bollywood Attitude: 2015

Thursday, 15 January 2015

Bridging the gap

Subhash Pednekar worked in a call centre for some years but over time, he felt that he needed to change his profession. Today he has found his calling as a counsellor with Sangath, an NGO from Goa which works in the field of mental health care across many sites in India. There are many people like Subhash who work with Sangath as counsellors.

Sangath believes that one of the major barriers to accessing mental healthcare is a lack of specialists. Prof Vikram Patel, psychiatrist and co-founder of Sangath, gives a glimpse of the abysmally low number of mental health experts in India and why people like Pednekar are essential in creating a scalable mental healthcare delivery system. “For its population, India should have 1,50,000 psychiatrists to have the same proportion as the U.K., but the number is actually about 3,000, that is, 2% of that number. So I had to think out of the box—about some other model of care given the paucity of qualified psychiatrists and psychologists.”

This alternative model of care to bridge the treatment gap involves intensive training and supervision of lay people by specialists to work as mental health counsellors. Arpita Anand, a psychologist with the PREMIUM project in Sangath, says, “The counsellors don't have the training background that psychologists do. In the PREMIUM project we selected lay graduates through a rigorous process and provided them with intensive training and supervision to provide counselling treatments to people with depression and drinking problems in primary healthcare centres”

The beauty or ease of the programme lies in the fact that Sangath's counsellors work in collaboration with staff at the local primary health centres. Surabhi Soparkar (name changed for confidentiality) was suffering from depression when she went for a regular health check-up to the centre. Here she met the Sangath counsellor who gave her a new lease of life. “They spoke to me with such warmth and familiarity, it was like my mother was asking me how I was doing,” she says. “I got better in just seven sessions.”

Since the counsellors are from the same communities as the patients, it gives them an advantage as they understand the reality of their patients' lives. Subhash Pednekar talks about his very first patient with alcohol problems. “Before counselling started he would have a large amount to drink. By the second session he was having one-third of the amount and by the third session he had given up alcohol,” he says. “If the patients can't come to the health centres, we go to their homes or even counsel over the phone. Sometimes if the patient’s condition does not improve after a certain number of sessions, we refer them to a psychiatrist.”

“In the absence of trained mental health professionals, this task sharing of frontline mental healthcare tasks helps us to reach those people who would otherwise have never received any treatment for their mental health problems,” says Dr Abhijit Nadkarni, a psychiatrist with Sangath. Through its other projects Sangath has demonstrated scientifically that it is cost effective to use lay people from the community to counsel patients with depression, schizophrenia and dementia.

Maybe it is time to scale up the programme in size, and as recognition of this effective model India’s new mental health policy recommends that primary healthcare centres across India should have a cadre of counsellors at the frontline of mental healthcare delivery.

To know more about the work of Sangath, click here.

When to seek medical help

Dr Santosh Chaturvedi, Professor of Psychiatry at the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, lists some of the common disturbances which indicate the possibility of a psychological problem, mental illness or a psychiatric disorder in ourselves or in those around us.

Change in behaviour: Indulging in behaviour that is not socially acceptable or appropriate, or behaviour that one is unable to control or stop. Disruptive behaviour or being too withdrawn can also be an indication.

Overthinking: Excessive worries and negative thoughts like self-blame, guilt, low self-esteem, or feeling great and grand in a manner that is untrue and beyond one’s capabilities are signs of an illness. If these thoughts occur often and are uncontrollable, one should consider seeking help. Also, if a person has unfounded fears that he or she is being watched or has fears that he or she is going to be harmed, it could be a sign of mental illness.

Feelings and mood: Mood changes are normal, but feeling sad or weepy for days on end or lack of interest in activities that were earlier pleasurable can be a sign of a depressive disorder. So is feeling worthless and hopeless and thoughts of self-harm. Likewise, feeling excessively happy or angry for days together, being overactive, aggressive, and destructive can be a sign of mania.

