TY - JOUR
T1 - Strategies to Facilitate Mental Healthcare Access in Marginalised Local Communities
T2 - Case Studies from India and Australia
AU - Isaacs, Anton
N1 - Funding Information:
The author reports no commercial or financial relationships that could be construed as a potential conflict of interest. The design and implementation of both the service models described in this article was led by AI with assistance from a number of people. AI would like to thank the following people for their contribution to the Maanasi project: Dr. Iby Neerakkal who generously gave of his time to be the consultant psychiatrist at Maanasi; the CHWs, Anju, Usha, Shantha and Gowramma for their dedicated service ensuring that Maanasi was a success; Professor Geetha Jayaram who organised funding from The Rotary Foundation; The departments of Community Health and Psychiatry at St. John’s Medical College, Bangalore and Rotary Midtown, Bangalore. AI would like to thank the following for their contribution to The Koorie Men’s Health Day: Aboriginal Elders, Laurie Marks, Clifford Wandin and Rex Solomon; Senior mental health clinician, Berwyn Lampitt and his team, Ramahyuck District Aboriginal Corporation, Sale and Latrobe Regional Hospital mental health services. AI would also like to thank HS for continuing guidance and support.
Publisher Copyright:
Copyright © 2022 ICMPE.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: Mental disorders are amongst the highest contributors to the Global Burden of Disease. However, despite the universal reach of these disorders, there are vast disparities in the provision of mental health services both between and within nations. Marginalised groups such as rural communities, ethnic minorities, refugees and indigenous peoples are known to be at higher risk of experiencing mental disorders but do not receive adequate care for it. Aims of the Study: The purpose of this paper is to describe lessons learnt in designing and setting up mental health services for two marginalised communities – one in rural India and the other in an Aboriginal community in South Eastern Australia. Methods: Two case studies of setting up a mental health service are described and compared to identify key elements to consider when developing services for hard to reach and marginalised communities. Results: Four key elements were identified. They are: (i) Overcoming issues related to mental health literacy (Recognising mental illness and knowing where treatment is available) (ii) Destigmatising the service (iii) Rendering the service culturally safe and (iv) Ensuring financial sustainability. Discussion: Marginalised communities commonly experience an unmet need for mental health services. This includes indigenous peoples around the world who continue to experience various forms of disadvantage. As a result, traditional mainstream services are needing to rethink the way they do business so as not to exclude those who need them the most. The involvement of suitable link persons can play a crucial role in addressing the unmet need for mental health services in these communities. Implications for Health Care Provision and Use: The increasing movement of population groups across geographical boundaries including refugees has resulted in major changes in the cultural make-up of populations over a short period of time. The elements generated from these models can be utilised in expanding mental health service provision to include such communities. Implications for Health Policies: Clear policies need to be developed to address the unmet need of hard to reach and marginalised communities for appropriate and accessible mental health services. This paper offers some direction for policy development in this space. Implications for Further Research: Further research and trials of service models to address the unmet need for mental health services among marginalised communities can be informed by the lessons learnt from these experiences.
AB - Background: Mental disorders are amongst the highest contributors to the Global Burden of Disease. However, despite the universal reach of these disorders, there are vast disparities in the provision of mental health services both between and within nations. Marginalised groups such as rural communities, ethnic minorities, refugees and indigenous peoples are known to be at higher risk of experiencing mental disorders but do not receive adequate care for it. Aims of the Study: The purpose of this paper is to describe lessons learnt in designing and setting up mental health services for two marginalised communities – one in rural India and the other in an Aboriginal community in South Eastern Australia. Methods: Two case studies of setting up a mental health service are described and compared to identify key elements to consider when developing services for hard to reach and marginalised communities. Results: Four key elements were identified. They are: (i) Overcoming issues related to mental health literacy (Recognising mental illness and knowing where treatment is available) (ii) Destigmatising the service (iii) Rendering the service culturally safe and (iv) Ensuring financial sustainability. Discussion: Marginalised communities commonly experience an unmet need for mental health services. This includes indigenous peoples around the world who continue to experience various forms of disadvantage. As a result, traditional mainstream services are needing to rethink the way they do business so as not to exclude those who need them the most. The involvement of suitable link persons can play a crucial role in addressing the unmet need for mental health services in these communities. Implications for Health Care Provision and Use: The increasing movement of population groups across geographical boundaries including refugees has resulted in major changes in the cultural make-up of populations over a short period of time. The elements generated from these models can be utilised in expanding mental health service provision to include such communities. Implications for Health Policies: Clear policies need to be developed to address the unmet need of hard to reach and marginalised communities for appropriate and accessible mental health services. This paper offers some direction for policy development in this space. Implications for Further Research: Further research and trials of service models to address the unmet need for mental health services among marginalised communities can be informed by the lessons learnt from these experiences.
UR - http://www.scopus.com/inward/record.url?scp=85127729298&partnerID=8YFLogxK
M3 - Article
C2 - 35302050
AN - SCOPUS:85127729298
SN - 1091-4358
VL - 25
SP - 11
EP - 19
JO - Journal of Mental Health Policy and Economics
JF - Journal of Mental Health Policy and Economics
IS - 1
ER -