Unique collaboration of modern medicine and traditional faith-healing for the treatment of mental illness: Best practice from Gujarat.

BACKGROUND AND AIMS: Modern psychiatry brings tremendous value to the treatment of mental illness, however, at times is inadequate in providing holistic care within a patient's broader cultural framework. Traditional healing and modern psychiatry together offer a comprehensive, patient-centred approach to treatment, which encompass a patient's spiritual and religious beliefs. In this context, "Dava-Dua" intervention-combination of psychiatric medicine and faith healing-is implemented by the Government of Gujarat at Mira Data Dargah in Mehsana District. The study assesses intervention outcomes, understand implementation challenges and patients' perspectives on the treatment. METHODS: Using a multi-method research approach, case records from July 2008 to March 2018 were retrieved for secondary analysis of patients' profile and outcomes; 26 patients from three groups: Dava, Dua and Dava-Dua; and 6 mental health service providers were interviewed to assess perspectives of patients and service providers on mental health, implementation barriers and facilitators. RESULTS: Despite some implementation challenges, the findings indicate that collaboration of modern psychiatry medicine and faith-based treatment practices certainly benefit patients with otherwise limited access to mental health care thereby protects human rights of patients. CONCLUSION: Dava-Dua model compliments existing primary healthcare services. It provides an access to modern medicine without compromising patients' religious and spiritual practices. It has the potential to scale-up and replicate where faith-healing is the prime treatment modality to cure mental illness provided implementation challenges are proactively addressed.

Psychosocial rehabilitation of people living with mental illness: Lessons learned from community-based psychiatric rehabilitation centres in Gujarat.

INTRODUCTION: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. AIMS: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. MATERIALS AND METHODS: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. RESULTS: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. CONCLUSION: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up.