Journal of Mental Health Education

Journal of Mental Health Education

The Journal of Mental Health Education is the official publication of The

Department of Mental Health Education, NIMHANS. The journal is peer-reviewed,

is published annually, and accepts high-quality work or writings in the broad fields of

mental, neurological and neurosurgical health and promotion. The journal is being

published through funding from the Dr. RN Moorthy Foundation.

With the goal of dissemination of knowledge to increase the wider public awareness of

mental health and to promote research in the field Mental Health Education, the

Department of Mental Health Education publishes the Journal of Mental Health

Education, a peer-reviewed online Journal with Annual print compilation of issues. The

first issue of the journal was published in 2017 under the Editorship of Prof. S.K.

Chaturvedi and Dr. Meena K.S.

Further details about the Department of Mental Health Education and its activities are

available at http://mentalhealtheducationnimhans.org/

Journal Ethics

The Journal is committed to meeting and upholding the standards of ethical behavior at

all stages of the publication process. We follow closely the industry associations, such

as the Committee on Publication Ethics (COPE), International Committee of Medical

Journal Editors (ICMJE) and World Association of Medical Editors (WAME), that set

standards and provide guidelines for the best practices in order to meet these

requirements.

Open Access Publication and Creative Commons Licensing

This is an open access Journal and articles are distributed under the terms of the

Creative Commons Attributions-Non-Commercial-Share Alike 4.0 License, which

allows others to remix, tweak, and build upon the work non-commercially, as long as

appropriate credits is given and the new creations are licensed under the identical terms.

Digital Archiving

The contents of the Journal will be saved on a cloud server in case of a Website

Malfunction. Ahead of Print Policy Articles published online under the Ahead of Print

model are considered published and can be cited and quoted using the DOI as the

reference source.

http://mentalhealtheducationnimhans.org/

Areas of Publication

This multidisciplinary Journal focuses publishing high quality, peer-reviewed papers in

the area of mental, neurological and neurosurgical health and promotions, book-reviews

and brief articles. The Journal highlights issues in education, training and developing

a skilled, healthy and committed mental health workforce. The Journal of Mental

Health Education is keen to receive original papers on mental health education and

mental health promotion, methodology, training, research, policy development and

practice- particularly from a nation and international perspective.

It considers for publication original research articles in the following areas:

Mental Health Education

Community Mental Health Education

First Aid for Mental Health

Prevention, Promotion and Intervention in Mental Health

Design, Implementation, Monitoring and Evaluation of Programs in Mental Health

Mental Health Awareness

Mental Health Literacy

Stigma and Discrimination in Mental Health

Digital Mental Health Education

Public Mental Health

Advocacy and policy making

Research Methodologies in Mental Health

Health Education Materials

Mental Health Education and Media

Aids and Methodologies in Mental Health Education

Theories and Evidence Based Research in Mental Health Education

Legal and Ethical Principles in Mental Health Education

In the above mentioned subjects, the Journal invites submission of original research

papers, brief reports, case discussions, debates, commentaries and controversies,

narrative and systematic reviews, essays, letter to editor, correspondence and book

reviews.

Potential readership for this Journal includes but not limited to mental health

professionals (psychiatrists, psychologists, psychiatric social workers, mental health

nurses), health educators, public health professionals, people from the media, non-

government organizations, administrators and policy makers working in the field of

Mental Health.

EDITORIAL BOARD JMHEDU

Concept and Mentor

Dr. Santosh K. Chaturvedi

Former Dean & Senior Professor of Psychiatry,

National Institute of Mental Health &

Neurosciences, Bangalore, India

Chief Editor

Dr. K. S. Meena

Additional Professor

Head of Department of Mental Health Education NIMHANS,

Bangalore, India

Deputy Editor

Dr. Latha K.

Assistant Professor

Department of Mental Health Education NIMHANS,

Bangalore, India

International Editorial Board

Dr Helal Uddin Ahmed

Associate Professor

Dept. of Child Adolescent & Family Psychiatry,

National Institute of Mental Health, Dhaka, Bangladesh

Dr. Afzal Javed

Chairman

Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan

Dr. Mitchell Weiss

Health Social Scientist & Professor

Swiss Tropical and Public Health Institute, University of Basel, Basel,

Switzerland

Dr. Matcheri S Keshavan

Professor of Psychiatry

Harvard Medical School, Boston, MA

Dr. Shinfuku Naotaka

Emeritus Professor

Kobe University School of Medicine, Japan

Dr. Gabriel Ivbijaro

Immediate Past President WFMH

Professor at NOVA University, (Lisbon) Portugal Medical Director,

The Wood Street Medical Centre, UK

Dr. Ali Ahsan Mufti

Assistant Professor

Jinnah Medical College Consultant Psychiatrist Ibadat Hospital, Peshawer

National Editorial Board

Dr. Rajaram Subbian

Psychosocial Consultant

Executive Director of Basic Needs, India

Core Team from NIMHANS, Editorial Board

Dr. Aravinda.B.A.Banavaram

Associate Professor, Department of Epidemiology, NIMHANS, Bangalore, India

Dr. Aruna Rose Mary Kapanee

Associate Professor, Department of Clinical Psychology, NIMHANS, Bangalore,

India

Dr.Arivazhagan

Professor, Department of Neurosurgery, NIMHANS, Bangalore, India

Dr. Poornima Bhola

Professor, Department of Clinical Psychology, NIMHANS, Bangalore, India

Dr. Prabha. S. Chandra

Professor, Department of Psychiatry, NIMHANS, Bangalore, India

Dr. Prabhat Kumar Chand

Professor of Psychiatry, Head of Centre for Addiction Medicine

NIMHANS, Bangalore, India

Dr. Geetha Desai


Dr. Sailaxmi Gandhi

Professor and Head, Department of Nursing, NIMHANS, Bangalore, India

Dr. Kavitha Jangam

Associate Professor, Department of Psychiatric Social Work, NIMHANS,

Bangalore, India

Dr. Deepak Jayarajan

Associate Professor, Psychiatric Rehabilitation Services, NIMHANS,

Bangalore, India

Dr. Santosh Loganathan


Dr. Reeta Mani

Additional Professor, Department of Neurovirology, NIMHANS, Bangalore,

India

Dr. N Manjunatha

Associate Professor, Department of Psychiatry, NIMHANS, Bangalore, India

Dr. Seema Mehrotra

Professor and Head, Department of Clinical Psychology, NIMHANS,

Bangalore, India

Dr. D. N. Nandakumar

Professor and Head, Department of Neurochemistry, NIMHANS, Bangalore,

India

Dr. Nandeesh. B. N

Associate Professor, Department of Neuropathology, NIMHANS, Bangalore,

India

Dr. Prasanthi Nattala

Additional Professor, Department of Nursing, NIMHANS, Bangalore, India

Dr. G. Radhakrishnan

Associate Professor, Department of Nursing, NIMHANS, Bangalore, India

Dr. Manoj. K. Sharma

Professor, Department of Clinical Psychology, NIMHANS, Bangalore, India

Dr. John Vijay Sagar

Professor & Head, Department of Child and Adolescent Psychiatry, NIMHANS,

Bangalore, India

Dr. Priya Treesa Thomas

Associate Professor, Department of Psychiatric Social Work, NIMHANS,

Bangalore, India

Dr. Mathew Verghese

Senior Professor and Head, Geriatric Psychiatry Unit, Department of Psychiatry,


Dr. Vandana V. P

Additional Professor and Head, Department of Speech Pathology and Audiology,


Dr. B. K. Yamini

Additional Professor, Department of Speech Pathology and Audiology,


Dr. P T Sivakumar

Professor of Psychiatry, Consultant in Geriatric Psychiatry Unit,

Department of Psychiatry, NIMHANS, Bangalore, India

Dr. Vranda M.N.