Personality: Any change in regular personality which leads to difficulties in adjusting with people, and results in interpersonal problems, can be an indicator of a psychiatric disorder.

Concentration and memory: Decrease in a person’s intellectual capacity, attention and concentration is a sign that requires immediate care. Occasional forgetfulness and lapses in concentration or memory are normal, but if it goes on for days together or worsens, it’s a sign of mental illness. If a person is not able to identify known persons, and is unaware of his surroundings and the time, it’s an indication that the illness has taken a more serious turn.

Experiences: People go through varied experiences—some happen once in a while and do not affect them. If these experiences are strange and disturbing, or fearful, help should be sought. These may be in the form of hearing voices of people who can’t be seen, or seeing people whom nobody else can, or feeling disconnected from one’s surroundings and self.

Stress and coping: Acute stress may lead to headache or bodyache, fatigue and other bodily symptoms. Sexual difficulties and concerns related to stress also need medical opinion and help. The signs are disturbed sleep, lack of appetite, loss of libido, and loss of weight.

How to help road accident victims?

If immediate help is provided, the lives of many road accident victims can be saved, #MumkinHaihttp://bit.ly/HelpVictims

CENTRE FOR HEALTH AND SOCIAL JUSTICE

Centre for Health and Social Justice works on issues of men, masculinity and gender, health rights of marginalized communities, and reproductive and sexual health and rights. Here is how you can participate in some of their work.

Call 1800-112-013, Centre for Health and Social Justice’s toll-free number, and ask questions related to gender or sexuality. The NGO’s volunteers will aim to respond to your questions via SMS within a week.
Become an online member of the Forum to Engage Men, a network that the NGO runs, by clickinghere.
Invite people from the NGO's network to your community to give talks or conduct workshops on gender equality.
Volunteer with the NGO-in management, documentation, facilitating training programmes, assisting with research, editing of articles and papers, organizing of events, etc. To know more, click here.
Donate computers, cameras, mobile phones, LCD projectors and books to the NGO.
Email the NGO at chsj@chsj.org if you want to participate in the Responsible Fatherhood campaign that they have undertaken in Maharashtra, Madhya Pradesh, Uttar Pradesh and Jharkhand or if you want to participate in events such as the ‘One Billion Rising’ campaign that is held in multiple cities.
Help the NGO distribute flash cards, training manuals, films, calendars, posters, stickers andboard games related to gender equality.
Organize exhibitions, film festivals or group discussions on gender-related issues in your community.
Share stories of change towards gender equality that you have come across by emailing the NGO.
Read up about gender-related issues. A list of some articles compiled by the NGO is here.
Work with the NGO. Read about vacancies here.

CONNECT WITH CENTRE FOR HEALTH AND SOCIAL JUSTICE

chsj@chsj.org

Phone

+91 11 2653 5203 / +91 11 2651 1425

Office Address

Basement of Young Women’s Hostel No. 2, Avenue 21, G Block, Saket, New Delhi - 110 017

Website

www.chsj.org |www.paintedpostcards.wordpress.com

ABOUT THE NGO

THE CENTRE FOR HEALTH AND SOCIAL JUSTICE

Founded in 2006, The Centre for Health and Social Justice (CHSJ) is a Delhi-based resource organization that works on issues of men, masculinity and gender, health rights of marginalized communities and reproductive and sexual health and rights. Among its many initiatives is the 2nd MenEngage Global Symposium, which it is a co-host of.

CHSJ also works closely with women’s groups and is a partner in the ‘One Billion Rising’ campaign for stopping violence against women. CHSJ’s work shows that given the opportunity, there are a significant number of men who are willing to try out new, equitable behaviours at home and in public. Such men also take public action to challenge gender discriminatory practices and work towards setting new social norms.

