A Community Participation Initiative During COVID-19 Pandemic: A Case Study From India.

BACKGROUND: A community participation initiative of stitching personal protective equipment (PPE), masks, and face shields for healthcare professionals working in the hospital during the COVID-19 pandemic was conducted using a case study design. METHODS: The hospital tailoring unit was used to cater to the in-house demand for stitching safety gear kits for healthcare professionals. A transect walk was conducted to survey hospitals for selecting material for stitching the safety gears and to draw up a plan to meet future demand. The psychiatric social worker induced a community participatory initiative using the method of social work of community organization. A flyer was prepared to invite participants with prior experience in tailoring for this initiative. All participants were trained by the master trainers of the tailoring unit. The participants were also interviewed about their views on this initiative in an informal interview. RESULTS: A total of 83 participants, including 26 individuals (8 volunteers and 18 who received an honorarium), 2 boutiques (n = 12), and 1 government organization, participated in the activity (n = 45). A total of 1700 complete PPE kits and 13,000 masks were stitched during this period. The participants reported that the benefit of being a part of this initiative was reduced boredom, sense of purpose and satisfaction, and improved mental health due to structured activity. CONCLUSIONS: A community participation initiative using the principles of community organization, a method of social work, can help produce desired outputs and improve the well-being of the participants.

A proactive approach: Examples for integrating disaster risk reduction and mental health and psychosocial support programming.

Natural disasters and humanitarian emergencies exert devastating impacts globally. Among these effects are disruptions in mental health and psychosocial well-being. Traditionally, mental health and psychosocial support (MHPSS) interventions have been implemented in response and recovery phases. Yet, the field of disaster management has demonstrated a shift towards disaster risk reduction (DRR). The degree to which the MHPSS field has followed this trend has been limited by several factors, including a lack of consensus-based guidance for MHPSS and DRR integration. However, examples from the field exist and demonstrate the feasibility of taking proactive approaches to supporting mental health and well-being and building better before emergencies occur. The following article outlines two case examples, one project in Sierra Leone and another in India, integrating MHPSS and DRR approaches and principles. Lessons learned from these cases and specific challenges in each context are highlighted and discussed.

Crossing barriers: Role of a tele-outreach program addressing psychosocial needs in the midst of COVID-19 pandemic.

Novel Coronavirus disease 19 (COVID 19) pandemic has affected more than 2 million individuals and causing over 0.1 million deaths worldwide. In India, the pandemic has gained momentum in the last few weeks with over 10,000 cases and 400 deaths. In the absence of any pharmacological cure on the horizon, countries have resorted to the use of strict public health measures to curtail spread of further infection to fight the coronavirus. The pandemic and its social implications have triggered mental health concerns among the masses. Providing psychological first aid and psychosocial support is vital in mitigating the distress and enhance the coping strategies of people to deal with this biological disaster. Tele-mental health services play an important role in this regard. In this article we describe our preliminary experience in understanding the psychological concerns of general public and addressing them by providing psychological support through a national telephonic helpline.

Uttarakhand Disaster 2013: A Report on Psychosocial Adversities Experienced by Children and Adolescents.

OBJECTIVE: To report the psychosocial adversities faced by children and adolescents in the Uttarkashi, district of Uttarakhand, experienced immediately after the Himalayan Tsunami in June 2013. Also to discuss issues pertinent to the disaster management including the needs of the disaster affected areas and future challenges. METHODS: This is a cross sectional observational report from the community assessment and interventions that were carried out as part of the disaster relief work by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore within 1 mo of the disaster. Assessments and interventions were done by a team consisting of psychiatry resident, clinical psychologist, psychiatric social worker and a nurse. All diagnosis were made using International Classification of Diseases 10 (ICD 10) and the data was analysed using descriptive statistics and chi-square tests. RESULTS: A total of 300 children were screened; the mean age of the sample was 11.5 y and 65(32.5%) were boys. Two hundred (66.7%) children/adolescents reported one or the other psychosocial adversities attributable to the disaster. Psychological distress was present in 54/300 (18%) of the individuals. Loss of shelter and loss of playing space were the social issues having a statistically significant association with psychological distress signals such as feelings of anxiety, helplessness, insecurity, grief and uncertainty. Stress induced diagnosable psychiatric disorder was not present in any child or adolescent, however stress related psychiatric symptoms were present in around 13%. CONCLUSIONS: Himalayan tsunami of Uttarakhand in 2013 was associated with considerable psychosocial adversities among the resident children and adolescents. As children are a vulnerable population, a public health approach towards assessment and management of the psychosocial adversities in this population is urgently required at the state and national levels.

Psychiatric and medical disorders in the after math of the uttarakhand disaster: assessment, approach, and future challenges.

PURPOSE: To present the descriptive data on the frequency of medical and psychiatric morbidity and also to discuss various pertinent issues relevant to the disaster management, the future challenges and psychosocial needs of the 2013 floods in Uttarakhand, India. MATERIALS AND METHODS: Observation was undertaken by the disaster management team of National Institute of Mental Health and Neurosciences in the worst affected four districts of Uttarakhand. Qualified psychiatrists diagnosed the patients using the International Classification of Diseases-10 criteria. Data were collected by direct observation, interview of the survivors, group sessions, individual key-informant interview, individual session, and group interventions. RESULTS: Patients with physical health problems formed the majority of treatment seekers (39.6%) in this report. Only about 2% had disaster induced psychiatric diagnoses. As was expected, minor mental disorders in the form of depressive disorders and anxiety disorders formed majority of the psychiatric morbidity. Substance use disorders appear to be very highly prevalent in the community; however, we were not able to assess the morbidity systematically. CONCLUSIONS: The mental health infrastructure and manpower is abysmally inadequate. There is an urgent need to implement the National Mental Health Program to increase the mental health infrastructure and services in the four major disaster-affected districts.

Mental Health Aspects of HIV/AIDS - Indian Perspective

India is a country with low HIV prevalence, yet, has the third largest number of people living with HIV/AIDS. An estimated 2.39 million people live with HIV/AIDS with an adult prevalence of 0.31%. The estimates highlight an overall reduction in adult HIV prevalence, incidence and AIDS related mortality in India (NACO, 2011). Psycho-social factors that impinge upon HIV progression include emotional well-being, stressors, coping skills and psycho-social support. The multi-centric study by NIMHANS supported by NIH highlights the effects of HIV stigma leading to mental health consequences like loss of self-esteem and self-worth. It is imperative to address stigma to improve the quality of life of PLHIVs (Ramakrishna et al., 2010). The frequency of AIDS Dementia Complex has declined to less than 20% and is seen in 1-2% of persons on HAART in India (Satishchandra et al., 2000). The mental health conditions seen at the NIMHANS HIV Clinic include depression being the commonest and its lifetime prevalence going upto 60%. Anxiety disorders are also common conditions among PLHIVs with around one-third having feature of it. Delirium has a prevalence of 40-60%. Psychosis is less common, but occurs in 4-10 % of PLHIV. Sleep disorders and Suicidality are commonly reported in the above diagnoses (Prabhachandra, 2011). Sexuality minorities being special groups have special mental health needs and are subject to immense marginalization. LGBT people are at higher risk for depression, anxiety, and substance use disorders (Ranade, 2003). The use of any mind altering substance causes serious problems to a person‟s physical and mental health as well as to the family (Prathimamurthy, 2011). Given this close intertwining of multiple factors in PLHIVs, a psycho-social model of care was developed by NIMHANS to address the mental health needs of PLHIVs through a cascading capacity building through training of trainers to train professional and lay counsellors. The capacity building kit has been standardised through the process of training Master Trainers for the countr