Community Mental Health Campaign
Sangaria (Raj.)

Community Mental Health Campaign is a comprehensive community based mental health programme in block Sangaria of District Hanumangarh in Northern Rajasthan. Started in 2011, the programme has goal of reducing treatment gap for mental disorders by improving treatment seeking behaviour of people in the area and by ensuring affordable mental health services in the area. The programme aims at enhancing mental health awareness of the people, reducing stigma against mental illness, and building capacity at primary health care level by providing training to physicians, community health workers and other health care providers. A monthly mental health consultation camp is also organized to provide free consultation to mentally ill people of the area. By the end of 2017 , about5000 patients have been benefitted in these camps. it has been continuously serving not only the people of Sangaria and surrounding villages but from the faraway places in Rajasthan, Punjab and Hariyana. Currently into its eight year, the programme is perhaps the longest community based mental health programme in non-government sector in Rajasthan and one of such kinds in India. The programme was started as a part of the project awarded under Humphrey Allumni Impact Award to Dr Dhanesh Kumar Gupta in the year 2011 and was continued under the auspices of Nishkam Foundation since 2012. The campaign has been sustained so long without any support from pharmaceutical or health care industry, or from government grants. It continues to gain momentum as a result of growing public response, incessant enthusiasm of volunteers and support of donors from the local community. A number of local organizations and regional institutions, including a medical college in the region, are collaborating with Nishkam Foundation in this Campaign. More than 100 Nishkam Sewaks and a dozen of organizations in the area have virtually turned hundreds of people into mental health campaigners.

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Overall Goal

To reduce the Stigma and treatment gap associated with mental disorders and drug abuse problems.

Objectives

  1. To enhance community awareness about mental health and drug abuse problems in Sangaria
  2. To bring about improvement in treatment seeking behavior of people in Sangaria for their mental health and drug abuse problems
  3. To train general practitioners of Sangaria in the diagnosis and treatment of mental disorders and drug abuse problems
  4. To train community health workers in identification, referral and follow-up of patients with mental disorders and drug abuse problems in Sangaria.
  5. To train non-formal health care providers in Sangaria in identification and referral of patients with mental disorders and drug abuse problems.
  6. To train community volunteers to work with health care providers for psychosocial rehabilitation of patients with mental disorders and drug abuse problems in Sangaria
  7. To sensitize the pharmacists and owners of medical stores in Sangaria about psychotropic medicines and to improve drug dispensing of these medicines.
  8. To provide treatment for selected mental disorders and drug abuse problems at primary health care level in Sangaria, with referral and support services of a psychiatrist at secondary health care level.
  9. To study the community processes occurring during the implementation of the project, such as community mobilization, community participation, community ownership, community resource utilization, community networking, community innovativeness, intra- and inter- community catalytic and cascade effects, generalization within and beyond community.

Launch Of The Project

Project was launched on 15th and 16th January 2011 in two steps-

  1. Inauguration of the program- The program was inaugurated by Mr Bharat Ram Meghwal, the honorable Member of Parliament from local constituency, Sriganganagar, on 15th January 2011 at Vriddhasharam (an old age home run by Samaj Sudhar Manch, a lead collaborator of Nishkam Foundation) Sangaria. Other prominent local officials and leaders were also present. A gathering of about 120 people including community leaders, community volunteers and media people attended the inauguration ceremony. A Mental Health Awareness Exhibition was also inaugurated on the same day. The inauguration ceremony was followed by a sensitization workshop with community leaders and with community volunteers.
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  2. Inauguration of Training Programs for Community Health Workers (CHWs) and General Physicians (GPs)- On 16th January 2011 the training program for CHWs and GPs was inaugurated by Dr Jyoti Dhingra, the Block Chief Medical Officer of Sangaria. The Officer In-charge of Community Health Center, Sangaria and the Vice President of Indian Medical Association- Sangaria branch and the Vice-Chairman of Municipal Board Sangaria were also present, along with about 100 people including CHWs, nursing students, principals of local teaching institutions and media people. The introductory training session was conducted separately for CHWs and GPs. Their responses on Training Need Assessment Questionnaire were discussed with them during the session and the subsequent training programme was modified based on trainees’ feedback.