Additional Professor, Department of Psychiatric Social Work,


Dr. Anish V Cherian

Associate Professor, Department of Psychiatric Social Work NIMHANS,

Bangalore, India

Dr. Debanjan Banerjee

Senior Resident, Department of Psychiatry NIMHANS, Bangalore, India

Dr. Lakshmana G

Assistant Professor, Department of Social Work, School of Social and

Behavioural Sciences, Central University of Karnataka, Kalaburgi, Karnataka

Associate Editors

Deepika Saini

Masters in Psychology, Currently a fellowship student in the Department of Mental

Health Education, NIMHANS, Bangalore, India

Dr. Rajeev Jayaram Paleri

MBBS, Currently a fellowship student in the Department of Mental Health

Education, NIMHANS, Bangalore, India

Student Editor

Manjiri Gokhale

Pursuing BSc PJCs (Psychology, Journalism, Computer Science), currently an

intern at the department of Mental Health Education

CONTENTS

S.NO TITLE PAGE NO.

EDITORIAL

i. What do I do? Predicament of Mental Health Education

during Pandemic

Dr. Santosh K Chaturvedi

1

COMMENTARY

1. A brief commentary on COVID 19: A Disguised Lesson of

Positivity

Shivani Haritay

4

2. Psychosocial impact of COVID 19 on Migrants

Muhammed Noorudheen

7

ORIGINAL ARTICLE

3. Academic Stress among 10th Standard Students during

COVID-19 Lockdown Period

Megha S. Rao

11

4. Awareness generation in the communities: field experience from the

CBOs

N. Janardhana

19

REVIEW ARTICLE

5. Policing During COVID-19 Pandemic and its Impact on

Mental Health

Apurva Kumar Pandya

40

S.NO TITLE PAGE NO.

BRIEF COMMUNICATION

6. Experience of Interning in the field of Mental Health Education

Manjiri Gokhale

58

7. NIMHANS Arogya Jagruti Kendra- A window to Educate

Minds and Empower Communities

Deepika Saini

65

Journal of Mental Health Education | NIMHANS |VOLUME 3 ISSUE 1 | April 2021

What do I do? The predicament of Mental Health Education during

Pandemics and looking forward

Dr. Santosh K Chaturvedi

Address for correspondence: Santosh K Chaturvedi, Former Dean & Senior Professor of

Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore -560029, India

How to cite this article:

Chaturvedi S. What do I do? The predicament of Mental Health

Education during Pandemics and looking forward. Journal of

Mental HealthEducation.2021;3(1):1-3

The role of mental health education

was exemplified during this current

pandemic. On one hand, its role was

in promotion of health in general and

mental health in particular, on the

other hand it had to deal with mental

health issues related to the pandemic.

There were numerous mental health

issues which emerged, some

unimaginable. There were fears and

anxieties related to contracting or

spreading infection, and there were

stigma issues towards frontline

workers and health professionals.

Mental health education professionals

thus needed to focus on the emerging

issues which kept changing by the

days.

1


They had to put other general mental health promotion and education issues on the back

burner, those issues were still as relevant as ever. This was similar to the situation of

medical profession; the predicament of doctors who were mired in confusion about what

their duty is and what they should do; save one life at the cost of losing another! Is it their

duty to follow the instructions or orders from their health leaders and systems or listen to

the voice of their conscience? If they follow the directions from their health leaders, they are

consigned to live with the guilt of not doing their duty lifelong.

The features of this ‘what do I do?’ phenomenon is related to healthcare delivery and related

matters, including mental health education. These have been experienced and reported by

many of our colleagues facing this predicament. The dilemma is the compromised autonomy

of the mental health education workers, their inability to do what they think is right and

needed. Mental health education programs on common mental disorders, situations and

conditions were halted, even though these had some links with the pandemic. In the pre

Covid-19 times general public were all advised to do regular physical activity, go for a walk

or a swim, or regular outdoor exercises in order to improve their respiratory and cardiac

functions and attaining well- being. All these were prohibited during the lockdown making

people more vulnerable to deal with the pandemic stress.

Stigma is an important theme in mental health education programs. One of the key objectives

of mental health promotion and education programs is reducing stigma towards mental illness

and those with mental illness. The pandemic has caused so much mental tension, anxieties

and fears that the role of mental health professionals and interventions has seemingly become

as important as the search for cure or treatment of the viral infection. There is also

tremendous stigma towards covid-19, people who turned positive on testing, or were at high

risk, or primary or secondary contacts. On the positive side, the government and public

have become well aware of the mental health issues, fears, anxieties and stress related to

covid-19 and launched extensive and mental health education on this aspect. Mental health

counsellors are being sought after and multiple telephone help-lines have been launched.

The counselling for such mental health issues and stigma could mainly be provided through

remote methods, like, tele-counselling and chats. Numerous health education materials in

the form of pamphlets, videos and use of technology to deal with this stigma have been

launched to counter the effect of stigma, negative impact of rumors, and to provide accurate

and authentic information. Thus, stigma associated with Covid-19 pandemic has reduced

stigma towards mental health and seeking mental health services and counselling. The

rumors and misinformation proved to be more than or as contagious as the virus itself.

This has led to fear in the public. This also led to stigma, not only against the infection, but

2


those who were even remotely associated with it. Rumors, like the virus, are infectious.

Fear and anxiety produced by such rumors are transmitted even if social distancing is

maintained. These cause widespread panic. A suitable way to deal with these would be

providing authentic knowledge and information through appropriate health information and

mental health education. These should be in different forms in order to reach the general

population, through mass media and social media.

A task force was set up to address the mental health aspects of the pandemic and make a plan

for action for psychosocial support. The committee suggested certain interventions may be

executed in the post-pandemic period, which included - preparations for addressing long

term reactions, which may evoke varied emotional response from the population, such as

suicide attempts, substance use and alike; support people in adjusting themselves to the ‘new

normal’ state, by providing continued psychosocial support; enhance the resilience, coping,

and adaptation levels in the community by devising specific awareness and interventions

programs and promote healthy lifestyles and habits to prevent future pandemics or the

morbidities associated with pandemics. Specific interventions on psychosocial support for

Covid-19 response included development of sensitization/training material for frontline

workers including health professionals for providing psychosocial support to such people,

sensitization of frontline workers including health professionals, development and

dissemination of messages to address anxiety, stigma and discrimination. For caregivers, it

was suggested to develop and disseminate messages for addressing psychosocial issues of

family caregivers’ burden and trauma including health professionals and other frontline

workers and development and dissemination of messages for addressing psychosocial

issues of people of vulnerable groups among the general population. Other suggestions to

be considered were development of sensitization/training material for frontline workers

including health professionals for providing psychosocial support vulnerable groups of

people; and development and dissemination of messages for addressing social stigma

attached with people in quarantine/isolation and frontline workers. As can be seen in these

suggestions, the role of mental health education in management of the impact of the

pandemic are of paramount significance. The health education and mental health education

sections and departments need more support and resources in order to meet the goals and

objectives of facing the psychosocial consequences of the pandemic. Being in the midst of

multiple strains and waves, it is clear, people have to live with this and similar pandemics

in future. Being prepared to face the uncertainties this time will definitely be of great help

and support.

