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SOME ASPECTS OF MENTAL HEALTH AND ECONOMIC CONDITIONS IN INDIA DR. B. J. PRASHANTHAM PROFESSOR OF COUNSELLING PSYCHOLOGY AND DIRECTOR INSTITUTE FOR HUMAN RELATIONS COUNSELLING AND PSYCHOTHERAPY CHRISTIAN COUNSELLING CENTRE, VELLORE, INDIA
OUTLINE OF THE PRESENTATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
JAWAHARLAL NEHRU, 1944 ,[object Object]
 
India’s districts ,[object Object],[object Object],[object Object],[object Object],[object Object]
Story of creation according to Puranas ,[object Object],[object Object],[object Object],[object Object]
Story of creation….. ,[object Object],[object Object],[object Object],[object Object],[object Object]
DSM IV INCIDENCE RATE ,[object Object],[object Object],[object Object],[object Object],[object Object]
DSM ,[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDEMIOLOGICL STUDY OF Prevalence of Mental disorders in India ,[object Object],[object Object]
Results:  National Prevalence rates for all Mental disorders  (per 1000 population) : 18-207 24-207 18-142 Range 65.4 66.4 64.4 Median Combined Urban  Rural
Prevalence rates for specific disorders 14 – 25.3 18.5 Anxiety Neurosis 0.5 - 63 31.2 Affective disorder:Depression 1.1 – 14.2 2.3 Schizophrenia Range Median
Prevalence of Mental Disorders in India ,[object Object],Shamsunder et al 1980, Bangalore General Practice 35.9% Harding et al 1980 Raipur Primary Health Centre(PHC) 17.7% Murthy et al  1976 Vellore  Hospital clinic 27% Author
Prevalence of Mental Disorders in India Channabasavanna et al 1995, Jigani PHC 23.9% Sriram et al 1988, Sakalwara PHC 17.3% Sheshadri et al 1988 Sakalwara PHC 11.8% Author context prevalence
Pothen et al ,2003, 2002, Vellore PHC 33.9% Nambi et al,2002 Vellore PHC) 44.0% Patel et al 1998 Panjim, Goa ,  PHC 46.5% Author Context Prevalence
NIMHANS :  70 million SUFFER FROM SERIOUS TO MILD FORMS OF MENTAL ILLNESSES ,[object Object]
50-90% not able to access help ,[object Object]
Place of Human Resources for Mental Health and Approaches to its Development in India ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POVERTY OF MENTAL HEALTH HUMAN RESOURCES ,[object Object]
AWARENESS AND HOPE IN THE 21 ST  CENTURY ,[object Object],[object Object],[object Object],[object Object]
OTHER DEVELOPMENTS IN INDIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Community mental health: Deinstitutionalization  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Population of India ,[object Object]
[object Object]
[object Object]
[object Object]
Poverty in different forms ,[object Object],[object Object],[object Object]
456 million below #1.25 a day ,[object Object]
One-third of world’s poor ,[object Object]
Women Issues ,[object Object]
Gender Justice ,[object Object]
Impact of global economic crisis on India ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Impact of economic crisis ,[object Object]
Vikram Patel1 & Arthur Kleinman2  ,[object Object],[object Object]
Mental and poverty… ,[object Object]
Poverty.. ,[object Object],[object Object],[object Object],[object Object]
POVERTY AND MENTAL HEALTH? ,[object Object]
PATEL STUDY.. ,[object Object]
BI-DIRECTIONAL ,[object Object]
ANXIETY AND CLINICAL DEPRESSION ,[object Object]
WHO REPORT CONFIRMS ,[object Object]
RESILIENCY FACTORS ,[object Object]
Cost of drugs ,[object Object]
200000 farmers commit suicide ,[object Object],[object Object]
National Human rights commission ,[object Object]
Times of India:Clinic that provides healthcare to beggars ,[object Object]
Jeffrey Sachs, advisor  to UN Secretary-General ,[object Object]
[object Object],[object Object]
[object Object],[object Object]
Government to lay stress on mental health services under the 11 th  five year plan  Friday, 20 February 2009 ,[object Object]
Resources available at NIMHANS… ,[object Object]
Resources available ,[object Object],[object Object]
CCC – 40 years of service to humanity:Examples ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Trying to identify relatives
 
