Reimagining Community Mental Health Care Services: Case Study of a Need Based Biopsychosocial Response Initiated During Pandemic.

Community mental health systems worldwide have undergone transformation in order to accommodate enormous demands of the pandemic and its mitigation efforts. The pandemic created unprecedented challenges that required Mehac Foundation (further referred as Mehac), a not for profit organization based in Kerala, to reassess our care delivery model. The aim of this report is to present a flexible, need-based biopsychosocial response; a case study effectuated by the Non-Governmental Organization (NGO) with a focus on minimizing the impact of COVID 19 on vulnerable communities, while adhering to timely regulations issued by the government. The key aspect of our biopsychosocial response was implementation of a phased approach that was rooted in real time need identification. The strategies will be described under broad headings of (i) adaptations for maintaining continuity of care, (ii) identifying vulnerable subgroups and need based psychological response, (iii) exploring social dimensions of the pandemic and implementing strategies to address them, (iv) ensuring team well-being and enhancing skills to effectively respond to the challenges.

Changes in intellectual and academic performance of children following computer-based training: Preliminary results.

BACKGROUND: The aim of this pilot study was to assess the effectiveness of a computer-based intervention on children who were average in academic performance. MATERIALS AND METHODS: Twenty-one children aged between 8 and 11 years, in classes 3(rd), 4(th) or 5(th) formed the sample with 12 in the experimental (who underwent the computer-based training) and 9 in the control group (who did not undergo the training). Pre- and post-assessment was done for all children using a battery of intelligence tests, and the marks obtained by the child at school. The difference in performance of the two groups was compared using the t test. RESULT: There was significant improvement within the performance of the experimental group in cognitive functioning (P<0.05) and school marks (P<0.05), as compared with the children in the control group. The limitations of the study include the small sample size, non-random allocation to groups and the (pre and post) assessments being carried out by the researcher. However, the trend of results is promising. CONCLUSION: Thus, a brief computer-aided intervention for improving neuropsychological functions such as attention and working memory has had a positive impact on the cognitive and academic skills of children who were average in scholastic performance.

A stress-coping model of mental illness stigma: II. Emotional stress responses, coping behavior and outcome.

Stigma can be a major stressor for people with schizophrenia and other mental illnesses, leading to emotional stress reactions and cognitive coping responses. Stigma is appraised as a stressor if perceived stigma-related harm exceeds an individual's perceived coping resources. It is unclear, however, how people with mental illness react to stigma stress and how that affects outcomes such as self-esteem, hopelessness and social performance. The cognitive appraisal of stigma stress as well as emotional stress reactions (social anxiety, shame) and cognitive coping responses were assessed by self-report among 85 people with schizophrenia, schizoaffective or affective disorders. In addition to self-directed outcomes (self-esteem, hopelessness), social interaction with majority outgroup members was assessed by a standardized role-play test and a seating distance measure. High stigma stress was associated with increased social anxiety and shame, but not with cognitive coping responses. Social anxiety and shame predicted lower self-esteem and more hopelessness, but not social performance or seating distance. Hopelessness was associated with the coping mechanisms of devaluing work/education and of blaming discrimination for failures. The coping mechanism of ingroup comparisons predicted poorer social performance and increased seating distance. The cognitive appraisal of stigma-related stress, emotional stress reactions and coping responses may add to our understanding of how stigma affects people with mental illness. Trade-offs between different stress reactions can explain why stress reactions predicted largely negative outcomes. Emotional stress reactions and dysfunctional coping could be useful targets for interventions aiming to reduce the negative impact of stigma on people with mental illness.

Dissociative fugue in the elderly.

Dissociative fugue is a rarely reported diagnostic entity. It is one of the least understood and yet clinically one of the most fascinating disorders in Mental Health. Here, we describe a case of fugue in a 62-year-old housewife who was brought to our hospital with pockets of memory loss. This case illustrates the need for timely referrals, which could channelize valuable professional time and help avoid expensive and unnecessary investigations.