3


A brief commentary on COVID 19: A Disguised Lesson of Positivity

Shivani Haritay Masters of Public Health, KLE JNMC, Belagavi, Karnataka

Address for correspondence: Shivani Haritay, Masters of Public Health, KLE JNMC,

Belagavi, Karnataka.

E-mail: [email protected]


Haritay S. A brief commentary on

COVID-19: A Disguised Lesson of

Positivity. Journal of Mental Health

Education. 2021;3(1):4-6

“Having an attitude that looks for

the positive and tries to be

optimistic can help you to filter out

some of the constant barrage of bad

or discouraging news- the figures

of the disease and how it’s

growing,” Wilcox said.

Covid-19 has created havoc all over

the world, leaving traces of death.

Negativity in the form of stress has

been witnessed in every aspect of

our lives. The constant fear of

being tested positive for COVID-

19 has been challenging for every

individual and a sense of being safe

is lost due to rise in the cases.

Major steps to cope up with this

pandemic crisis included restriction

of movement and social distancing,

which led individuals to be isolated

at home, affecting their mental

4

mailto:[email protected]


health indirectly as recreational activities like travelling, exploring streets and others were

completely stopped for a period of time which added to their frustration and anger. The sense

of anxiety about one’s own health had brought changes in eating and sleeping patterns.2

The present crisis is a transitional phase as the past shows us to value the present that is most

important to us and to look into the future to discover the newness of life. 3 COVID-19 has

been a disguised teacher who taught us the key lessons of life. The transmission of

COVID- 19 has indicated that if one does not take care of himself, he can be at the risk of

getting infected or infecting those around him. The second most important lesson was to

value the smallest steps like maintaining hygiene and sanitation, following the simplest

rules and regulations set by the government. Thirdly, to be aware of one's own action

towards the environment, following the guidelines of wearing a mask and gloves is

absolutely right but discarding them in a proper way is also equally important. Fourth

lesson was learning how to respect time, the questions like how much time did I lose being

sad, angry, or gain a moment being happy? During this phase time played a vital role, it

reconnected one to his own hobbies and cultivated an art of adjustment. Fifth, the share of

responsibilities at home, the gender based roles merged during this time, for family time

played a vital role. Sixth, the greatness of sacrifices by our health care frontline workers, law

and order officials and others proved to be a true inspiration. Lastly COVID-19 through its

nature of virus showcased it mightiness of power over humanity, the greatest take away

from it was together if humans decide to accept change, no power can conquer the will of a

man, today every individual has united together to fight back against the pandemic, with a

hope to end this crisis sooner. Positive emotions, such as comfort, happiness, joy, love, and

gratitude, can help maintain and improve human mental health.3 To conclude being

positive during a challenging time like a pandemic, seems little tough but looking at the

broader aspect and with a choice in change of thought, positivity can help in coping not

only stress but also one’s own routine making it more productive and cheerful. Covid-19

has paved a path in shaping human life in every aspect while battling with the crises.

References

1. Readers Blog by Times of India. India :Archie Mishra April 19 2020, (cited on

September 21, 2020) available at

https://timesofindia.indiatimes.com/readersblog/bubblybarebones/15ways-to-stay-

positive-du ring-covid-19-12287/ (last accessed on September 21, 2020)

2. Centers for Disease Control and Prevention (2020) Coping with Stress available at

5

https://timesofindia.indiatimes.com/readersblog/bubblybarebones/

https://timesofindia.indiatimes.com/readersblog/bubblybarebones/15ways-to-stay-positive-during-covid-19-12287/




https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress- anxiety.html

(last accessed on September 21, 2020

3. Yamaguchi, K., Takebayashi, Y., Miyamae, M., Komazawa, A., Yokoyama, C., & Ito, M.

Role of focusing on the positive side during COVID-19 outbreak: Mental health perspective

from positive psychology Psychological Trauma: Theory, Research, Practice, and Policy

2020. 12(S1), S49 S50.

6

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html


Psychosocial impact of COVID-19 on Migrants

Muhammed Noorudheen1, Lekshmi Vimala2, Anish V Cherian3

1MPhil Scholar, Department of Psychiatric Social Work, NIMHANS, Bengaluru

2PhD Scholar, Department of Psychiatric Social Work, NIMHANS, Bengaluru

3Assistant Professor, Department of Psychiatric Social Work, NIMHANS, Bengaluru

*Address for Correspondence: Muhammed Noorudheen, MPhil Scholar, Department of

Psychiatric Social Work, NIMHANS, Bengaluru, India,



Noorudheen M, Vimala L, Cherian

A V. Psychosocial impact of

COVID- 19 on migrants. Journal of

Mental Health Education.

2021;3(1):7-10

Though the pandemic is not a new

concept to humankind, the current

Covid-19 outbreak is different

from all the previous ones that we

have overcome. The virus in itself

may not be life-threatening, but

most of the population could get

affected due to the absence of

vaccines and ‘herd immunity’ not

being applicable. It puts the health

care system under strain leading to

catastrophic repercussions.1 In the

absence of a vaccine, the only

viable option available to help

flatten the curve, is to follow the

precautionary measures diligently

7



lockdowns included. Currently there are restrictions of social interaction in workplace,

schools and other public spheres, except for essential public services such as fire, police,

hospitals.2 However, this measure has seen adverse after effects in the informal sector, with

the worst brunt being borne by the migrant laborers, who are left with no job, money or

shelter3 and asked to stay put till end of the lockdown, as their movement would act as a

risk factors. Migrant workers have been chronicled as highly vulnerable to stress due to

displacement, undernutrition, low immunization coverage rate, and various physical and

mental health conditions.4 They are also often exposed to challenging and unsafe

conditions, occupational hazards, poor living conditions, and the absence of a supportive

family or societal structure. They also do not have access to educational or health

programmers.5 Difficulties in communication due to language barriers, traditional beliefs,

and socio-economic status are significant challenges for migrants.6 There is inadequate data

that connects migration, livelihood strategies, and the economic growth in India, which has

resulted in inaccurate policies and a lack of political commitment to improve the lives of the

migrants.7,12 Though migration has been found to be a leading cause of mental health issues8

and suicide9,the subject is not much explored in India. Women are potentially more

affected by the loss of livelihood, domestic violence, and forced early marriages. In

addition, Prof. Aman pointed out that 133 people died by suicide out of distress about the

COVID infection, loneliness, travel restrictions imposed during the lockdown, and the

hopelessness over their inability to return home.10

Policy changes at the state level have to be brought to ensure proper dissemination of services

to the migrant workers. Though there are policies that exist to protect the migrants (such as

the National Rural Employment Guarantee Act, 2005 and the Minimum Wages Act, 1948),

these are fragmented in nature and do not address the concerns related to physical and mental

health in its entirety.5 Disaster preparedness and risk reduction need to be implemented

from a disaster perspective, such as awareness raising, early warning, emergency

communication and effective recovery. These all have to be application level from the

systematic framework. Sensitization and training of concerned policy makers and health

stakeholders such as government officials, healthcare workers, and private employers are to

be done on a large scale so that adequate information about the necessary health and public

services will help prevent expected psychological distress and promote mental health well-

being among migrants. The existing community and religious organizations can be

developed to mobilize the psychosocial support and resources required.11 Alternative

identity cards can be issued to the migrant workforce (similar to what has been

implemented in Kerala) to provide education and welfare services including health

provisions and child policies.12

8


The economic and sociocultural changes experienced that acts as a risk factor for poor

mental health also needs to be addressed.8 Helplines and Crisis interventions need to be

available to the migrant workforce during disaster and times of emergency (such as the

current outbreak) to take care of the specific needs of the migrant population so that events

similar to the ‘long walk’13 that happened recently in New Delhi can be avoided.