From its inception, CHSJ has been working to achieve gender equality. Today, the organization works in over 1,500 villages across Uttar Pradesh, Maharashtra, Madhya Pradesh, Jharkhand and Rajasthan as well as with students in over 15 universities.

Some of CHSJ’s campaign themes have been ‘Break the Silence, Stop Violence’ (‘Chuppi Todo, Hinsa Roko’) and ‘Wake up Now’ (‘Ab To Jago’) to address silence in the face of widespread domestic violence and ‘New Norms for New Men: Equality in Status for Boys and Girls, Equal Numbers of Boys and Girls’ (‘Naye Mard ki Nayi Soch: Samaj Mein Ladka Ladki Mein Darja Barabar, Sankhya Barabar’) to address the issue of declining sex ratio. Other issues that they work on include participation of men in domestic work, continuing girl’s education, encouraging women’s participation in panchayats and so on.

IMPACT

When calls and messages poured in

Guests featured in Season 3 talk about the overwhelming response they received after they appeared on the show

Vivek Raj Anand,
Humsafar Trust

The helpline of Humsafar Trust was inundated with calls
and emails seeking support. Over 450 young LGBT individuals connected with us and some even came out to their parents and it was heartening that many families and loved ones showed compassion and understanding. The best moment of the day of telecast was a phone call we received from a young man. We were just about to leave office when he called and said that he had been contemplating suicide but after watching the episode, he had decided to live. The Satyamev Jayate episode will remain a major turning point in the lives of LGBT communities. Thank you!
Contact: vivek.hst@gmail.com

Piyush Tewari,
SaveLIFE Foundation

Thanks to Mr Aamir Khan and Satyamev Jayate, road accidents have finally been recognized as a major epidemic affecting India. Not only did the episode help SaveLIFE Foundation get support and recognition across the country, but it has enabled thousands of people to directly contribute to making our roads safe. Over 18 lakh people have voted for a strong road safety law; close to 3,000 people have signed up to become volunteers with us; hundreds have helped us report over 1,200 dangerous trucks carrying protruding rods; and we continue to receive donations ranging from a few hundred rupees to several thousands every other day.
Contact: piyushtewari@savelifefoundation.org

Shubham Jaglan

Our phones didn't stop ringing after the telecast. We received almost 1,000 calls. My grandparents in Israna village have also got many calls. Dean Jones, the cricketer with whom I have played in the past, also wrote to me! My family and I are very happy with the response that the show received.
Contact: shubhamjaglan@yahoo.co.in

Ratna Chibber

The Satyamev Jayate episode on mental health was a path-breaking event. Sharing my story as a caregiver on Satyamev Jayate brought so many families from across the country as well as some parts of the world in connect with me to share their stories and seek solutions. I felt that our out-of-the-box experiment of drawing patients out in the mainstream by placing them in small shops and kiosks has really touched the chord somewhere. Satyamev Jayate was of great help in disseminating the concept and shattering the myth that persons with mental illness can never be good employees. What is even more important is that the programme gave credibility in the eyes of skeptics.
Contact: md@kromatiks.com

Deepti Chavan

I have received many emails saying that I am an inspiration. Someone sent me an email saying that his wife who has many negative thoughts felt motivated to start thinking positively about life in general after watching my story. My friends said that I am a fighter and they are proud of me. An MDR TB patient also called saying that she will ensure her complete recovery and is determined to emerge stronger.
Contact: deepticomesback@gmail.com

Deepak Kashyap

"Aap ke yahaan aise TV pe ye sab baat ho sakti hai, mashallah!" ("You guys can talk about all of this on TV in your country!"), exclaimed a Pakistani friend of mine after he saw Satyamev Jayate's episode on sexual orientation. He was quick to add, "I felt so good and liberated." Despite some security filters, I received about 400 Facebook messages, 200 emails and hundreds of phone calls.The show touched a lot of people and more importantly sparked a debate in the mind of those who thought that the subject of LGBT rights could dare not speak its name in public.
Contact: deepak.j.kashyap@gmail.com

