Mental health for masses through telemedicine
Location
The use of the novel technology of Telemedicine to provide psychiatric services in remote communities with no access to affordable mental health care.
About You
Section 1: About You
First Name
Thara
Last Name
Rangaswamy
Website URL
Country
India
Section 2: About Your Organization
Organization Name
Schizophrenia Research Foundation (India)
Organization Website
Organization Phone
+91 44 26153971
Organization Address
R/7A, Noth main Road, anna nagar West Extension, Chennai 600101
Organization Country
India
Is your organization a
Non‐profit/NGO/citizen sector organization
Your idea
Name Your Project
Mental health for masses through telemedicine
Country your work focuses on
India
Describe Your Idea
The use of the novel technology of Telemedicine to provide psychiatric services in remote communities with no access to affordable mental health care.
Innovation
What makes your idea unique?
The use of novel technology (telemedicine) to overcome the limited reach of mental healthcare infrastructure existing in rural Tamil Nadu.
SCARF has pioneered the use of Telemedicine in the delivery of psychiatric services in India.
We have been successful in establishing a tele-psychiatry network in collaboration with local NGOs and have been able to provide the required mental health services (consultation, medication, referrals, etc) completely free to those accessing these services.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
1)Has clearly demonstrated that TeleMedicine can be used effectively for Mental Health services. 2)Provided mental health care in areas that had no access to psychiatric service. They had remained untreated, as their access to mental health care was limited primarily due to financial constraints and non-availability of mental health service providers in the area.3) Individuals who were ill and remaining at home have since initiation of treatment from the Tele-Med center have improved and have begun to go for work.4) The Program has demonstrated to the community that Mental illness is treatable and that it can be treated with medicines like other illnesses.5) Awareness about mental illness was created in the community, and in recent times the field workers have been able to identify and bring individuals who have illness duration of less than one month. (Earlier the detection and therefore shorter the duration of illness - better the recovery)
Problem
We are largely addressing the issue of untreated mentally ill and disabled.(Due to lack of access to affordable mental health care services). The primary beneficiaries are those suffering from mild and severe mental disorders and their families. Mental health is a vital ingredient of helath and many conditions such as schizophrenia and depression can result in loss of man-days and disability adjusted life years
Actions
In addition to having a trained community mental health team comprising of psychiatrists, psychiatric social workers and allied professionals, conversant with the telemedine technology, partnerships have been established with local NGOs that can host peripheral tele-medicine units and have well developed network of fieldworkers and volunteers who are used to mobilize and identify affected persons in need of mental health services. Partnerships have also been established with funding agencies to finance this initiative.
Results
1.Over 700 individuals have beniffited from the program.
2. we have been successful in establishing a telemedine network and in establishing partnerships with local NGOs who have now included mental Health as one of the services that they will deliver.
3.We have clearly demonstrated that TeleMedicine can be used effectively for Mental Health services.
Provided mental health care in areas that had no access to psychiatric service.
4.Individuals who were ill and remaining at home have since initiation of treatment from the Tele-Med center have improved and have begun to go for work.
5.The Program has demonstrated to the community that Mental illness is treatable and that it can be treated with medicines like other illnesses.
6.Awareness about mental illness was created in the community
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
We hope to reach out to a bigger section of the population and provide them with mental health care services through a mobile tele-medicine unit that can cover a wider area, especially those areas that cannot at present be covered by us due to the lack of connectivity is something that we are looking to address in the next couple of years. SCARF has written to ISRO in this regard and are also in discussion with other vendors and developers of related technology to find a suitable and cost effective solution.
It is well established that the life of ay community mental health programme is just as long as funding is available. It is therefore imperative that we work on strategies for sustaining and continuing this work, after the project ends.
The District Mental Health programme whose main agenda is to integrate mental health with primary care is reasonably active in Tamil Nadu. Discussions with the nodal officer, DMHP, Tamil Nadu have revealed that the DMHP programme can be expected to be functional in the project area in 2-3 year time. It will therefore be logistically appropriate to refer to the PHCs and other mental health / primary care centres within the ambit of the DMHP all the patients who are beneficiaries of this programme. This would assure continuity of care.
The entire unit can then be shifted to another district/ area not covered by DMHP.
What would prevent your project from being a success?
The biggest obstacle to the expansion to the project is the lack of connectivity with regards to ISDN lines, broadband connection, etc that are necessary to run the program. Satellite link is prohibitively expensive unless sponsored by a government agency such as ISRO, therefore the use of ISDN lines in the present project. The second obstacle is the time taken in getting the needed connection etc from the network service providers. The third obstacle is the relative high cost of the tele medicine equipment and software.