Three Components of the Campaign

The Community Mental Health Campaign has three main components:

  1. Mental Health Awareness (Maansik Swasthya Jagrukta)
  2. Community Capacity Building for Mental Health (Maansik Swastha Prashikshan)
  3. Mental Health Services (Maansik Swasthya Sewa)
A. Mental Health Awareness (Maansik Swasthya Jagrukta)

Enhancing awareness about mental health is the first step in changing people’s attitude towards mental illnesses and changing their help seeking behaviour for their mental illnesses and drug abuse problems. A variety of activities and programmes have been organized in the villages of block Sangaria since January 2011. These activities include monthly mental health awareness exhibitions at the free consultation camps, awareness raising visits to the villages, mental health messages broadcasted on local cable TV channel and displayed at the health centres and general practices, mental health exhibitions and movie shows in villages, including during socio-cultural festivals and fairs. A 50-minutes movie on mental health awareness titled ‘Man Ke Darpan Mein’ has been produced in the community through community resources and has been shown at over 30 occasions at different places since October 2011. Awareness workshops and seminars have been organized in schools and colleges to raise mental health awareness among the youth. Nishkam Mental Health Week is celebrated every year in October during which focused and intensive awareness activities are organized in the area.

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B. Capacity Building for Mental Health:

Capacity building activities include training programmes for various groups of health care providers and community volunteers and sensitization workshops with community leaders. The training activities for general physicians have been carried out in collaboration with Sangaria branch of Indian Medical Association. So far 13 sessions have been carried out. The community health workers working in state government’s health centres in villages of Sangaria have been provided 6 sessions of training. Local health care providers, faith healers, chemists/pharmacists are the other groups of trainees. Sensitization workshops have been organized for community leaders (Sarpanches, the village heads and Ward Members of Sangaria). The aim of capacity building is to guide mentally ill people in the treatment process and provide treatment for common mental disorders in Sangaria through trained general physicians.

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C. Mental Health Services:

Free consultation to patients with mental illnesses and drug abuse is provided in mental health service delivery camps organized in Sangaria every month since February 2011. Psychiatrists affiliated with Nishkam Foundation and from Sardar Patel Medical College Bikaner and Tek Chand Memorial Psychiatric and Deaddication Hospital SriGanganagar provide their services free of charge to the patients coming not only from Sangaria and surrounding villages, but also from neighboring blocks and districts. Currently the camps are organized at Seth Shri Sita Ram Sahuwala Charitable Trust Dharmshala. About 4000 patients have sought treatment in 45 camps organized till December 2014. While many of these patients were advised to follow-up with their family physician (GP) or psychiatrist, others preferred to continue follow up in the subsequent camps. Some of the patients having neurological problems (other than epilepsy) are referred to neurologist in the regional medical college in Bikaner, about 250 km from Sangaria and patients with multiple co-morbidities are referred to medical college hospitals in Rajasthan or Delhi. Volunteers of Nishkam Sewa Smiti Sangaria and the other collaborating organizations manage these camps.
Some of severely sick patients are also provided service through home visits in the community.

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Success Stories

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Activities under Community Mental Health Campaign Sangaria at a glance

S. No. Type of Activities Description of Activities No. of sessions
Till Dec'2017		 Attendance at sessions
Till Dec'2017
1. Capacity building
  1. Sensitization workshops for community leaders.
  2. Sensitization workshops for volunteers.
  3. Training program for Community Health Workers*.
  4. Training program for Local Health Care Providers.
  5. Training workshop for pharmacists/ chemists.
  6. Training program for General Physicians.
  7. Workshop with Dentists.
  8. Sensitization workshop for school teachers.
  9. Exploratory workshop with local spiritual leaders and faith healers.
  • 6
  • 14
  • 13
  • 4
  • 5
  • 13
  • 1
  • 4
  • 1
  • 105
  • 298
  • 650
  • 70
  • 107
  • 184
  • 7
  • 303
  • 15
2. Awareness
  1. Monthly mental health awareness exhibitions at camp site
  2. Mental Health Awareness Exhibitions and Movie shows in villages and
    Sangaria town
  3. Mental Health Awareness Rallies during Mental Health Week
  4. Painting Competitions for school children during Mental Health Week#
  5. Movie broadcast through Local TV Cable
  6. Personal contact programme through village visits
  7. Mental Health Awareness Education in religious programmes in villages
    and Sangaria town.
  • 74

  • 65
  • 16
  • 27
  • 12
  • 110

  • 11
  • 14800

  • 35000
  • 2400
  • 1270
  • -
  • 6300

  • 15000
3. Patient Care Monthly free patient consultation camps. 78 10039

* 24 student nurses also attended the first sessions
# Prizes given to 300 children of different age groups