Saumil Majmudar, EduSports

The EduSports team received over 500 calls from across the country-from parents, school leaders and government officials. Specifically, 40 schools (covering approximately 50,000 children) have asked us to meet them and present our programme's details. Many schools that we have been in touch with, but which were skeptical about the notion of sports as an integral part of education, have turned extremely positive in their discussions. Even in our interactions with government officials, we have heard positive references to the SMJ episode on Sports. The 5th edition of EduSports' Annual School Health and Fitness Survey has revealed alarming statistics about the state of India's children's health and fitness. This survey, covering 1,15,559 students across 287 schools in 85 cities, reveals that 40% of children don't have healthy Body Mass Index (BMI) levels and 40% kids don't have required endurance levels. Getting children to play in schools is the only solution and the Satyamev Jayate episode has galvanized parents, school leaders and government to give this issue the attention it deserves. Thank you Team SMJ!
Contact: saumil@edusports.in

Dr Lenin Raghuvanshi

I received so many calls, SMSes and messages on Facebook from people who watched the episode. Many of them loved Aamirji's stand on who a 'Moga' is. My mother told me after seeing the show that we need to bring a change in how we bring up our children. That was a great realization for her. Some casteist people as well as patriarchs said that they are surely going to change. My partner Shruti is very happy that I told the truth. Thank you for bringing me closer to my loved ones.
Contact: lenin@pvchr.asia

Dr Anjali Chhabria

Hundreds of people have mailed and called me andmany of them have also sought help on sexuality-related issues. I have even had visitors from a few remote villages coming to me in Mumbai for a counselling session. Some parents told me that they cried after watching the episode and can now understand what their kids might have gone through. I am thankful I was part of the Satyamev Jayate show.
Contact: anjali.chhabria@gmail.com

Matthew Spacie, Magic Bus India Foundation

Satyamev Jayate underscored our responsibility to society: we know we have to work harder than ever to make sure each and every child in need gets access to her or his basic development needs.
Contact: matthew@magicbusindia.org

Shailesh Shetye

The response has been huge. My friends, colleagues and family members had asked almost 5,000 people to watch the episode. Several people reached out with heartfelt messages and resolve to support not only my case but the whole issue after watching this episode. The then Police Commissioner of Gurgaon sent a request to be added to the 'Justice for Kshama' Facebook group. So many other people from India and abroad have offered support as well. The challenge for me is to translate all of these positive comments into some tangible outcome. It is important for me to ensure that the case gets the necessary attention and the culprits are punished through a fair and speedy trial.
Contact: shailesh.shetye@hotmail.co.uk

Simran Shaikh

In a country where most people can't cope with 'anomalies' in sexual and gender identities, Satyamev Jayate has made visible the hidden struggle endured by millions of Indians. An open discussion on national television on alternative sexualities would have changed my life had I been fortunate enough to watch it when I was a 14-year-old boy struggling with my identity.
Contact: ssimran1982s@gmail.com

Vijay Barse,
Slum Soccer

We received around 200 phone calls from across the country and from South Africa, U.S.A. and Australia on the day the episode aired and the numbers have kept adding since then. A group from Malda in West Bengal invited Akhilesh Paul and myself to organize a football tournament and felicitate participating teams. It is very difficult to show connections between the two very different aspects of sports and development, but we thank SMJ for not only doing this so well, but also for featuring the work of a lot of NGOs working in this sector.
Contact: reachus@slumsoccer.org

Dr Santosh Chaturvedi, National Institute of Mental Health and Neuro Sciences

The impact of the episode on Nurturing Mental Health has been tremendous.Many people took the trouble to travel long distances to consult NIMHANS and me. Some even said that they were made aware about them or their family members having a mental health problem after watching the episode. Some even shared their experiences of not being adequately helped in the past. The programme has gone a long way in reducing stigma and discrimination towards the mentally ill. This should encourage others not to be secretive about their mental health. I would like to tell people to not ignore problems related to feelings, thoughts and behaviours. Seek early help for a good recovery and improved quality of life.
Contact: chatur@nimhans.kar.nic.in

Dr Yatin Dholakia

Medical experts were happy to see that Satyamev Jayate had presented a very balanced and informative programme on TB. They especially appreciated the extensive research done by the team. Patients have become more aware of the disease and now have concerns regarding their status and want to take extra precautions so that they can prevent their disease from progressing.

