A Community Participation Initiative During COVID-19 Pandemic:A Case Study From India

Background: A community participation initiative of stitching personal protective equipment (PPE), masks, and face shields for healthcare professionals working in the hospital during the COVID-19 pandemic was conducted using a case study design. Methods: The hospital tailoring unit was used to cater to the in-house demand for stitching safety gear kits for healthcare professionals. A transect walk was conducted to survey hospitals for selecting material for stitching the safety gears and to draw up a plan to meet future demand. The psychiatric social worker induced a community participatory initiative using the method of social work of community organization. A flyer was prepared to invite participants with prior experience in tailoring for this initiative. All participants were trained by the master trainers of the tailoring unit. The participants were also interviewed about their views on this initiative in an informal interview. Results: A total of 83 participants, including 26 individuals (8 volunteers and 18 who received an honorarium), 2 boutiques ( n = 12), and 1 government organization, participated in the activity ( n = 45). A total of 1700 complete PPE kits and 13,000 masks were stitched during this period. The participants reported that the benefit of being a part of this initiative was reduced boredom, sense of purpose and satisfaction, and improved mental health due to structured activity. Conclusions: A community participation initiative using the principles of community organization, a method of social work, can help produce desired outputs and improve the well-being of the participants

Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia: Validity and Pilot Testing

Qualitative research has highlighted the complex interplay of multiple factors that preclude persons with schizophrenia in rural Indian settings for discontinued psychiatric treatment. In this context, this paper aims to establish the face and content validities of an interview schedule titled „Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia‟ which comprehensively assesses factors for discontinued psychiatric treatment and the feasibility of its administration of the schedule. SOFIA contains 16 factors. This schedule involves three phases of interviewing patients and family members. This was given to twelve experts who used likert scales to rate each items wells as the dimensions of the schedule. Later on, fifteen persons with schizophrenia were interviewed with SOFIA to test the feasibility of administration. The results showed that Fourteen items were rated as either satisfactory (score=4) or very much satisfactory (score=5) by all twelve experts; remaining two were rated as 4 or 5 by 11 experts. Regarding comprehensiveness of the factors, scoring methods and general instructions given to the interviewers, all provided scores > 4; regarding method of interviewing, 11 provided score of > 4; with regard to overall interview schedule, all experts provided scores > 4. Pilot testing revealed that it took 60 minutes to administer SOFIA

Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia: Validity and Pilot Testing

Qualitative research has highlighted the complexinterplay of multiple factors that preclude persons withschizophrenia in rural Indian settings for discontinuedpsychiatric treatment. In this context, this paper aims toestablish the face and content validities of an interviewschedule titled „Schedule of Factors InfluencingAdherence (SOFIA) to Psychiatric Treatment in Personswith Schizophrenia‟ which comprehensively assessesfactors for discontinued  psychiatric treatment and   thefeasibility of its administration of the schedule. SOFIAcontains 16 factors. This schedule involves three phases of interviewing patients and family members.  This wasgiven to twelve experts who used likert scales to rate eachitems wells as the dimensions of the schedule. Later on,fifteen persons with schizophrenia were interviewed withSOFIA to test the feasibility of administration. The resultsshowed that Fourteen items were rated as eithersatisfactory (score=4) or very much satisfactory (score=5)by all twelve experts; remaining two were rated as 4 or 5by 11 experts. Regarding comprehensiveness of thefactors, scoring methods and general instructions given tothe interviewers, all provided scores > 4; regardingmethod of interviewing, 11 provided score of > 4; withregard to overall interview schedule, all experts providedscores > 4. Pilot testing revealed that it took 60 minutes to administer SOFIA

The abilities of improved schizophrenia patients to work and live independently in the community: a 10-year long-term outcome study from Mumbai, India