 
 
 
 
 
 
 
 
 
 
Recent news and views in APA Journals in 2008 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE SITUATION IN MYANMAR AND CHINA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DALAI LAMA’S STATEMENT
31 % 69 %
 
  Long term Evaluation of  First Batch  who had Counselling  – PTSD status *  Six cases were absent for evaluation. Symptomatic  No.   %   Asymptomatic No.   %   149  0  149  100 %  20 – Months After Counselling ( Nov – Dec 2007)  * 246  59  24.0%  187  76.0 % Immediately  After Counselling ( May 2006 )  252 203  80.6% 49  19.4 %  Before Counselling ( August to Dec 05)   Total P TS D Status Period of Evaluation
Village Perumalpettai
 
Uric Bronfen Brenner:An Ecological Approach Macrosystem Exosystem Mesosystem Microsystem
Odds Ratios of Risk Factors for PTSD, before and after Adjusted by Logistic Regression Note:   Total number of cases = 1404 @ Reference Category  * Odds Ratio ** Adjusted using Logistic Regression + PTSD  Prevalence % # 95% Confidence Intervel  1.967 – 6.516 0.000 1.0 3.520 0.000 1.0 4.102 1316  56.3% 88  84.1% 6. Family Problem No @ Yes 1.081 –1.842 0.011 1.0 1.411 0.000 1.0 1.815 333  46.8% 1071  61.5% 5. Family Structure Joint @ Nuclear 0.377 – 0.907 0.017 1.0 0.585 0.003 1.0 0.540 117  70.9% 1287  56.9% 4. Professional Stability Stable @ Unstable 0.696 – 1.204 0.325 – 0.642 0.521 0.000 1.0 0.915 0.471 0.126 0.000 1.0 0.809 0.343 418  67.0% 618  62.1% 368  41.0% 3. Economic grade (Monthly Income, Rs.) upto, 499 @ 500 – 4999 5000 + 1.491 – 2.357 0.000 1.0 1.874 0.000 1.0 2.075 647  48.5% 757  66.2% 2. Gender Male @ Female 1.031 – 1.712 1.389 – 2.766 1.559 – 4.631 0.028 0.000 0.000 1.0 1.329 1.960 2.687 0.023 0.000 0.000 1.0 1.328 1.980 2.970 579  51.5% 525  58.5% 217  67.7% 83  75.9% 1. Age 18 – 29 @ 30 – 44 45 – 59  60 + 95% C.I # Sig. P O.R. * Sig. P O.R. * Adjusted ** Unadjusted PTSD N  Prev  + Risk Factors
Mental health and social change: PRASHANTHAM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CCC EXAMPLES ,[object Object],[object Object],[object Object]
CCC Examples … ,[object Object],[object Object],[object Object]
Psychology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health ,[object Object],[object Object]
CROSS-CULTURAL ISSUES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASPECTS OF CULTURE AFFECTING MENTAL HEALTH :Professor Verghese ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dr. R. Srinivasa Murthy, Who consultant’s suggestions: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Meeting the mental health needs of developing countries: NGO innovations in India ,[object Object],[object Object],[object Object],[object Object],[object Object]
NGO’s… ,[object Object]
NGO’s.. ,[object Object]
[object Object]
PUBLIC HEALTH FOUNDATION OF INDIA ,[object Object]
Some Board Members of PHFI ,[object Object]
Social determinants of health: WHO report ,[object Object]
SOME POSITIVE STEPS TAKEN BY INDIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Still needed  actions: Community based, culturally sensitive paradigms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LIBERATION IS ABOUT VICTIMS ,[object Object],[object Object],[object Object],IS A VICTIM
VICTIMS… ,[object Object],[object Object]
The Paradox of our Times By  H.H. Dalailama ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Paradox of……. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Paradox of……. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SOME REFERENCES ,[object Object],[object Object],[object Object],[object Object]
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REFERENCES ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]

