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Research Papers

Evaluation of postpartum depression using the Edinburgh Postnatal Depression Scale in evaluation of postpartum depression in a rural community in India.

Published in: International Journal of Social Psychiatry (1999) Vol. 46 No. 1 (74-75)

Postpartum depression has been extensively studied in the West, but has received little attention in our country. We sought to study the feasibility of adapting and using the Edinburgh Postnatal Depression Scale (EPDS), a self-administered screening instrument, in our setting.

Our postpartum women differ from those for whom the EPDS was originally designed in several ways. A significant number are illiterate, hence a self-administered scale will have limited applicability. Specialised psychiatric care is virtually nonexistent in the periphery. Hence, the physician handling the woman’s antenatal care and delivery will also have to assess her for postpartum depression.

We modified the scale with these considerations in mind. Our findings suggested that several factors peculiar to our setting diminish the acceptability of an EPDS-like approach. An alternative approach to elicit the relevant symptoms could be an open-ended discussion centred around their family, with probes at appropriate junctures regarding negative feeling states and ability to function adequately in the new role.

The Role of Belief Systems and Shared Culture on Mental Health 

Published in: Int J Contemporary Medicine (2018) Vol. 6 No. 1 (128-30)

This paper posits that the lived beliefs arising from the concept of the mythical Kashi can explain the adaptive social behaviors and support systems of the residents of modern-day Varanasi. Based on the cultural and mythological beliefs of the residents, the researcher points out that the individual sees himself and his city as a whole and not as a sum of its parts. The sense of community and the understanding of the concept of fun make the individuals more resilient and adept to cope with most situations. Every individual based on their understanding of their culture, has a sense of purpose, and can identify with the shared beliefs of any other individual of that community.

Models of Psychiatry: Science and Mythology of understanding the mental disorder.

Published in: Int J Contemporary Medicine (2018) Vol. 6 No. 1 (131-32)

This article explores the concept of ‘truth’ as understood in scientific disciplines, and the implications it has on the evolution of the understanding of the mind and the brain. It draws parallels between the ways of understanding mythology and the way that models are used in psychiatry.  It discusses the possibility of studying mythology that is lived in today’s world as a means of furthering our understanding of psychiatric models.

Mental health impact of the COVID -19 pandemic on reverse migrant workers in Uttarakhand – A cross-sectional study

Published in: Indian Journal of Social Psychiatry 2021; 37: 407-12

The announcement of a nationwide lockdown in India in March 2020 in response to the CoVID-19 pandemic led to an exodus of migrant workers back to their homes. With the passage of several months, these reverse migrants eventually reached their homes and re-entered their own communities.

In our 5 villages too, around 500 young men returned from the cities as reverse migrants. This study assessed the impact of the later phase of the CoVID-19 pandemic and lockdown on these reverse migrants, and compared this impact with the local residents, who have never migrated.

Our results were different from what the literature on the subject suggested but did not surprise us.

No significant depression or anxiety was found in the reverse migrants group. These findings can be attributed to factors such as social support from the community members, engagement in work and the use of approach-based coping mechanisms.

Why the willingness to return to the city? A study from Uttarakhand on ‘Reversal of Reverse Migration.’ 

Published in: International Journal of Indian Psychology, 2021 9(4), 1663-1669.

DIP:18.01.159.20210904, DOI:10.25215/0904.159

Migration has been a pattern in the hills of Uttarakhand for decades. This region has seen men migrating to the cities in order to earn a livelihood for them and their families, but the pandemic forced them to reverse migrate to their homes. 

A year into the pandemic and deteriorating finances, the reverse migration was reversing in Kumaon, Uttarakhand. This study included a semi structured interview with men from our previous study who moved back to cities in search of jobs. 

An analysis of the interview showed that despite having a social and financial security at their homes these men move back to cities for only one reason: EMPLOYMENT.  The research also highlighted a few themes that focus on their lives in the city and hometown as well as how migration is the only means of survival for these men in Uttarakhand.

Sustainable community mental health services: a description and review of an integrated care model in Uttar Pradesh 

Published in: International Journal of Indian Psychology, 2021 9(4), 1663-1669.
DIP:18.01.159.20210904, DOI:10.25215/0904.159 

This paper describes a sustainable community mental health program delivering services integrated with primary health care in eastern Uttar Pradesh. Mental health services were integrated into the community-based primary health programs of Ramakrishna Mission, Varanasi (RKM) as part of the Jan Man Swasthya Program (JMSP) in 2013. The program was delivered with JMSP support for three and a half years till June 2017, when funding ended. From then onwards, mental health services continue to be delivered till date in a sustainable manner.

Over the 4-year sustained period studied in this paper, the program demonstrated sustained benefits to clients, as well as program fidelity and adaptation. This experience can contribute towards attaining similar outcomes both in new community mental health programs, as well as in the public NMHP.

Telepsychiatry in integrated care: A retrospective comparative study from Uttar Pradesh.

Under publication
Lack of affordable and accessible mental health care is a major contributor to a huge burden of mental health disorders in India. Integrating mental health into primary care is a model proposed to address this treatment gap. Tele-psychiatry can be a cost-effective modality to achieve the goal of integration.

We compared the efficacy of ‘Integrated Tele-Mental Health’ with that of face-to-face interventions through Mobile Medical Units (MMU). We then compared the outcomes of physicians of various levels of expertise in mental health care.  

The use of integrated tele-mental health was shown to be an effective model in reducing the treatment gap and empowering the primary care physicians in delivering mental health care. 

With adequate training, physicians can be at par with mental health professionals for screening for mental health disorders. Given the scalable nature of the technology, there is enormous potential in its usage to address the lack of accessible mental health care.

Reports

State of mental health in Delhi: Prevalence of psychiatric morbidity, subjective wellbeing, and patterns of help-seeking behavior among the general population of Delhi –  2008

This landmark study was conducted by Manas on behalf of The Planning Commission of India and is now authoritative source material for a variety of Delhi-centric programs and studies. It was supported by the Socio – Economic Research division.

In this study, our aim was to understand the mental health status and sense of wellbeing amongst the general population in Delhi. Our focus was to identify the level of psychological distress faced by the general population as well as to have some indicators of the prevalence of psychiatric morbidity in the city and their health seeking behaviour.

The research studied responses of 2381 participants and it indicated high prevalence of psychiatric morbidity (7.6%) and poor subjective wellbeing. Health seeking behaviour was found to be limited as very few people seek professional help when it comes to mental health. The level of awareness regarding mental health was also found to be considerably low.

Evaluating existing systemic capacity and need for psychosocial care for boys and girls in conflict situation with focus on establishing robust, sustainable psychosocial support system while incorporating gender nuances

Under publication