References

1. Ackerman. D. Infectious disease experts explain how the coronavirus pandemic is different

from a flu pandemic. Business Insider India. [Internet] [2020, April]. Available from:

https://www.businessinsider.in

2. Sardar T, Nadim SS, Chattopadhyay J. Assessment of 21 days’ lockdown effect in some

states and over all India: a predictive mathematical study on COVID-19 outbreak. arXiv

preprint arXiv:2004.03487. 2020 Apr 7.

3. Slater J, Masih N. In India, the world’s biggest lockdown has forced migrants to walk

hundreds of miles’ home. The Washington Post. Mar. 2020 Mar;28. Available from

https://www.washingtonpost.com

4. Nitika AL, Nongkynrih B, Gupta SK. Migrants to urban India: need for public health action

Indian journal of community medicine: official publication of Indian Association of

Preventive & Social Medicine. 2014 Apr;39(2):73.

5. Borhade A. Health of internal labour migrants in India: some reflections on the current

situation and way forward. Asia Europe Journal. 2011 Apr 1;8(4):457-60.

6. Virupaksha HG, Kumar A, Nirmala BP. Migration and mental health: An interface. Journal

of natural science, biology, and medicine. 2014 Jul;5(2):233.

7. Deshingkar, Priya and Akter, Shaheen. Migration and Human Development in India

Published in: Human Development Research Paper (HDRP) Series. 2009, Dec Vol.13.

8. Firdaus G. Mental well-being of migrants in urban center of India: Analyzing the role of

social environment. Indian journal of psychiatry. 2017 Apr;59(2):164.

9. Anil RA, Nadkarni A. Suicide in India: a systematic review. Shanghai archives of

psychiatry.2014 Apr;26(2):69.

10. Dheeraj Mishra. RTI Shows the Government Did Collect Data on Deaths of Migrant

Workers During Lockdown. The Wire. 2020 Sep 17. Available from

https://thewire.in/rights/centre-indian-railways-lockdown-deaths-migrant-workers-shramik-

special-rti

11. Reitmanova S, Gustafson DL. Mental health needs of visible minority immigrants in a small

9

https://www.businessinsider.in/

https://www.washingtonpost.com/

https://thewire.in/rights/centre-indian-railways-lockdown-deaths-migrant-workers-shramik-special-rti





urban center: Recommendations for policy makers and service providers. Journal of

Immigrant and Minority Health. 2009 Feb 1;11(1):46-56.

12. Aggarwal, V, Singh, P. Mitra, R. Low interstate migration is hurting India's growth and

states are to blame. Business Standard. 2019, August 26. Available from

https://www.business-standard.com

13. Nayar PK. The Long Walk. Journal of Extreme Anthropology. 2020 Mar 29;4(1):E1-6.

10

https://www.business-standard.com/


Academic Stress among 10th Standard Students during COVID-19

Lockdown Period

Megha S Rao1, Sindhu V 2 1Lecturer, Department of Psychology, M.E.S College of Arts, Commerce & Science,

Bangalore

2Former Behaviour Trainer from YourDOST organization, Bangalore.

*Address for Correspondence: Megha S Rao, Lecturer, Department of Psychology,

M.E.S College of Arts, Commerce & Science.



Rao S, V. S. Academic stress among 10th

standard students during COVID- 19

Lockdown period. Journal of Mental

Health Education. 2021;3(1)11-18

Abstract

Aim: To understand the level

of academic stress among 10th

standard students who were

taking tests on a daily basis

through online mode due to

COVID-19 lockdown.

Method: A total of 60 students

(30 boys and 30 girls) were

selected using a purposive

sampling method. The

Educational Stress Scale for

Adolescents (ESSA, Sun,

Dunne, Hou, & Xu, 2011a)

which is a revised 16 item

scale which includes five

factors – pressure from study,

workload, worry about grades,

11



self-expectation and study despondency was used for the study. Along with this scale, a

question on how this lockdown period helped participants to cope with the situation was asked

and the responses were collected using Google forms. Mean, Median, independent samples t-

test, Pearson Product Moment Correlation were the statistics used to analyze the data.

Results: It was found that there is no significant difference in the academic stress level among

boys and girls. However, the mean scores indicated that girls were more stressed compared

to boys. It was also found that there was a significant positive relationship between pressure

from study and worry about grades and study-despondency. Low levels of academic stress

were found among boys and girls. Low level of stress under the factors word-load, self-

expectancy and study-despondency and average level of stress under pressure from study

and worry about grades was reported.

Conclusion: Involving in various activities would help students cope better with the

academic stress.

Key words: Academic stress, 10th standard students, online mode, COVID-19

Background

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by a newly

discovered Coronavirus.1 Dr. Sameer Malhotra, director and head, Department of Mental

Health and Behavioral Sciences, Max Healthcare says that students who are giving board

exams are concerned about the uncertainty that future holds.2 S. Arumainadhan, the

President of the Tamil Nadu Students’ Parents Welfare Association, Chennai said that “This

situation is stressful for students. There is a lot of stress that the students are burdened with

during board exams and now this COVID-19 will stress them even more.”3

Methodology

The study used survey methods which were exploratory in nature. A purposive sample of 60

students (30 boys and 30 girls), studying in tenth standard were chosen to understand the

level of stress as they were dealing with uncertainty and were taking many subject related

tests. Consent for participation was obtained and responses were collected using Google

forms between 1st and 6th of May 2020. A question “Has this lockdown period helped you

develop or learn anything new? If yes, please mention what new skill you have learnt” was

asked mainly to understand how students were dealing with the lockdown period.

12


Tools: The revised version of Educational Stress Scale for Adolescents (ESSA, Sun, Dunne,

Hou, & Xu, 2011a) was used to estimate the level of academic stress. It contains 16

statements rated on a 5-point Likert scale ranging from 1 (Strongly disagree) to 5 (Strongly

agree). The total score ranges from 16 to 80: a high score indicating greater stress. This scale

has five factors: ‘Pressure from study’ (four items about the perceived pressure from daily

learning, from parents, peer competition and students’ concern about the future); ‘Workload’

(three items regarding perceived burden of homework, schoolwork and examinations);

‘Worry about grades’ (three items regarding stressful emotions due to dissatisfaction with

academic grades); ‘Self- expectation stress’ (three items about stressful feelings when self-

expectation failed to be met) and ‘Despondency’ (three items about dissatisfaction and lack

of confidence and concentration in academic study). This instrument has satisfactory to good

internal consistency with Cronbach’s α = .82 for the total scale. Test-retest reliability is

satisfactory with .78 for the total scale.

Analysis

SPSS Version 16.0 was used to calculate the mean and median to understand the level of

stress under five factors. Independent samples T-Test was computed to see if there is a

significant gender difference in academic stress and Karl Pearson Product Moment

correlation to understand the relationship between all the five factors.

