MAANASI - A Sustained, Innovative, Integrated Mental Healthcare Model in South India

Geetha Jayaram; Ramakrishna Goud; Suhas Chandran; Johnson Pradeep

doi:10.5463/dcid.v30i2.851

Geetha Jayaram ⁽¹⁾, Ramakrishna Goud ⁽²⁾, Suhas Chandran ⁽³⁾, Johnson Pradeep ⁽⁴⁾

(1) Johns Hopkins University, Departments of Psychiatry, & Bloomberg School of Public Health, Meyer 109, Johns Hopkins Hospital, Baltimore, MD 21287, United States,

(2) St. John's Medical College, Bengaluru, India,

(3) Department of Psychiatry, St. John's Medical College, Bengaluru, India,

(4) Department of Psychiatry, St. John's Medical College, Bengaluru, India

https://doi.org/10.5463/dcid.v30i2.851

Issue
Vol. 30 No. 2 (2019): Summer 2019

Submitted
September 14, 2020

Published
October 4, 2019

Keywords:

global mental health, psychiatric care, integrated care, rural mental health, community health care workers, caseworkers

PDF

Abstract

Studies in low and middle-income countries (LMICs) point to a significant association of common mental disorders with female gender, low education, and poverty. Depression and anxiety are frequently complicated by lack of disease awareness and non-adherence, the absence of care and provider resources, low value given to mental health by policy-makers, stigma, and discrimination towards the mentally ill. This paper aims to show that female village leaders/ community health and outreach workers (CHWs) can be used to overcome the lack of psychiatric resources for treatment of common mental disorders in rural areas.

A multidisciplinary team was set up to evaluate and treat potential clients in the villages. A program of care delivery was planned, developed and implemented by: (a) targeting indigent women in the region; (b) integrating mental health care with primary care; (c) making care affordable and accessible by training local women as CHWs with ongoing continued supervision; and (d) sustaining the program long-term. Indigenous CHWs served as a link between the centre and the community. They received hands-on training, ongoing supervision, and an abridged but focused training module to identify common mental disorders, help treatment compliance, networking, illness literacy and community support by outreach workers. They used assessment tools translated into the local language, and conducted focus groups and client training programs. As a result, mental healthcare was provided to clients from as many as 150 villages in South India. Currently the services are utilized on a regular basis by about 50 villages around the central project site.

The current active caseload of registered clients is 1930. Empowerment of treated clients is the final outcome, assisting them in self-employment. Rural mental healthcare must be culturally congruent, and must integrate primary care and local CHWs for success. Training, supervision, ongoing teaching of CHWs, on-site resident medical officers, research and outreach are essential to continued success over two decades.

Full text article

Generated from XML file

Authors

Geetha Jayaram

Johns Hopkins University, Departments of Psychiatry, & Bloomberg School of Public Health, Meyer 109, Johns Hopkins Hospital, Baltimore, MD 21287

gjayara1@gmail.com (Primary Contact)

Ramakrishna Goud

St. John's Medical College, Bengaluru

Suhas Chandran

Department of Psychiatry, St. John's Medical College, Bengaluru

Johnson Pradeep

Department of Psychiatry, St. John's Medical College, Bengaluru

Author Biographies

Geetha Jayaram, Johns Hopkins University, Departments of Psychiatry, & Bloomberg School of Public Health, Meyer 109, Johns Hopkins Hospital, Baltimore, MD 21287

Dr. Geetha Jayaram is a senior faculty member of the Departments of Medicine, Public Health and Nursing at the Johns Hopkins University in Baltimore, Maryland, USA. She is a community psychiatrist, program builder, researcher and clinician. She is the Founder of the Maanasi project.

Ramakrishna Goud, St. John's Medical College, Bengaluru

Dr. Ramakrishna Goud is Professor and Chair of the Department of Community Medicine at St John's Medical College Hospital, St John's National Academy of Health Sciences, Bangalore, India. He is the Director of Maanasi on the ground, responsible for overall supervision of the project.

Suhas Chandran, Department of Psychiatry, St. John's Medical College, Bengaluru

Dr. Suhas Chandran is an Assistant Professor in Psychiatry at St John's Medical College Hospital, St John's National Academy of Health Sciences, Bangalore, India. His areas of interest include community psychiatry, child and adolescent psychiatry among others. He has been associated with the Maanasi project since more than a year and visits the rural mental health clinic on a weekly basis.

Johnson Pradeep, Department of Psychiatry, St. John's Medical College, Bengaluru

Dr. Pradeep Johnson is Associate Professor and the Lead Psychiatrist who consults for the Maanasi program. He is responsible for education of the residents and Community Health Workers as well. He supervises and teaches residents in psychiatry.

1.

Jayaram G, Goud R, Chandran S, Pradeep J. MAANASI - A Sustained, Innovative, Integrated Mental Healthcare Model in South India. DCIDJ [Internet]. 2019 Oct. 4 [cited 2025 Feb. 23];30(2):104-13. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/335

Download Citation

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License By-NC-ND 4.0 that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

Article Sidebar