Enough data not available on mental health issues among tribals: Experts

The meeting organized by The George Institute for Global Health India brought together key stakeholders to discuss the issues related to tribal mental health and also listed out key recommendations

Image for representational purpose only.

New Delhi: With the aim of mainstreaming the dialogue around various aspects of tribal mental health, The George Institute for Global Health India, in partnership with other organizations organized a roundtable on “Mental Health of Scheduled Tribes in India” in New Delhi on 28th August. The roundtable focused on issues related to lack of data and research in the area of tribal mental health and why is it important to bring in this neglected community into the mainstream. Some of the other topics touched upon during the roundtable were service needs of the tribal community, 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 also addressed some very pertinent questions on the gaps in research on the overall health and mental health among Scheduled Tribes.

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 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 in to the mainstream discussion about their health, check their needs and develop research accordingly.”, he added.

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 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.

Also present at the roundtable Dr P Subramaniam, Director, Tribal Research Centre, Department of Tribal Welfare, Government of Tamil Nadu said, “The tribal population is generally isolated and lack the basic medical facilities and there is inadequate health infrastructure. Their overall health status is extremely poor, especially mental health. Currently the Government is working closely with NGOs for conducting mental health awareness camps, however, these need to be conducted more intensively on a regular basis.”

“We also need to have a strong national level policy for mental health of Scheduled Tribes in our country.”, he added.

During the roundtable, Prof R Srinivasa Murthy, Professor of Psychiatry(Retd.), NIMHANS, Bangalore said, “We need to have a thorough understanding of the development personality 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 following intervention

  • ASHAs were able to follow up on 80% of screen positive cases

  • Use of mobile health to provide mental health services was 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 addresses in a better and effective manner. The roundtable resulted in key recommendations in form of a report, addressing various issues related to tribal mental health.

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