Results and discussion

Table 1 (Appendix 1), shows Academic stress does not differ significantly among boys and

girls of 10th standard students taking tests on a daily basis during the lockdown period of

COVID-19. However, the mean scores indicate that the academic stress is slightly higher

among girls (mean=49.933, SD=7.49) than boys (mean=49.500, SD=8.754) with a t-value

0.206. This finding indicates girls reporting more academic stress than boys.

Table 2 (Appendix 1), shows a significant relationship between the different areas of

Academic stress across gender by 10th standard students taking tests on a daily basis during

the lockdown period of COVID-19. Pressure from study has a positive correlation with

worry about grades (r=0.434, p<0.01). Pressure from study has a positive correlation with

self- despondency (r=0.472, p<0.01). This indicates that increased pressure from study can

increase worry about grades and self-despondency.

The findings of the study show that participants experience low levels of academic stress

13


(35%) compared to average (33.3%) and high (31.7%) levels of Academic stress.

Average level of stress under the factors Pressure from study (low= 33.3%, average=35%,

high=31.7%) and Worry about grades (low=40%, average=41.7%, high=18.3%).

Low level of stress under the factors workload (low= 40%, average=28.3%, high=31.7%),

Self-expectancy (low=32.3%, average=9.4%, high=20.8%) and Study-despondency (low=

30.2%, average=15.6%, high=16.7%).

The level of stress was found to be low among the participants as they had involved themselves

in different activities. Girls were involved in cooking, household chores, drawing, playing

games, chess, learning songs, acting and reading story books. Few had taken the opportunity

to improve their academic progress for board exams and one of the participants was

involved in learning how to ride a bike. Boys were involved in cooking, solving Rubik’s

cube, practicing yoga, exercising, trying to build their body, riding, household chores and a

few of them had taken the opportunity to improve their academic progress for board exams,

and one of the boys had mentioned that he was practicing anger management and being

calm at times.

However, a few boys did mention that they were not happy as they felt depressed staying

alone and not meeting their friends for a long time. Among 60 participants, 17 participants

indicated that they had not been involved in any major activities as such.

Suggestions

From this study we can understand that although there is uncertainty, participants coped with

their stress level by involving themselves in different activities. Stress is caused by thinking

about the future and not being focused completely. To manage the stress level, a certain

strategy to cope with academic stress can help the mover come.

The coping strategies may include learning new skills through practice, using positive self-

talk, taking responsibility for mistakes, forgiving ourselves, focusing on what we can control

and practicing good self-care.

Implications

The result of this study helps parents, students and teachers understand that pressure from

studying can have an impact on study-despondency and their worry about grades. However,

adapting and accommodating coping strategies or focusing on different activities may lower

the level of academic stress.

14


Limitations

● Limited scope for generalization of the study’s conclusion due to small sample size.

● Participants only from urban areas were considered.

● Participants were not selected randomly.

Conclusion

The level of stress is low on academics as a whole among 10th standard students, taking tests

on a daily basis during the lockdown period due to COVID-19. Participants have shown low

levels of stress under workload, Self-despondency and Self-expectancy. There is no

significant difference across gender in academic stress. There is a significant relationship

between pressure from study and worry about grades, study-despondency across gender.

References

1. World Health Organization, Health topic, Coronavirus available at

https://www.who.int/health-topics/coronavirus#tab=tab_1

2. Ghosh S, (2020), Express News Service, New Delhi, available at

https://www.newindianexpress.com/lifestyle/health/2020/may/07/anxiety-feeling-of-

uncertainty-mental-health-talks-rise-amid-covid-19-lockdown-2140214.html

3. Deeksha J (20/03/2020), TN students, parents hoping state will go CBSE way, postpone

Class 10 exams, available at https://www.edexlive.com/news/2020/mar/20/tn-students-

parents-hoping-state-will-go-cbse- way-postpone-class-10-exams-10790.htm

15

http://www.who.int/health-topics/coronavirus#tab%3Dtab_1

http://www.who.int/health-topics/coronavirus#tab%3Dtab_1

http://www.newindianexpress.com/lifestyle/health/2020/may/07/anxiety-feeling-of-

http://www.newindianexpress.com/lifestyle/health/2020/may/07/anxiety-feeling-of-

http://www.edexlive.com/news/2020/mar/20/tn-students-

http://www.edexlive.com/news/2020/mar/20/tn-students-


APPENDIX 1

Table 1 shows mean, standard deviation, t-value and significant difference in Academic

stress across gender, by 10th standard students taking tests on a daily basis during lockdown

of COVID-19.

Scale Groups Mean SD p-value t-value

Academic stress Boys 49.5000 7.49

Girls 49.9333 8.784

0.497 0.206

16


Table 2 shows the significant relationship between different areas of Academic stress

across gender i.e. Pressure from study, workload, and worry about grades, self-expectation

and study- despondency by 10th standard students taking online classes during lockdown

of COVID-19.

Factors of

PFS WL WA G

SE SD

Acade

mic

stress

PFS

1

0.1

76

0.43

4**

0.1

45

0.472*

*

WL 0.176 1 -

0.16

9

0.1

07

0.039

WAG 0.434

**

-

0.1

69

1 0.1

26

0.213

SE 0.145 0.1

07

0.12

6

1 0.154

SD 0.472 **

0.0 39

0.21 3

0.1 54

1

p<0.01

PFS=Pressure from study, WL=Workload, WAG= Worry about

grades, SE=Self-Expectation and SD= Study-Despondency.

17


18


Awareness generation in the communities: field experience

from the CBOs N. Janardhana1*, DM. Naidu2, Guru Raghevendra3

1Dr, N. Janardhana, MSW, M.Phil, Ph.D, Professor, Department of Psychiatric

Social Work, NIMHANS, Bangalore, Karnataka.

2DM. Naidu (deceased), Programme Manager, Basic Needs India, Bangalore.

3Guru Raghevendra, Programme Manager, Samarthanam Trust, Bangalore.

*Address of correspondence: N. Janardhana, MSW, M.Phil, Ph.D, Professor,

Department of Psychiatric Social Work, NIMHANS, Bangalore, Karnataka.



Janardhana N, Naidu M D, Raghevendra G.

Awareness generation in the communities: field

experience from the CBOs. Journal of Mental

Health Education. 2021.3(1):19-39.

Abstract

Mental illness attracts less

empathy and more distrust than

any other forms of illness. People

may consciously or

unconsciously isolate themselves

from people with mental illness

and their families. Lot of

misconception govern the faith of

people with mental illness.

Mental illness often generates

misunderstanding, prejudice,

confusion and fear. There is an

urgent need for developing

awareness generation in order to

reduce ill effects of stigma.

researcher have collated various

means of awareness generation

program while working with

19


the partners in initiating community based rehabilitation program for people with

mental illness in the community. Researcher have shared various mediums of

awareness generation like, street theatre, puppet shows, wall writings, booklets, rallies,

etc., as means of generating awareness in the community. Intervention programs need

to be designed using locally available community resources. The awareness generation

should involve community members, so that they can sustain the program.