Akhilesh Paul

A man whose story is similar to my past got in touch with me and said that he related with whatever I said and is inspired to turn his life around.Many people called me to say that they were very happy about my story of transformation and couldn't believe it!
Contact: annafootball007@gmail.com

Dr Muhammed Shaffi

I got a tremendous response from across the country. Many people pledged support. I received many emails and calls too thanking Satyamev Jayate for highlighting the serious lacunae in the implementation of the DOTS programme - many of the calls were from RNTCP staff themselves. It was heartening to see that the programme took the message of TB to millions of viewers across the globe.
Contact: shaffi@hsrii.org

Dr Hamid Dabholkar, Parivartan Trust

It was really a pleasure and honour to be a part of the Satyamev Jayate episode about mental health. This was the first time that the issue of mental health was given such importance in the wider public discourse. The response from the mental health community, patients and families was simply overwhelming. We received emails and phone calls for help from across the country. Many calls for help came at critical moments when the caller or someone close to him/her was thinking about ending his/her life. It is reassuring that we were able to reach out to and help many people.
Contact: hamid.dabholkar@gmail.com

Dr Madan Kataria, Laughter Yoga International

The response to the show was exceptionally good. We received more than 100 requests to open new laughter clubs and several hundred emails with requests for laughter yoga training. It is mind-blowing. I want to thank all of you for this great opportunity to spread laughter yoga to many people.
Contact: mk@laughteryoga.org

Dr Anurag Bhargava

Some committed workers in the field wrote to me expressing happiness that the problem of TB had been highlighted at a time when there is a great need to increase the momentum on TB diagnosis, treatment and prevention in India. It was surprising for many people to know that infection with the TB germ is so widespread in India - around 40% of the population (500 million people) are infected with the TB germ and are at risk of developing active TB disease. The fact that a balanced diet, which is the foundation of health and good immunity, also protects us like a vaccine from developing active TB was new as well as reassuring for many people who got in touch with me after watching the show.
Contact: anuragb17@gmail.com

Dr Soumya Swaminathan

I got several emails from strangers asking about dealing with TB for themselves or family members (many from even U.S.A). A group of engineering students has come forward to help in any way they can.
Contact: soumyas@nirt.res.in

Gaurav Singhal, Society Against Violence in Education

People have become much more sensitive towards ragging, I would say. We have perceived a change in how the public looks at ragging. Now they understand that it isn't fun; it takes lives.
Contact: gaurav@no2ragging.org

Think before you act

Rajesh was an auto-rickshaw driver in Delhi. His family was preparing for Navratri celebrations in Karnal and he had promised to join them. But that day never came. He was brutally killed by a group of men.

“He was beaten up mercilessly by a group of men just because the rear of their car was nudged by his rickshaw,” says his mother, Sashi Bala. He begged those men to spare him because he had small children, but they beat him up with bricks. The men, who were drunk, also shoved his face into an overflowing drain and left him to die. In one fell swoop, the children lost their father, a wife her husband and the mother, her son. “Because of a moment of rage, our family has been destroyed,” says Sashi Bala.

Today Rajesh's wife Sageeta makes ends meet by running a stall on the street. “Those men never even gave a thought that this man might have a family—what did they lose? We lost everything,” she says. Sashi Bala wishes they would have controlled their anger, “You can pay for the damage to a car, but how do you bring a human being back to life?”