Helpful Role of Community Based Approach in Improving Mental Health  in Remote Rural Areas

Mental Health

          In recent times of Covid-19 the importance of giving adequate attention to mental health has been re-emphasized time and again. Here again, however, the new and welcome phase of giving more emphasis to mental health has not yet reached the more remote rural areas. However those with long experience of working on mental health in remote rural areas say that the problem of mental health can be very serious  even in very remote villages.

Another welcome aspect of the recent discourse on mental health in India has been that the significance of a community based response is being increasingly recognized in India. Again it needs to be asserted that this is even more true in the context of more remote rural areas where this can be the most relevant approach. This has also clearly emerged from the experience of those who have worked with dedication on the issue of mental health in remote villages for a long time.

Girija , popularly known as Girija Sir, is one such experienced social worker of Jharkhand and Bihar. He says, “ When our activists reached remote villages to identify and contact those with mental health problems and their family members, they were surprised regarding how long their serious problems had not received any attention at all. In fact in several cases the only treatment and attention had been in terms of superstitious practices.”

Along with his friend and colleague Satish, Girija  has been involved closely in an extensive program of mental health in these two states based on community approach. They together coordinate the work of Nav Bharat Jagriti Kendra ( NBJK ) which along with several sister organizations implemented a community based project on community health with special emphasis on remote villages.

The efforts of NBJK efforts along with the efforts of its sister organizations during the last 15 years or so have brought relief to a large number of mental health patients and their family members in parts of Jharkhand and Bihar.

These efforts were made by the NBJK and its network of 20 organizations under a decade long project. However, even after the financial support for the project ended, keeping in view its social usefulness and appreciating its need by people, the NBJK continued some aspects of this work using its own meager resources.

The importance of this work increased all the more due to the earlier neglect of mental health issues particularly in rural areas. Despite the existence of a well-equipped mental health institute in Ranchi , people in remote villages did not have access to essential information on this issue and felt helpless if one or more persons in the family suffered from mental health. This led to much distress and also to neglect of important remedial action.

The mental health programs of NBJK and associated organizations took essential information regarding remedial action and treatment to many remote villages of Jharkhand and Bihar. A much larger number of people started coming forward for the treatment of mental health problems. The seriousness of the problems faced by people with mental illness and epilepsy got highlighted at a wider level so that these issues can get the proper attention in state-level policy making.

As people became better aware of proper treatment, they were able to increasingly come out of the grip of superstitions. However the difficulty of taking patients to far away hospitals remained. To overcome this problem, special camps were organized by NBJK and collaborating organizations. The large number of people who came to these camps indicated the extent to which these serious problems need to be addressed in these villages.

Community based rehabilitation was emphasized in this effort which is really the need for  these remote villages. People felt a big sense of relief when instead of taking suffering family members to far-away hospitals, they could see a significant improvement in their conditions as a result of community based efforts and special camps organized close to their villages and linked to these community efforts.

Important learning experiences were emerging from these efforts, but these suffered after the decade long project ended. However keeping in view their usefulness, the NBJK somehow continued to organize some camps for people suffering from mental health illness and epilepsy. Efforts to link rehabilitation to strong self-help groups in these villages  also led to their sustainability.

This programme also proved to be a good example of how activists and members of various small organisations could cooperate with a bigger and more experienced organisation (NBJK) to take a badly needed programme to a much wider area.

This programme also made efforts for policy changes which can be more helpful for mental health patients. Keeping in view the several good results of this programme and the valuable experience gained by many activists in the course of implementing this, there is a need to implement a second phase of this programme. As a lot of experience has already been gained , this new phase can be used in an even better way for drawing wider lessons and more care can be given to this aspect from the very beginning. More such programmes are clearly needed, but it is important to remember that only those organizations with pre-existing strong  community areas can be expected to succeed in the context of this rather sensitive area of social work.

Bharat Dogra is a journalist and author who has been involved with several social movements.



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