Key words: Stigma, Discrimination, Community Based Rehabilitation,

Introduction

The word Stigma means a mark of shame associated with a particular circumstance,

quality or a person. In the context of mental health issues, stigma is a mark of

degradation associated with person living with mental illness1,2. It is not just that

person who becomes mentally ill gets stigmatised but the entire family has to face the

brunt3,4. This has been the age-old issue, and passed on from generation to generation.5

Such people were called as lunatics, mad, mental, loose, incapable etc. In the East,

people still believe that mental illness is caused due to witchcraft, misdeeds in the

previous lives, curse, etc.6 These sort of perceptions, misconceptions, myths and

apprehensions leads to stigmatise people with mental illness and their family

members.5,7 The stigma is so tremendous that people feel ashamed and deny their

illness. Therefore, the first and foremost element that shrouds the realm of mental

illness is stigma attached to it. It is a huge burden on the family members. The very

thought of someone in the family getting mental illness is a big shock and they do not

want to believe it. Hence, they first go to temples, black magicians, witches and faith

healers and waste whole lot of financial and other resources, before reaching menstal

health care services8. The burden of stigma may exceed the burden of the disease in its

impact on social, emotional, and work functioning, thus negatively affecting the overall

quality of life.9

Janardhana and Naidu in their study have found various forms of stigma faced by

families of people with mental illness10. They have reported harmful treatment,

chaining and locking in the rooms, social boycott for the families, denial of property

rights for persons with mental illness, legal separations due to mental illness, caregivers

20


getting ostracized, and also denial of right treatment. In another study with children

with disabilities, Janardhana et al.,4 (2016) have found various ugly forms of

discrimination and stigma seen are social boycott, denial of property rights, physical

restraints, decreased prospectus of marital life due to disabled member in the family,

discriminations from the state policies, and women with disabilities face more brunt of

their disabilities.

Due to stigma associated with mental illness, families become victims of

discrimination and human rights abuse. When poverty, physical neglect and social

marginalization intersect, the impact on the people with mental illness and their

families can be devastating. People with mental illness are kept hidden away at their

home, denied basic rights of mobility, education and employment. They are viewed as

incapable and dependent persons.10 Such discrimination in some cases starts from their

family members and spreads right up to the policy makers and state authorities as the

policies for people with mental illness are not user friendly. 11 As a result of such

discrimination the people with mental illness and their families face chronic health

issues, socio-economic burden and destitution. Sometimes it is so difficult to

define the marginalization — they are outside the margin or within the community

meaning, locked in the rooms, institutionalized, families isolating themselves, enrolling

in special homes, not admitting that they have a person with mental illness in their

families, and etc.12 Social attitudes and stigma play an important role in limiting

the opportunities for people with mental illness for their full participation in social

and economic life, often even within their own families.13

Stigmatizing attitudes towards mental disorders are responsible for substantial distress

among caregivers, and delay in seeking appropriate help for treating their family

member with mental illness14,15 and often find it difficult to rehabilitate them as they do

not have adequate opportunities for employment.15,16 Moreover, stigma is not confined

only to severe mental illness but also to common mental disorders. 17,21

Researchers have proved that stigma has become one of the public health problem and

need to develop strategies and mechanisms to create awareness in the community so

that people with mental illness would get adequate opportunities for living with

dignity.22,25 World Health Organization has called for action amongst its member

nations to develop strategies of creating awareness to reduce stigma26, and several

activities in this area have been implemented by both government and non-

21


governmental organization23. The researchers in the current paper have shared their

experiences of using different methods and mediums of awareness generation by

utilizing the local resources available within their reach.

Method

The researchers were working in Basic Needs India, a registered Trust and a resource

group in community mental health and development. The Basic Needs India partnered

with the CBOs and NGOs for including mental health issues in their development

activities in all south Indian states. Basic Needs India, a resource group in community

mental health and development, worked with partner organizations like SACRED in

Ananthpur and Kurnool district, Andhra Psradesh; Samuha in Koppal and Raichur

district, Grameena Abyadaya Seva Samasthe, Dodabalapura, Karnataka; ADD India

and Vidyasagar partners in states of Tamil Nadu and Kerala. The researchers supported

these organizations in building their capacities to include people with mental illness in

their disability programs in their project areas in rural areas. During the process of

capacity building, the field staff/CBR workers would come out with different methods

using materials available within their reach in developing awareness materials.

Researchers have tried to capture some of the methods and materials used for creation

of awareness materials in writing this paper. The aim of this paper is to capture various

methods of awareness generation which can be used in the community for dealing with

the ill effects of stigma. During the review and consultation with the partner

organization, people with mental illness and other disability groups were also evolving

strategies for dealing with stigma and discriminations. The researcher would like to

share community based strategies evolved for dealing with the stigma in the current

paper.

Means of awareness generations with people’s participation and utilizing

community resources

Sl

no

Modes of

awareness

generation

Key features

1 Street theatres Street theatre troops are

made in their locality

involving field staff, and

volunteers in the

22


community. Language and

cultural factors are taken in

to consideration while

writing the script for the

street theatres. This would

attract people to participate

and also has scope for

interaction after the street

theatres, and helps in

identifying people with

mental illness, as

community members would

identify and refer them to

the field staff.

2 Posters using

materials in

their reach

Waste materials like used

tyres, cement gunny bags

and other materials are used

to write posters which are

cost effective and also easy

to carry for the field staff to

places where they conduct

awareness programs.

3 Wall writing The awareness material

generated would stay for

long time till they repaint.

Most of the family

members have volunteered

to give space for such

writing, they have taken

responsibility for

safeguarding such writing.

This would address the

sustainability of program.

4 Wall painting It generated community

participation, people in the

community actively

participate in filling paints

for the sketches. It also

makes them own the

painting. This would be

long lasting addressing the

sustainability of the

program.

23


5 Press clubs Print media need to actively

participate in capturing the

experiences of people with

mental illness and their

families. People with

mental illness and their

caregivers should be

encouraged to share their

experiences during

observation of world

mental health day and

world disability day, so that

people would get sensitized

about the needs, and their

attitudes can be changed

and create safe environment

for people with mental

illness

6 Books in local

language

Demystifying the technical

information into a simple

booklet for people to

understand the concept of

mental health and mental

illness. These books can be

kept in public transport

vehicle, so that people can

read while traveling.

7 Puppet shows Scripts prepared can be

enacted through puppet

shows, which would attract

children and people in the

community, this also helps

to relate to the problems

and would be able to

identify people with mental

illness in their areas

8 Caregivers

groups and

associations

Encouraging caregivers to

form self-help groups also

help to save money and get

loans for livelihood

activities. These groups

would generate strengths

for the families to evolve

24


support for dealing with

their problems.

9 Medicine box

using materials

in their reach

Developed by field staff to

deal with the problems of

medicine adherence, as

people tend to get confused

about which medicine and

when to take.

10 Recorded DVD

(Videos)

The DVDs are used in the

local cable networks, and

during community festivals,

which would create

awareness on mental

illness.

11 Songs Field staff taking interest in

creating songs and tuning is

also an effective method

generating awareness.

12 Rallies Rallies organized as part of

observing world mental

health day and world

disability day is used as a

platform for sensitizing the

district authorities and local

community about the needs

of people with mental

illness in their areas.

13 Observations of

world mental

health and

world disability

day

When people with mental

illness, their alliance

partners, families and local

community take

responsibility for such

events. The panchayats also

would participate and

support such initiatives by

observing cost of such

celebrations.

