Abstract
Aim: This study aims to build the capacity of the people at grass root level as gatekeepers of mental health. It will assess the effectiveness of the Gatekeeper Training Program (GTP) on gatekeeper behaviour, awareness, attitude, and mental help seeking intention. Design: An evaluative research approach in two phases. Phase 1: Cross-sectional house-to-house exploratory survey. Phase 2: A quasi-experimental design with multiple follow ups at 0, 6 and 12 months. Method: Data will be collected using standardized tools like Mental Health Knowledge Questionnaire (MHKQ), Community Attitude towards Mentally Ill (CAMIS), Mental Help Seeking Intention (MHSIS) and Gatekeeper Behavior Scale (GBS). For Phase 1, a house-to-house survey will be conducted among the selected colonies of Koraga tribe to determine their awareness, attitude, and mental help seeking intention regarding common mental health problems. Phase 2 includes identification of the leaders/representatives of the selected tribal colonies, and involving them in GTP. Pre-test and multiple post-test will be conducted in Phase 2 at 0, 6, 12 months. The study is funded by Indian Council of Medical Research from 16 August 2021 for 3 years duration. Discussion: Treatment gap in psychiatric disorders remains an issue of great concern. Evidence based research promotes task shifting approaches in dealing with mental health problems in the community. Capacity building programs like GTP for the underprivileged section of the society are important especially in low and middle income group of countries. Impact: This need based GTP, will ensure mental health first aid in the society. Early identification of people with mental health problems at their doorsteps has huge impact on the prognosis of the illness, closing the treatment gap and stigma reduction.
Highlights
Tribal communities in India cannot be classified as one homogenous group, as they vary at different levels of development and belong to other ethnic-lingual groups
The occupation of the Koraga tribe is at the pre-agricultural stage of development, i.e., they are experts in basket weaving, which is the primary source of income, but presently majority of them work as daily wage laborers (Pujar et al, 2017)
According to National Health and Family Survey (NHFS) 3, 72% of tribal men aged 15-54 years were addicted to tobacco, and 50% of tribal men were addicted to alcohol (Ministry of Health and Family Welfare & Ministry of Tribal Affairs, 2013)
Summary
Tribal communities in India cannot be classified as one homogenous group, as they vary at different levels of development and belong to other ethnic-lingual groups. The Koraga tribe is one of the most backward tribes classified under Vulnerable Tribal Group (PVTG) as declared by the Government of India This tribe is scattered over many districts of the State, in Udupi and Dakshina Kannada. Poverty and illiteracy are the main problems in their community (Roy et al, 2015) They are the poorest among the scheduled tribes of Karnataka (Nalinam, 2013); around 48.4% of Koraga population have a meager monthly income of Rs.2001-4000 (Pujar et al, 2017). A recent study from the West Godavari district of Andhra Pradesh, predominantly comprising people from scheduled tribes, highlighted that 15% of the present generation of the tribal population was affected by common mental disorders like stress, depression, suicide risk, and anxiety (Maulik et al, 2017). It was concluded that females or people from lower castes having severe mental illness were more at risk to be economically poor due to stigma related to mental illness (Trani et al, 2015)
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