Psychiatric Social Work Program in Rural Community: A Multi-sectoral Initiative

Abstract

Background: Community based programmes with the combined focus on promotive and curative aspects are the planned objective of interventions and services organised by psychiatric social workers in a rural community for identification and treatment linkage provision for mental health problems. Aim of the Study: The aim of the survey is to find out the mental health related problems in the rural community and to provide psychiatric social work services in the rural community by providing linkages to community based psychiatric extension services. Methods:  This research cum intervention program used a survey method, with the universe of the study consisting of all the persons residing in Samardoloni village in Sootea Block, in Sonitpur district of Assam.  People, who are permanent members of their respective household of Samardoloni village, formed the sample for the present study. Household survey was done with data being collected through the semi-structured tool for socio-demographic data and clinical information. Psychiatric social work programme was conducted in the community for awareness' and de-stigmatization of mental illness. Results: In the survey, 271 households were assessed and it was found that in the surveyed village, forty-seven (47) persons were identified as having mental illness and other related problems; eleven (11) persons were having Epilepsy, thirteen (13) persons had Psychosis, eight (8) persons had Somatization disorder, five (5) persons had Child related psychiatric disorder  and ten(10) people were having substance related disorders. Awareness program on mental health and illness was conducted in the community at three levels. First, at the Community-level, sensitization for acceptance and de-stigmatizations of mental illness, secondly, at the School-level, addressing various problems of children and adolescents for teachers and children, and thirdly, at the group level, targeted knowledge and information was given to the persons identified with mental disorders during the survey and were further motivated to access treatment at the local PHC where psychiatric treatment was available. Conclusion: Psychiatric social worker services can address various mental health issues through inter-sectoral collaboration with local rural functionaries. Focused activities for various groups can be useful at community-level for identifications, acceptance, de-stigmatization of mental illness and providing psychosocial care in the community. The role of a psychiatric social worker as a networker for linkage building and coordinating is emphasized apart from being a researcher and as an interventionist in psychiatric social work.  Initiative resulted in treatment accession for 37 patients of the 47 identified. Community participation formed an integral component in mobilizing and utilizing community members and for early identification and linkage provision for treatment. The initiative impacted inter-sectoral systems to plan, coordinate, assess, educate, counsel and link- up and sustain within the community resources.

Keywords: Community, psychiatric social work, mental illness