25


Awareness Materials

The partner organizations utilised the local resources in developing awareness

materials. Below given are some of how the examples a flex with symptom of mental

illness was prepared. This was displayed in all the awareness program (street theatre,

community group meeting and on camp days). Another partner organization created

awareness materials using used tyres covered with the empty cement gunny bags, and

colours were used to write messages on it. Another partner organization in Bihar

collected empty cement bags from the construction site, with the help of Self Help

Group, got them stitched and used as banner during the camp day.

Caregivers along with people with mental illness, NGO personnel addressing press club

during world mental health day observation. Caregivers and people with mental illness

wanted to sensitize print media and also used print media in presenting their

psychosocial needs so that people in the community do not ostracise people with

mental illness.

26


Puppet show in Pudukotai

Regular awareness sessions designed around a puppet show were held in the street of a

village that lies within their area of operation. The ‘stage’ was a simple suspended

banner behind which the puppeteers worked. The banner summarized causes,

treatments and symptoms of mental illness, the purpose being to demystify the subject

and to raise the awareness of the public towards mental health issues.

A short puppet show based on the story of a family break-up and the recovery of a

mentally ill person was followed by a play that showed the effects of bi-polar disorder.

The acting was dramatic and held the attention of the audience, which was made up

almost entirely of women and children, around one hundred people altogether. The

performance was around twenty minutes long in total and was followed by a short

address to the audience that reinforced some of the main messages.

Street Theatre in Bangalore urban Slum

Awareness sessions designed around a case study from their experience from the field.

8 field staff enacted different roles in the street theatre staged a woman with mental

illness, portraying how she would become victim of socio cultural practices and

violence acting as precipitator for mental illness. The story also depicted the role of

field staff in identifying people with mental illness, facilitating treatment process in and

then home based intervention, involvement in livelihood opportunities. The ‘stage’ was

27


simple and attracted crowd on the busy street of slum. The performance was around

thirty minutes long in total and was followed by a short address to the audience that

reinforced some of the main messages.

Wall writing

Community members were encouraged to take responsibility for owning the awareness

pictures. Public building had been identified with the support of the community

members, an artist was invited to draw an outline for the awareness charts. The

community members were encouraged to take responsibility for filling the colours in

the outline diagram. The community members took responsibility of owning it, and

guarding it from all damages. These become an effective tool in changing their

attitudes towards mental illness and also promote inclusion of people with mental

illness. The messages about mental illness had been written on the walls of the main

road in the village and in the National and state highways, which also added towards

reduction of stigma in the community.

Community Owning Wall Writing

PC: Apsa

28


Awareness materials in the Public Transport (Auto)

A small Handbook with 25 pages of basic information on mental illness for the lay

individual was developed, and kept in small cotton bags which can be tied to the back

side of the driver seat of the auto-rickshaw. The passengers traveling in the auto could

pick up these books, and read while travelling.

29


Federation of people with disabilities advocating for the rights of people with mental

illness

People with disabilities were encouraged to include people with mental illness in their

disability groups as mental illness is one of the disability. With the support of other people with

disabilities, rally was organized to sensitize government officials and community members

about their needs. Through these rallies, it was intended to spread awareness and expected

people to recognize people with mental illness, facilitate and create opprtunities for people

with mental illness in their neighbouhoods.

30


A field staff in order to deal with the problem of drug adherence was appointed as people were

forgetting about the medicines to be taken in morning, afternoon, and night. The self help

group members and the field staff developed a medicine box using the cardboard which had

3x7 compartments for 7 days. They also made a small bag with three openings of different

colors; red indicating morning; white indicating afternoon and black indicating night.

Medicines were kept in this bag, as it was more convenient for people to take medicines

prescribed for morning, afternoon and night.

Field staff were talented, and wrote songs and tuned them. The same medium was used for

awareness generation. One of the partner from Andhra Pradesh composed a song “manam

marithe ie jagathu mareanu (if we change, society will also change). These songs were sung in

public platforms, caregivers’ meeting and disabled people’s organizations. This acted as a

medium of collecting people and encouraged people’s participation in social cause.

31


Caregivers Association at Erumalainayakanpatti

The work of caregivers’ associations came up on frequent occasions during the review and it

appeared to be one of the most effective features of the work of Basic Needs India. Through

ADD India and St Joseph Development Trust, organized all the caregivers in the project area

of Theni District and registered a Caregivers Association to discuss issues of the caregivers and

their mentally ill family members in the Association meeting held monthly once. The

Association made plans for observing world mental health day, world disability day and

caregivers’ day. With the support of the partner organizations, rallies were organized, giving

representations and advocating with the district authorities of availing health and welfare

needs.

Kittur Rani Chennamma Self-help Group

Self-help groups are a platform for creating awareness programmes. The self-help group of

women in Marasandra in Y N Hoskota was clearly working hard to be strong in the face of

personal tragedy and unrelenting poverty. Comprising twelve members, they explained that

their main purpose is to promote savings of Rs.100 per month per person so that individuals

can accumulate enough to buy a buffalo/cow. This would then be a source of regular income;

the milk being sold to a cooperative at a guaranteed rate per litre. One of the women had lost

her husband to snakebite and so the group was rallying around to support her and her three

children. The link with mental illness comes through the treasurer, Krishnaveni, who had been

accepted into the group for her literacy skills and was in remission after taking treatment for

her schizophrenia. The point here is that her illness was not seen by people because she had

skills to offer.

Videos capturing the journey of a person (Lalaeppa) with mental illness were recorded in their

place of residence by a trained cinematographer and these CDs were used for creating

32


awareness programme. These CDs were played in public forums, so that people would realize

their role in facilitating rehabilitation for people with mental illness. One of the week long

residential training programme ended with developing a script, and trainees enacted the role of

person with mental illness, family members, field staff and health professional, captured the

journey from identification, referral, treatment, follow up from field staff, involvement in daily

routine and income generation activity and mainstreaming in community activities.

Discussion

Overall, the above mentioned community based interventions were associated with significant

reduction in stigma attached to mental illness. Educational interventions when combined with

different mediums like wall writing/ small community group meeting/ puppet show and street

theatre would have a better impact and outcome in changing the attitudes of people in the

community. Constant interaction with the community with different mediums would lead to

reduction in stigma. The current study confirms that community based awareness interventions

are effective in changing the attitudes of people, so that they facilitate rehabilitation care for

people with mental illness in their community. The effectiveness of “mass media”

interventions in reducing discrimination and negative community attitudes and emotions with

respect to people with a mental illness was carried out by Clement and others.27 They found

that the interventions had a small to moderate effect on reduction in stigma and concluded that

the educational interventions alone or when combined with other interventions were

consistently associated with a reduction in stigma for different types of mental disorder.

Corrigan and others28 in their study have found that mediums of awareness generations are

33


effective in stigma reduction. They also have found that the quantitative evidence that stigma

interventions are effective for specific categories of mental disorder, including depression and

psychosis/schizophrenia. They concluded that there is clear need to undertake further research

to evaluate the effectiveness of stigma reduction interventions for these conditions need to be

the focus of future researches.

The current study does confirm that educational components and those with a consumer

contact components are effective in reducing stigma. Further investigation of the effectiveness

of standalone educational interventions for the specific clinical conditions may be required.

There is a clear need for further research investigating the effect of consumer contact, whether

there is a difference in the effectiveness of contact, education and education combined with

contact. There is some evidence to suggest that population level interventions using mass

media campaigns and social marketing can be effective29.

