Integrating Mental Health Interventions with Primary Health Care: An Experience from an Urban Slum of Delhi, India

Abstract

Background: Mental disorders are common throughout the world. Mental disorders usually not recognized at PHC level lead to unnecessary investigations and treatment, putting a financial burden on patients. This paper describes integration of community mental health services with other services provided at a primary health center (PHC) in an urban slum of Delhi. Objectives: 1) Develop Mental Health Resource Centers with training facilities. 2) Awareness generation, advocacy and stigma reduction. 3) Develop a model of universal mental health program. Methods: This study is a community-based study, carried out over a period of one year from September 2014 to August 2015 at field practice area of the community health department of a tertiary care hospital in Delhi. A mental health resource center was established, under which people of various categories were trained. Awareness generation, advocacy and stigma reduction was done by performing a number of community meetings. A dedicated psychiatric OPD, including psychological counseling, was held biweekly. Community mental health workers (CMHWs) played an important role in fulfilling our objectives. Results: Training of 425 participants was planned and 468 people actually attended the training about common mental ailments. Road shows (4), door-to-door campaign (2), Jan Sabhas (45), mental health advocacy seminars (3), etc., were used to generate awareness about mental illnesses. Total of 867 persons attended our psychiatric OPD. 605 (69.7%) were females and 262 (30.25%) were males. Most common mental illness which was encountered was depression (18.45%). Conclusion: Integration of mental health with other dimensions of health is achievable and effective at the Primary Health Care level.