Sutar Roshan, Lahiri Anuja, Diwan Sanjeet, Satpathy Parmeshwar, Rozatkar Abhijit
Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India.
J Neurosci Rural Pract. 2021 Apr;12(2):335-342. doi: 10.1055/s-0041-1723071. Epub 2021 Apr 1.
Mental health care needs of urban, rural, and tribal regions of India are varied and challenging, which require region-specific approaches. A significant treatment gap calls out for a state-wise introspection of existing service delivery models to cater to the specific mental health needs. In Madhya Pradesh, key findings were noted from a camp conducted in one of the tribal districts. To establish patient-centered services, it is important to understand their mental health care needs. A cross-sectional study within a mental health camp was conducted in the east-central tribal district of Madhya Pradesh by using a semi-structured interview. Treatment deficit, pathways to care, and treatment barriers were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20. Among 113 patients who sought help, treatment deficit was 85% with patient factors contributing 76% predominantly affecting the unmarried group of patients. Common mental illnesses (CMIs) outnumbered severe mental illnesses (SMIs) of which anxiety spectrum disorder contributed the most. SMIs still appear to remain undiagnosed till late in the course of illness. Nicotine dependence was higher in males ( < 0.001), and an increase in the dependence pattern was observed with increasing age ( = 0.001). Rising awareness and recognition of CMIs as a common mental health concern while under-recognition of SMIs among tribal communities needs further research. Considering attribution of symptoms to unknown factors, treatment barriers revolving around patient factors, and higher nicotine dependence in males, a timely evaluation of a multitargeted intervention to establish the balance in access to mental health care among the tribal population of Madhya Pradesh is warranted.
印度城市、农村和部落地区的心理健康护理需求各不相同且颇具挑战性，这需要因地制宜的方法。巨大的治疗差距要求对现有的服务提供模式进行邦级反思，以满足特定的心理健康需求。在中央邦，从在一个部落地区开展的营地活动中得出了一些关键发现。要建立以患者为中心的服务，了解他们的心理健康护理需求很重要。
在中央邦中东部部落地区的一个心理健康营地内，通过半结构化访谈进行了一项横断面研究。
评估了治疗不足、就医途径和治疗障碍与人口统计学及临床变量的相关性，并使用SPSS 20版本的卡方检验和逻辑回归方法进行分析。
在113名寻求帮助的患者中，治疗不足率为85%，其中患者因素占76%，主要影响未婚患者群体。常见精神疾病（CMIs）的数量超过严重精神疾病（SMIs），其中焦虑谱系障碍占比最大。严重精神疾病在疾病进程后期似乎仍未得到诊断。男性的尼古丁依赖率更高（<0.001），且随着年龄增长，依赖模式呈上升趋势（=0.001）。
部落社区对常见精神疾病作为常见心理健康问题的认识和识别有所提高，而对严重精神疾病的认识不足，这需要进一步研究。考虑到将症状归因于未知因素、围绕患者因素的治疗障碍以及男性较高的尼古丁依赖，有必要及时评估多目标干预措施，以在中央邦部落人口中实现心理健康护理可及性的平衡。