Background: The outcome of schizophrenia has several determinants. Socioecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socioecological condition that has several challenges for mental health. The present study reports on the long-term status of patients with schizophrenia in such a mega city: Mumbai, India. Aim This study aims to reveal the long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods: The cohort for this study was drawn from a 10-year follow-up of first episode schizophrenia. Patients having completed 10 years of consistent treatment after first hospitalisation were assessed on psychopathological and recovery criteria. Clinical as well as social parameters of recovery were evaluated. Descriptive statistics with 95% confidence intervals are provided. Results: Of 200 patients recruited at the beginning of this study, 122 patients (61%) were present in the city of Mumbai at the end of 10-year follow-up study period. Among 122 available patients, 101 patients (50.5%) were included in the assessment at the end of 10-year follow-up study period, 6 patients (3.0%) were excluded from the study due to changed diagnosis, and 15 patients (7.5%) were excluded due to admission into long-term care facilities. This indicates that 107 out of 122 available patients (87.7%) were living in the community with their families. Out of 101 (50.5%) patients assessed at the end of 10 years, 61 patients (30.5%) showed improved recovery on the Clinical Global Impression Scale, 40 patients (20%) revealed no improvement in the recovery, 43 patients (72.9%) were able to live independently, and 24 patients (40%) were able to find employment. Conclusions: With 10 years of treatment, the recovery rate among schizophrenia patients in Mumbai was 30.5%. Among the patients, 87.7% of patients lived in the community, 72.9% of patients lived independently, and 40% of patients obtained employment. However, 60% of patients were unable to return to work, which highlights the need for continued monitoring and support to prevent the deterioration of health in these patients. It is likely that socioecological factors have played a role in this outcome

The Role of Health Systems Factors in Facilitating Access to Psychotropic Medicines: A Cross-Sectional Analysis of the WHO-AIMS in 63 Low- and Middle-Income Countries

In a cross-sectional analysis of WHO-AIMS data, Ryan McBain and colleagues investigate the associations between health system components and access to psychotropic drugs in 63 low and middle income countries

Impact of district mental health care plans on symptom severity and functioning of patients with priority mental health conditions: the Programme for Improving Mental Health Care (PRIME) cohort protocol

Background: The Programme for Improving Mental Health Care (PRIME) sought to implement mental health care plans (MHCP) for four priority mental disorders (depression, alcohol use disorder, psychosis and epilepsy) into routine primary care in five low- and middle-income country districts. The impact of the MHCPs on disability was evaluated through establishment of priority disorder treatment cohorts. This paper describes the methodology of these PRIME cohorts. Methods: One cohort for each disorder was recruited across some or all five districts: Sodo (Ethiopia), Sehore (India) , Chitwan (Nepal), Dr. Kenneth Kaunda (South Africa) and Kamuli (Uganda), comprising 17 treatment cohorts in total (N = 2182). Participants were adults residing in the districts who were eligible to receive mental health treatment according to primary health care staff, trained by PRIME facilitators as per the district MHCP. Patients who screened positive for depression or AUD and who were not given a diagnosis by their clinicians (N = 709) were also recruited into comparison cohorts in Ethiopia, India, Nepal and South Africa. Caregivers of patients with epilepsy or psychosis were also recruited (N = 953), together with or on behalf of the person with a mental disorder, depending on the district. The target sample size was 200 (depression and AUD), or 150 (psychosis and epilepsy) patients initiating treatment in each recruiting district. Data collection activities were conducted by PRIME research teams. Participants completed follow-up assessments after 3 months (AUD and depression) or 6 months (psychosis and epilepsy), and after 12 months. Primary outcomes were impaired functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and symptom severity, assessed using the Patient Health Questionnaire (depression), the Alcohol Use Disorder Identification Test (AUD), and number of seizures (epilepsy). Discussion: Cohort recruitment was a function of the clinical detection rate by primary health care staff, and did not meet all planned targets. The cross-country methodology reflected the pragmatic nature of the PRIME cohorts: while the heterogeneity in methods of recruitment was a consequence of differences in health systems and MHCPs, the use of the WHODAS as primary outcome measure will allow for comparison of functioning recovery across sites and disorders