national healthcare budget is allocated to mental health care . The recent National Mental Health Survey in India reveaed that about 90 per cent of people with depression have not received any care in the previous 12 months. “VISHRAM, show the first evidence on how this massive treatment gap might be reduced,” said the lead author of the study, Dr Rahul Shidhaye, Associate Professor, PHFI.
