A Distinctive Treatment Model

Dr Manoj Kumar quotes eminent psychiatric researcher Vikram Patel, “Mental health care is too important to be left to professionals alone. We need to deliver [mental] health care using whoever is available and affordable in our local communities.” At Mental Health Action Trust, a similar treatment model is followed, based on task-sharing, modern technology and decentralisation. In this way, Dr Kumar is reducing the cost per patient by up to 70% in a year. Task-sharing is a well-known international concept in the field of community healthcare. Dr Kumar explains, “If all the care is actively provided by professional psychiatrists alone, there will never be enough of them to ensure comprehensive care to the patients. So in task-sharing, the psychiatrists and clinical psychologists attend only the critical patients with complex issues. Alongside, they train and supervise young doctors and non-medical volunteers to handle the recovery and rehabilitation process.”

MHAT works together with Palliative Care Centers, Primary Health Centers and other civil society organisations to create more widespread awareness about the importance of mental health. Community centres are set up where people attend to get cost-effective treatment and advice. Local support partners are assigned to carry out regular home visits for psychosocial therapy, talking to the patient’s family and forming small self-help groups. These volunteers include homemakers, shopkeepers, rickshaw-pullers, tea-sellers or farmers, each of them contributing in one way or the other.

Tele-psychiatry is another exciting aspect where licensed psychiatrists interact with a patient through video conferencing and prescribe the basic medicines. The patients generally come with serious problems like bipolar disorder, severe depression, schizophrenia, intellectual disability and other psychotic issues. At the initial stage, medication is required to control the symptoms. So a proper sequence of diagnosis, prescription and arrangement for free treatment has to be maintained.

Once a patient recovers, they are offered effective counselling, rehabilitation and even vocational training at times, to give them a chance at a happy, satisfactory life. Mental Health Action Trust also delivers financial support including food and housing expenditure to many patients’ families. Today Mental Health Action Trust is working across five districts of Kerala in about 55 community groups taking care of over 4000 patients. This community treatment model devised by Dr Manoj Kumar has been applauded nationwide and earned him a place among the prestigious Ashoka Fellows.

Overcoming Hurdles and Winning People’s Trust When the organisation started in 2008, finance was a major challenge. They did not receive enough funding due to lack of recognition. However, once a few patients were successfully cured, word started spreading, and soon they earned the trust of the local people. Mental illness slowly ceased being a taboo as more and more locals started coming in. So MHAT not only cures patients and helps them integrate into the mainstream society, but also has been successful in eradicating the stigma surrounding mental health.

Overcoming Hurdles and Winning People’s Trust When the organisation started in 2008, finance was a major challenge. They did not receive enough funding due to lack of recognition. However, once a few patients were successfully cured, word started spreading, and soon they earned the trust of the local people. Mental illness slowly ceased being a taboo as more and more locals started coming in. So MHAT not only cures patients and helps them integrate into the mainstream society, but also has been successful in eradicating the stigma surrounding mental health.

An Important Message For Everyone “Mental health care should not be something which only specialists can deliver. Everybody can be involved in it. You don’t need to be a professional to provide mental health care,” says Dr Manoj Kumar. He insists that certain changes should be achieved to provide mental health treatment on a large scale to poorer people. “Firstly, treatment should be free of cost. Secondly, we need to make a transition from institution-based treatment to community-based care. We should shift the focus from medication to a complete recovery, and start actively including non-professionals as well.” Then only, he feels, a positive change can happen to the mental health situation in India.