Mental health remains a critical global challenge, with behavioural disorders and self-harm accounting for nearly 16 per cent of disability-adjusted life years worldwide. The SMART Mental Health Programme was conceived as an implementation platform for India’s national healthcare strategies, underpinned by the World Health Organization’s Mental Health Gap Action Programme. Rina Mukherji tells us how community health workers, when supported by doctors and simple digital tools, can effectively reach out to people missing out on mental health care worldwide. She also mentions (below) an indigenous portable point-of-care-ultrasound (POCUS) scanner for sports injury diagnosis and management
A community-based campaign and digital tools can significantly reduce the risk of depression, anxiety and self-harm in rural India, as revealed by an assessment study done by the George Institute of Global Health of India’s Systematic Medical Appraisal, Referral & Treatment (SMART) Mental Health Program. The programme, the published study found, has led to a remarkable shift in knowledge, attitudes and behaviour related to mental health, and helped dismantle the stigma surrounding mental health issues.
Mental health remains a critical global challenge, with mental illness, behavioural disorders, and self-harm accounting for nearly 16 per cent of disability-adjusted life years worldwide. As per the National Mental Health Survey, about 150 million people need treatment for mental health issues in India. Despite this, the treatment gap for managing mental disorders stands at 75-95 per cent in low- and middle-income countries like India. This is mainly because the shortage of mental health professionals in India is acute, particularly in rural areas where trained health workers are scarce.
The SMART Mental Health Program was conceived as an implementation platform for India’s national healthcare strategies, underpinned by the World Health Organization’s Mental Health Gap Action Programme. It intended to address the gap in delivering mental health services by training village health workers in basic mental health care, while using innovative methods for service delivery. It also ran an anti-stigma campaign using videos, posters, brochures, and plays to reach out to communities.
The study screened almost 170,000 adults from 44 primary health centres (PHCs) across Faridabad and Palwal Districts of Haryana and the West Godavari District in Andhra Pradesh. Of them, 9,900 were part of a 12-month trial where two key strategies were implemented. These were:
- a community campaign to reduce mental health stigma
- a digital healthcare initiative for those at high risk of mental disorders
At the end of the period, it was found that:
- There was a significant reduction in depression among those involved in the intervention.
- The cure rate, measured by remission, was significantly higher, with 75 per cent of the intervention group achieving full recovery, as compared to 50 per cent in the control group.
- There was a marked increase in knowledge and improvement in attitudes related to mental health. This was accompanied by a notable decrease in the stigma associated with mental issues. In fact, the study noted positive effects as early as three months into the program.
The study proved that community health workers, when supported by doctors and simple digital tools, can and effectively reach out to people missing out on mental health care worldwide, Prof David Peiris, chief scientist at The George Institute, who was part of the study, said the findings are in line with the World Health Organization and Lancet Commission’s call for new strategies to tackle mental health disorders worldwide. The strategy adopted by SMART can provide an effective alternative in low- and middle-income countries and impoverished areas of high-income countries as seen here, with some adjustments made as per local conditions.
Portable scanner for on-field diagnosis of sports injuries
Researchers at the Center of Excellence in Sports Science and Analytics at the Indian Institute of Technology (IIT-Madras) have developed an indigenous portable point-of-care-ultrasound (POCUS) scanner for sports injury diagnosis and management. The artificial intelligence-powered scanner uses biomedical ultrasound to scan for injuries in sportspersons. This allows for on-field diagnosis of injuries, and immediate assessment of the extent of injury. Thus, medical professionals can take a call on whether to permit the sportsperson to continue playing or not and, hence, prevent further deterioration of any medical condition.
Explaining the development, Prof Arun K. Thittai, Department of Applied Mechanics and Biomedical Engineering, IIT-Madras, who led the team that developed the device, said, “We observed a current technological gap and a need for a point-of-care device for injury management and rehabilitation of athletes within routine training premises. A quick assessment of musculoskeletal injuries on the field will help sports players get immediate attention and focus on recovery.” Furthermore, the researchers are working on using POCUS to build a complete athlete monitoring system.
The POCUS scanner has sufficient resolution and is safe, since it produces no radiation. A working POCUS prototype for musculoskeletal imaging, developed at the Biomedical Ultrasound Imaging Lab at the institute is ready. The researchers intend to complete development of the product prototype by this year-end. Testing and collection of pilot data from the field will be subsequently planned in consultation with sports authorities. At the moment, a sportsperson gets access to the latest medical technologies only when moved to a hospital. There is little access to medical devices or technology during routine training or in the sports arena. POCUS hopes to change this for the better.
(The writer is a senior journalist based in Pune.)
from Webdoux