Mental health — the NGO experience
MEETING THE MENTAL HEALTH NEEDS OF DEVELOPING COUNTRIES — NGO Innovations in India: Vikram Patel and R. Thara — Editors; Sage Publications India Pvt. Ltd., B-42, Panchsheel Enclave, New Delhi - 110017. Rs. 675.
MASSIVE CHANGES that occur around us in all spheres have implications for the way of life in the future, including care of mentally ill persons and the mental health of populations.
The lack of awareness of the magnitude of mental health needs as well as the lack of provisions for organised care in India is far from what is happening in the developed countries.
Developing countries are quite ill-equipped to deal with the problems caused by mental disorders due to a variety of factors, including gross scarcity of resources such as trained personnel and finances. There is an urgent need to develop innovative and cost-effective strategies and interventions to respond to the challenges posed by mental health problems in developing countries. The non-governmental sector has a significant role and responsibility in this area.
However, there is paucity in the number of non-governmental organisations (NGOs) committed to mental disorders and other mental health-related issues. The editors of the book under review have assembled descriptions of 17 NGOs working on various aspects of mental health in different parts of India.
The broad areas of mental health services of the NGOs covered in the book are: child mental health, (Samadhan, New Delhi; Sangath, Goa; Research Society, Mumbai; Antarnad, Ahmedabad); women's mental health, (IFSHA, New Delhi; Bapu Trust, Pune); severe mental disorders, (Schizophrenia Research Foundation (SCARF, Chennai; Medico-Pastoral Association, Bangalore; Richmond Fellowship Society, Bangalore; Paripurnata, Calcutta; Ashagram, Barwani, Madhya Pradesh); suicide prevention, (Sneha, Chennai; Prerna, Mumbai); substance abuse, (TTK, Chennai; National Addiction Research Centre - NARC, Mumbai); carers of the mentally ill (AMEND, Bangalore; Alzheimer's & Related Disorders Society of India - ARDSI, Cochin). Either the founder or a current leading functionary of the organisation has lucidly described the genesis, evolution, current activities, concerns and future perspectives of each organisation.
The programmes described in the book are driven by high commitment born out of the personal experience of several individuals. They are locally relevant in their own settings, culturally appropriate and promote active community participation.
The book started out as a means to focus on NGOs' action in the field of mental health, with the explicit objective of documenting their innovative achievements and examining the issues to determine their success and viability. An attempt is made in it to focus on generating a consensus on the role, contributions and future strategies or plans of NGOs working in mental health area.
Low awareness about mental illness pervades every sector of our society — from families with mentally ill relatives to health policy-makers and donors. In this context, it was gratifying to note the progress made by mental health NGOs in various fields, in spite of the considerable challenges they had to face.
The majority of NGOs featured in the book are located in southern and western India. Most are located in urban settings, reflecting perhaps higher awareness levels and availability of professionals in these areas. Some NGOs like SCARF, Sneha and TTK have gained significant recognition, nationally and internationally. While most of these NGOs began by focussing on specific activities, almost all have diversified and integrated new programmes into their areas of work.
These mental health NGOs have their own strengths and limitations. The strengths are: working in partnership, innovations in practice and transparency in administration.
The limitations are: sustainability, accountability and scope. The monitoring and evaluation of NGO activities is often weak and concerns are occasionally expressed about the financial integrity of some.
The book projects the good practice models in variety of mental health activities and provides inspiration to others who may wish to involve themselves in innovations in mental health care in developing countries.
S. NAMBI
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