Coping Strategies and Perceived Social Support in Wives of Persons with Alcohol Dependence Syndrome

Background:  In India alcohol is the most commonly used substance of abuse. The effect of alcoholism in husbands mostly leads to disturbances in marital life.These effects may directly or indirectly drain out caregivers of substance abusers. One of the most affected among caregivers are the marital partners. In other words it is the wives of substance abusing husband who are the victims. Coping mechanisms are used by the wives to handle the stressful situation has a vital role in reducing psychological difficulties. In case of wives with alcohol dependent husbands, the social support is a buffer for crisis periods. Aim of the study: The study is aimed to enquire the coping strategies and perceived social support of the wives of persons with alcohol dependence syndrome. Material and methods: A total 30 wives of persons with alcohol dependence syndrome according to ICD-10 were taken as the sample using purposive sample collection. Socio-demographic profile was assessed through semi-structured questionnaire while coping strategies was assessed through Ways of Coping Scale (1986) and the Multidimensional Scale of Perceived Social Support (1988) was applied to assess the perceived social support after taking their informed consent. Data analysis was done using SPSS for descriptive statistics. Results: The result shows that varied types of coping strategies were used by wives of persons with alcohol dependence. In contrast the previous studies suggest use of emotional focused or escape avoidance coping. This study suggests that adaptive copings such as positive reappraisal, seeking social support and problem solving were used in comparison to escape avoidance.  In contrast to previous studies perceived social support was found to be high in this study group. Conclusion: It is well known fact now that coping strategies plays a major role in dealing with stressful life situations and perceived social support also have positive impact over health. Finding from this study suggests that any psychosocial intervention designed for this group must consider these facts and findings. Eventually these findings from the study can be used to help in enhancing the wellbeing of wives of alcohol dependents. Key words: Alcohol Dependence, coping strategies, perceived social suppor

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

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 illnes

Marital quality in wives of persons with alcohol dependence syndrome

Background: Marriage is a strong bond between couples with the promise of lifelong dedication and emotional wellbeing. The effects of alcoholism in husbands may lead to disturbances in marital life. Lack of understanding, unpredictable behaviour of the husbands, and their irresponsibility in family matters can often lead to poor quality of a couple’s relationship. Aim of the study: The study is aimed to understand the marital quality of the wives of persons with alcohol dependence syndrome. Material and methods: Thirty wives of persons with alcohol dependence syndrome according to ICD-10 were taken as the sample, using purposive sample collection. Socio-demographic profile was assessed through semi-structured questionnaire while Marital Quality Scale (MQS-1995) was applied to assess the marital quality after taking their informed consent. Higher scores indicate poorer quality of marital life. Data analysis was done using SPSS for descriptive statistics. Results: The domain mean scores of rejection, understanding, and decision-making, and the total score of marital quality were high. Thus, indicating poorer quality of marital life among the wives of persons with alcohol dependence. Conclusion: Alcohol dependence is highly associated with poor marital quality as the person with alcohol dependence tends to adapt faulty communication patterns and behaviour which in turn leads to poor adjustment, unhappiness, and a high degree of dissatisfaction with relationships. Treatment plan for this group should be planned keeping these factors in consideration, as a priority

Psychiatric morbidity, quality of life, and perceived social support among elderly population: a community-based study

Background: The growth in the elderly population means an inevitable increase in general physical health, psychobiological and mental health-related problems. Aim of the study: The present study aims to examine psychiatric morbidity, quality of life, and perceived social support among elderly population. Research design: A cross-sectional community-based study was conducted. People in age group of 60 years and above, who were permanent members of their respective households of Ranga Pukri Para and Dekargaon village in Tezpur, Sonitpur district of Assam, were the sample for the present study. One thousand four hundred and ninety adult populations had been identified as sample frame from the electorate list. One hundred and four people of age 60 years and above had been identified from the list for the study purpose. Random sampling method was used for selection of the sample. Semi-structured socio-demographic datasheet, General Health Questionnaire-12 (GHQ-12), CAGE questionnaire, Multidimensional Scale of Perceived Social Support, and World Health Organization Quality of Life (WHOQOL-BREF) scale were administered to the respondents. Results: Based on the GHQ-12 score, it was found that 24% of the respondents showed an indication of mental health problems and from the CAGE score, it indicated that 13% of the respondents were found to be misusing or was in dependence in alcohol. The result from the present study indicated that elderly population was getting more family social support, followed by friends and from significant others. The result indicated that the mean score was low in the domain of social relationships. Environment domain was high followed by physical health and psychological domains of WHOQOL-BREF. Conclusion: In the elderly population, overall health can be influenced by multiple factors, including a person’s physical, psychological, behavioural, and social factors. The mental health professionals can provide resources, services, and opportunities for the elderly population and their families

National Mental Health Survey of India, 2016 - Rationale, design and methods.

Understanding the burden and pattern of mental disorders as well as mapping the existing resources for delivery of mental health services in India, has been a felt need over decades. Recognizing this necessity, the Ministry of Health and Family Welfare, Government of India, commissioned the National Mental Health Survey (NMHS) in the year 2014-15. The NMHS aimed to estimate the prevalence and burden of mental health disorders in India and identify current treatment gaps, existing patterns of health-care seeking, service utilization patterns, along with an understanding of the impact and disability due to these disorders. This paper describes the design, steps and the methodology adopted for phase 1 of the NMHS conducted in India. The NMHS phase 1 covered a representative population of 39,532 from 12 states across 6 regions of India, namely, the states of Punjab and Uttar Pradesh (North); Tamil Nadu and Kerala (South); Jharkhand and West Bengal (East); Rajasthan and Gujarat (West); Madhya Pradesh and Chhattisgarh (Central) and Assam and Manipur (North East). The NMHS of India (2015-16) is a unique representative survey which adopted a uniform and standardized methodology which sought to overcome limitations of previous surveys. It employed a multi-stage, stratified, random cluster sampling technique, with random selection of clusters based on Probability Proportionate to Size. It was expected that the findings from the NMHS 2015-16 would reveal the burden of mental disorders, the magnitude of the treatment gap, existing challenges and prevailing barriers in the mental-health delivery systems in the country at a single point in time. It is hoped that the results of NMHS will provide the evidence to strengthen and implement mental health policies and programs in the near future and provide the rationale to enhance investment in mental health care in India. It is also hoped that the NMHS will provide a framework for conducting similar population based surveys on mental health and other public health problems in low and middle-income countries