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BJ Prashantham Mental Health & Eco

  • 1. SOME ASPECTS OF MENTAL HEALTH AND ECONOMIC CONDITIONS IN INDIA DR. B. J. PRASHANTHAM PROFESSOR OF COUNSELLING PSYCHOLOGY AND DIRECTOR INSTITUTE FOR HUMAN RELATIONS COUNSELLING AND PSYCHOTHERAPY CHRISTIAN COUNSELLING CENTRE, VELLORE, INDIA
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  • 11. Results: National Prevalence rates for all Mental disorders (per 1000 population) : 18-207 24-207 18-142 Range 65.4 66.4 64.4 Median Combined Urban Rural
  • 12. Prevalence rates for specific disorders 14 – 25.3 18.5 Anxiety Neurosis 0.5 - 63 31.2 Affective disorder:Depression 1.1 – 14.2 2.3 Schizophrenia Range Median
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  • 14. Prevalence of Mental Disorders in India Channabasavanna et al 1995, Jigani PHC 23.9% Sriram et al 1988, Sakalwara PHC 17.3% Sheshadri et al 1988 Sakalwara PHC 11.8% Author context prevalence
  • 15. Pothen et al ,2003, 2002, Vellore PHC 33.9% Nambi et al,2002 Vellore PHC) 44.0% Patel et al 1998 Panjim, Goa , PHC 46.5% Author Context Prevalence
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  • 55. Trying to identify relatives
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  • 72. Long term Evaluation of First Batch who had Counselling – PTSD status * Six cases were absent for evaluation. Symptomatic No. % Asymptomatic No. % 149 0 149 100 % 20 – Months After Counselling ( Nov – Dec 2007) * 246 59 24.0% 187 76.0 % Immediately After Counselling ( May 2006 ) 252 203 80.6% 49 19.4 % Before Counselling ( August to Dec 05) Total P TS D Status Period of Evaluation
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  • 75. Uric Bronfen Brenner:An Ecological Approach Macrosystem Exosystem Mesosystem Microsystem
  • 76. Odds Ratios of Risk Factors for PTSD, before and after Adjusted by Logistic Regression Note: Total number of cases = 1404 @ Reference Category * Odds Ratio ** Adjusted using Logistic Regression + PTSD Prevalence % # 95% Confidence Intervel 1.967 – 6.516 0.000 1.0 3.520 0.000 1.0 4.102 1316 56.3% 88 84.1% 6. Family Problem No @ Yes 1.081 –1.842 0.011 1.0 1.411 0.000 1.0 1.815 333 46.8% 1071 61.5% 5. Family Structure Joint @ Nuclear 0.377 – 0.907 0.017 1.0 0.585 0.003 1.0 0.540 117 70.9% 1287 56.9% 4. Professional Stability Stable @ Unstable 0.696 – 1.204 0.325 – 0.642 0.521 0.000 1.0 0.915 0.471 0.126 0.000 1.0 0.809 0.343 418 67.0% 618 62.1% 368 41.0% 3. Economic grade (Monthly Income, Rs.) upto, 499 @ 500 – 4999 5000 + 1.491 – 2.357 0.000 1.0 1.874 0.000 1.0 2.075 647 48.5% 757 66.2% 2. Gender Male @ Female 1.031 – 1.712 1.389 – 2.766 1.559 – 4.631 0.028 0.000 0.000 1.0 1.329 1.960 2.687 0.023 0.000 0.000 1.0 1.328 1.980 2.970 579 51.5% 525 58.5% 217 67.7% 83 75.9% 1. Age 18 – 29 @ 30 – 44 45 – 59 60 + 95% C.I # Sig. P O.R. * Sig. P O.R. * Adjusted ** Unadjusted PTSD N Prev + Risk Factors
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