First of its kind round table on mental health of scheduled tribe communities
The round table meeting was hosted on 28th August 2017 by The George Institute for Global Health India in partnership with other organisations. It brought together key stakeholders to discuss the issues related to tribal mental health- resulting in a detailed report with key recommendations on how to address the tribal mental health issues in India.
India has the world’s largest concentration of indigenous population with close to 90 million (8.6% of the total Indian population) Scheduled Tribes living in the country. However, there is very little evidence and research about the overall health and diseases burden among these scheduled tribes. Moreover, very little is known about the status of the burden of mental disorders among this population. Tribal mental health has been an ignored and neglected area in the field of healthcare services.
The round table meeting facilitated dialogue around various aspects of tribal mental health focussing on issues related to lack of data and research in the area of tribal mental health and the importance of bringing this neglected community into the mainstream. Some topics touched upon were service needs of the tribal community, the role of socio-economic development in tribal communities that affect mental health and the need for strengthening the evidence base for bringing in policy changes and practice around mental health in Scheduled Tribe communities.
The roundtable brought forth some very important points of discussion such as the mental health needs of the tribal population, need for evidence based research on tribal mental health, identifying future research opportunities in the area and to identify and bring together stakeholders who can be involved in providing better mental health care for the tribal population.
Speaking at the roundtable, Dr Pallab Maulik, Deputy Director, and Head of Research, The George Institute for Global Health India, said:
There is lack of information on the mental health of Scheduled Tribes in India from the research as well as service delivery perspective. Some of the projects undertaken in India show that there are mental health issues among Scheduled Tribes, but we are not looking at them at all. We need to look at bringing the tribal community into the mainstream discussion about their health, check their needs and develop research accordingly.
Prof. R. Srinivasa Murthy, Professor of Psychiatry(Retd), NIMHANS, Bangalore, said:
We need to have a thorough understanding of the behaviours and personalities of the tribal population and look closely at the social/ community cohesion and mental health of Individuals. Considering the culturally deep-rooted past of the Scheduled Tribes, we need to bring in a culturally relevant mix of healthcare service delivery to counter metal health issues.”
Data from a research conducted by The George Institute for Global Health India, in the West Godavari district of Andhra Pradesh shows that almost 5% population in Scheduled Tribe Areas in the region suffer from common mental disorders like stress, depression, anxiety and suicide risk. The data generated from the Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme, also suggests that the mental disorder burden among tribals in the West Godavari district of Andhra Pradesh are similar to populations in other rural areas in the region. The concept of the SMART Mental Health interventions was to bring in innovative models of healthcare delivery to bridge the gap in service provision and use the power of mobile technology to reach out to remote areas and develop applications which can be used by lay health care workers or primary care doctors with limited mental health training.
Some key outcomes of the intervention were:
- Mental health services use increased from 0.8% to 12.6%
- Depression and anxiety scores amongst those who were screen positive reduced significantly the following intervention
- ASHAs were able to follow up on 80% of screen positive cases
- Use of mobile health to provide mental health services were appreciated by all stakeholders
- ASHAs felt empowered by the training and took initiatives of their own to motivate people to seek care
Stakeholders at the roundtable discussed that data, research and services for mental health need to be vastly improved in the country so that the mental health problems of the community can be addressed in a better and effective manner.
Some of the key recommendations given during the roundtable were:
- Identifying research questions subsequently leading to the formation of a task force
- Bring in new innovative models of service delivery such as utilizing ASHA workers for preliminary screening and referral
- Bring in technology intervention for better screening and decision making
- Bring in a culturally relevant model of healthcare delivery.