Another aspect of telemedicine that needs to addressed is “What happens after the consultation,” Do the patients have access to the medication prescribed, if available can they afford it, especially those who are financially disadvantaged (whom the present program targets), keeping in mind that the mentally ill are marginalized section in Indian society. Under the present program SCARF provides them medicine free cost, for this to sustain funds would have to be made available on a regular basis to stock up on the required medicines.
The obstacles to raising the necessary finances and support are various, stemming from the fact that mental health is not an area of priority, concern or investment by either the government or private organizations. Even within the health sector, mental health receives the least attention and financial assistance.
How many people will your project serve annually?
101‐1000
What is the average monthly household income in your target community, in US Dollars?
Less than $50
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Operating for 1‐5 years
In what country?
India
Is your initiative connected to an established organization?
If yes, provide organization name.
How long has this organization been operating?
More than 5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have any non-monetary partnerships with NGOs?
Yes
Does your organization have any non-monetary partnerships with businesses?
Yes
Does your organization have any non-monetary partnerships with government?
Yes
Please tell us more about how these partnerships are critical to the success of your innovation.
Partnerships have been established with local NGOs that can host peripheral tele-medicine units and have well developed network of fieldworkers and volunteers who are used to mobilize and identify affected persons in need of mental health services.
What are the three most important actions needed to grow your initiative or organization?
Since in India, Health is a State subject and does not fall under Central Government legislations, a lot of initiatives and policies announced by the Central Government does not get implemented by the States. A better synchronization between the two will be beneficial. Easier availability of psychiatric medication and availability of it in Public Health Centers (PHC) will go a long way towards making mental heath services affordable and accessible. Similarly increasing the bandwidth and lowering the cost of digital access will stimulate growth of telemedicine and make it more accessible and affordable and therefore easier to implement.
With hindsight we are now of the opinion that partnerships are most likely to be sustained if they are in association with organizations that would make use of the telemedicine platform for other interventions/consultations. If the telemedicine unit is used for a single purpose (psychiatry for example) then it is less likely to be sustained over a period of time as the stakeholders in the venture is limited. Broadening the base and increasing the number of stakeholders would see the program being strengthened. If more specialty consultations can be provided by other specialist units (e.g. Geriatrics clinics, Pediatric clinics), on a voluntary basis, through the same platform then the telemedicine program will be an even greater success.
The Story
What was the defining moment that led you to this innovation?
Schizophrenia imposes enormous burden from the level of the family to the society in general. It is indisputable that proper treatment leads to substantial reduction in the burden and suffering due to the illness .Thus treatment of psychosis as early as possible has a potential to improve course and outcome of psychosis.
Studies in Tamil Nadu have identified substantial number of patients with schizophrenia who were never treated especially in rural communities . Among reasons identified for not taking up treatment were the non-availability of psychiatric care services in their areas, difficulty in accessing the needed services due to the remoteness of their residence, the expenses and time spent to reach service providers, the cost of medicines, lack of awareness about treatment available and ignorance about mental illness.
In an effort to address these issues SCARF has over the past decade started several rural community mental health programs. The significant features of these programs included establishing the feasibility of initiating and operating community mental health programs in the community, training lay community volunteers to identify various kinds of mental health problems, and creating public awareness about mental health problems using indigenous methods. SCARF also networked with other Governmental and non-governmental organizations and thereby provided opportunities for global rehabilitation of the patients and their families.
In an attempt to reach out to this neglected population, SCARF has harnessed the technology of Tele-Medicine.
SCARF’S foray into tele psychiatry happened as a response to Tsunami of 2004, with funding from OXFAM and then Deutsche Bank Foundation. While those who suffered mental health consequences as a result of Tsunami gradually improved, we were left with a large sample of persons with chronic psychotic conditions, many of whom were untreated or partially treated. This led us to use the technology for a full-fledged community program.
Tell us about the social innovator behind this idea.
The idea was first proposed to SCARF by Oxfam Trust as part of their psychosocial intervention program following the tsunami. SCARF has since expanded its reach and scope seeing the potential of the technology from the concept of using it a temporary intervention program following a crisis to a full fledged community mental health program.
How did you first hear about Changemakers?
Email from Changemakers
If through another, please provide the name of the organization or company
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 | Naveen Shakir said: On November 20, 2009 the judges reviewed the entries for the Changemakers Rethinking Mental Health: Improving Community Wellbeing ... about this Competition Entry. - 794 days ago read more > |
| Mental health for masses through telemedicine has been chosen as a finalist in Rethinking Mental Health: Improving Community Wellbeing. - 807 days ago |
| scarfindia updated this Competition Entry. - 859 days ago |
| scarfindia submitted this idea. - 859 days ago |
