Pyramid of Mental Healthcare
Mental health care is largely misunderstood in today’s time. There is a perception that more specialized faculties are necessary in order to treat mental illnesses. Even I have previously suggested that the low number of mental health professionals may end up being a downfall for India. Well today, I accept that I was wrong on that.
WHO has proposed a pyramid of the levels of mental health care. This includes the possible centers of treatment of patients as well as the role of community. Let us take a look into the various levels and correct the mistakes I have made in the past.
Self care is found at the base of this pyramid of care. It demands the lowest resources and is used most commonly. Here WHO is not saying that you should keep your problems to yourself. Instead, it professes the importance of accepting the need for care and seeking it from family and friends first.
Informal Community Care
It is seeking help from informal community resources like faith healers, religious heads, NGOs and so forth. It is important to note that these informal community care services don’t need to work exclusively from professional health care. Instead, there needs to be a dynamic relationship between the two.
Religious or NGO heads must have the pragmatism to refer someone they haven’t been able to help, to a medical professional. These services cannot form the ‘core’ of mental health care, rather it plays the role of a facilitator to the formal care systems.
They are a part of the pyramid, not the keystone on it.
Community Based Services & Services in General Hospitals
The next part of the pyramid is the promotion of community based services and provision of psychiatric care in general hospitals. According to this, it is important to have a psychiatry wing in general hospitals rather than having specialized psychiatric care centers.
The integration of mental health care is easier said than done. Often, the stigma attached to mental health makes the staff unwilling to work in hospitals with a psychiatric wing. The staff also needs to be trained thoroughly to ensure that the patients receive the best quality of care possible.
This would help with early identification and treatment of illnesses which would ultimately make the higher levels of care obsolete. If people at risk are identified in time, the chances of them becoming seriously ill reduce drastically.
These are the facilities that are dedicated to treating mental illnesses. Earlier, I had said that we need more mental health facilities but actually that is not so. It was found that institutionalizing patients didn’t help with their recovery as was previously thought.. It actually leads to further isolation of people from the society which isn’t healthy.
The WHO says that we need to limit the number of mental hospitals and promote self care and community mental health services; both, formal and informal. The future of mental health care lies in the community.
The Optimal Mix of Services, Geneva, World Health Organization, 2007.
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