Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1420 Madison Avenue, New York, NY, 10029, USA.
MINDS Foundation, Vadodara, Gujarat, India.
Psychiatr Q. 2019 Jun;90(2):303-309. doi: 10.1007/s11126-019-9625-8.
Unmet needs in mental health care are high in low and middle-income countries like India. We propose recruiting community health workers (CHWs) to provide mental health services and address the treatment gap, but there is limited data available on the training needs for this potential role. The aim of this study is to help determine what type of formal mental health training and programming could most benefit CHWs in India. This was a cross sectional study design. Self-administered surveys were conducted amongst CHWs in the villages of Vadodara District, Gujarat, India. Statistical analyses included two tailed t-tests using Microsoft Excel 2011. The most common causes for mental illness were attributed to anxiety (61%) and brain disease (61%) followed by stress (45%) and alcohol use disorder (38%). CHWs were dismissive of faith healers ability to treat mental illness (72.9%) showing a strong approval for recommending psychiatric care for the mentally ill (84.4%). Over 50% of participants believed that mentally ill have a lower IQ and that they were unpredictable, but at the same time asserted that people with mental illness can live in the community (80.8%), and recover if given treatment and support (91.8%). Results are promising with CHWs displaying basic knowledge of the etiology and treatment of disease harboring positive attitudes towards psychiatrist's ability to treat mental illness. Future direction should focus on training CHWs towards minimizing stigmatizing views and increasing their knowledge of mental illness in order to scale up mental health services in these low resource communities.
在印度等中低收入国家，精神卫生保健方面的未满足需求很高。我们建议招募社区卫生工作者（CHWs）提供精神卫生服务并解决治疗差距，但对于这种潜在角色的培训需求，数据有限。本研究旨在帮助确定哪种形式的正规精神卫生培训和计划最有益于印度的 CHWs。这是一项横断面研究设计。在印度古吉拉特邦瓦多达拉区的村庄中，对 CHWs 进行了自我管理的调查。统计分析包括使用 Microsoft Excel 2011 进行的双尾 t 检验。精神疾病最常见的原因归因于焦虑（61%）和脑部疾病（61%），其次是压力（45%）和酒精使用障碍（38%）。CHWs 对信仰治疗者治疗精神疾病的能力不屑一顾（72.9%），强烈赞成向精神病患者推荐精神科护理（84.4%）。超过 50%的参与者认为精神病患者智商较低，而且不可预测，但同时断言精神疾病患者可以在社区中生活（80.8%），如果给予治疗和支持，他们可以康复（91.8%）。结果令人鼓舞，CHWs 对疾病的病因和治疗有基本的了解，对精神病医生治疗精神疾病的能力持积极态度。未来的方向应侧重于培训 CHWs，以减少污名化的观点，并增加他们对精神疾病的认识，以便在这些资源匮乏的社区扩大精神卫生服务。