Although researchers have found evidence that different mediums of awareness generation do

have impact in stigma reduction 18, 19, our findings suggest that different mediums presented in

this article have been integrated in to the activities of the integrated community development.

However, employing parallel measures of awareness generation along with scope for live

interaction with the community members would have better impact, similar finding has been

reported by Stauart30. Community based interventions delivered via community participation

was found to be effective. Many community based interventions programs are delivered face-

to-face with scope for interaction from the community and also scope for reflecting on some of

the messages made these mediums more effective. Similar views have been shared by others

employing the awareness programmes 31 -34.

Griffiths et al.,35 have reported that there is paucity of studies that had investigated the effects

of stigma interventions for different types of mental disorder and for different intervention

types, particularly in the case of consumer contact. It is clear that different mediums of high-

quality awareness generation is required and need of the day in order to facilitate community

care for people with mental illness.

The different methods of awareness generation given in this paper is different from the

psychoeducation models used in the institutional care. The psychoeducation models use one to

one interaction with the family members, concentrate more on medicine adherence and relapse

prevention. Whereas, the different modes of awareness generation given in the paper

concentrate more on dealing with myths and misconception directly dealing with the attitudes

of people in the community, which would help in reintegrating people into the community life

and also experiencing dignified living for people with mental illness. The reintegration can be

achieved only when people provide opportunities for livelihood, interactions, inclusion in

34


community activities for people with mental illness.

Future Research

However, future researches should concentrate in testing out the effective modes of awareness

generation with scientific methodologies in different cultural settings so that these mediums

can be up-scaled with community participation to reach the unreached. Future research is

needed to systematically compare the efficacy of single-level vs. multi-level stigma

interventions in order to determine the conditions under which multi-level stigma interventions

may be preferable to single-level interventions. Future research is also needed to evaluate how

changes at one level of stigma (e.g., intrapersonal) would impact on other levels of stigma

(e.g., community). Research should also focus on identifying mechanisms of change in multi-

level stigma interventions, and to explore the barriers and facilitators to the dissemination of

multi-level stigma interventions across diverse cultures. Finally, there is a need to improve the

quality of studies in this area, particularly with respect to reducing stigma and facilitating care

and rehabilitation of people with mental illness in their own community.

Limitations:

The paper addressed a clinically important topic that has rarely been explored. The current

study has some limitations. The current paper analysed various modes of awareness

generations used by Community based organizations for generating awareness about mental

illness. However the authors have not made any efforts in terms of testing out the efficacies of

different strategies, which is a main limitation of this paper. Efforts of such Community based

organizations need to be appreciated, recognized, applauded, emphasized not acknowledged in

the literature. There is a need for developing measures to assess the impact of different modes

of awareness generation. There may be many more modes and strategies of awareness

generations which are not covered in this paper is one of the limitations of this paper. The

awareness generations done by different people and in different places can have different

outcome, authors were not able to capture what worked well and what did not workout. The

field workers do not have any formal training in mental health, with the support of the

psychiatric social worker they were able to generate materials for awareness, more professional

inputs would have strengthened the materials, which acted as one of the limitations of this

paper. Data also would have been collected with people attending such awareness programme

so that we would have found out the impact of awareness generations on attitudes related to

mental illness.

35


Conclusion:

Stigma is inherently a multi-sectoral and cross cutting phenomenon and thus affects all spheres

of life for people with mental illness and their families. Myths and misconceptions prevailing

towards mental illness leads to stigmatised behaviours reducing opportunities for participation

and inclusion for people with mental illness in the communities. Changing attitudes of people

only can create opportunities for people with mental illness to lead and experience their life

with dignity. Need to develop strategies using local resources in order to create an awareness

programmes. The authors have shared their experiences of different modes of awareness used

in their mental health and development programme. It becomes necessary for mental health

sector to invest on developing various means of awareness generation, concentrating various

community groups in the community.

These efforts would sustain in the community and also help in overcoming the ill effects of

stigma. There is a need for convergence between different sectors, need to invest their time and

resources to help such initiatives and also observe them in their regular programmes. Such

modes of awareness efforts would be sustained in the community, in order to deal with stigma,

so that lives of people with mental illness and their families would be eased and experience

dignified life. More attention is required from the learned and scientific group in reaching out

to people, and their scientific skills clubbed with field staff efforts would go a long way in

developing scientific means of awareness generation. There is an urgent need for partnership

from scientific communities, policy makers, authorities in-charge for implementation of

programmes at the district and state levels, and other stakeholder, so that the experiences can

be captured with strong methodologies, replicated and propagated for its implementation

throughout the country. Despite progress over the past decade in the development of multi-

level stigma interventions, much work remains to strengthen and broaden with scientific

research in not only testing the efficacy but also being innovative in fully utilizing the

technology in the new digital India.

Acknowledgement: would like to acknowledge the field staff of GASS in Dodabalapura,

Narendra Foundation in Pavagad, Samuha in Koppal, Raichur and Karwara districts of

Karnataka, Field staff of the partners of ADD India and Vidya sagar in Tamil Nadu and Kerala,

field staff of SACRED in Ananthpur and Kurnool districts of Andhra Pradesh. Would like to

thank people with mental illness and their caregivers, people with disabilities, and field staff

who have permitted the authors to take photographs and use the same for publication in

developing the sector.

36


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39


Policing During COVID-19 Pandemic and its Impact on Mental

Health

Dr. Apurva Kumar Pandya1*, Dr. Somen Saha2

1Economic Evaluation, Specialist, Indian Institute of Public Health, Gandhinagar

2Associate Professor, Indian Institute of Public Health, Gandhinagar

*Address for correspondence: Dr. Apurva Kumar Pandya, Indian Institute of Public

Health Gandhinagar, Opp. Air Force Headquarter, Near Lekawada Bus Stand, Lekawada,

Gandhinagar-382042


Introduction


Pandya A K, Saha S. Policing During

COVID-19 Pandemic and its Impact on

Mental Health. Journal of Mental Health

Education. 2021;3(1)40-57

The coronavirus disease 2019

(COVID-19) pandemic has put

the world on a standstill.

Governments are forced to take

immediate measures to control

such a pandemic which include

lockdown, forced isolation

of infected patients, quarantine

affected people and social

distance. Therefore, viral

outbreaks are often paralleled

with symptoms of fear, anxiety,

and depression (Banerjee, 2020;

Brooks et all 2020; Ho et al,

2020; Roy et all, 2020; Yao et

al, 2020; Zhang et al, 2020).

Review Article

40



Police personnel have been a part of “essential workers” who are the first responders

taking on active roles in the fields to prevent the infections and maintain law and order

(van Dijk, & Crofts, 2017). The World Health Organization and other international

agencies have recognized police personnel as first responders who are most vulnerable to

mental health problems (Inter-Agency Standing Committee 2020; International

Federation of Red Cross and Red Crescent Societies, 2020;WHO 2020).

The State Police Force (SPF) is a state-level agency which is in charge of maintaining law

& order. The primary role of SPF is to uphold and enforce laws, control and prevent crimes.

The Central Armed Police Forces (CAPF) refers to a group of seven security forces such as

Central Reserve Police Force, Central Industrial Security Force, Border Security Force, Indo

Tibetan Border Police, Assam Rifles, Sashastra Seema Bal, and National Security Guard

under the authority of Ministry of Home Affairs in India. They protect the borders of the

nation from external aggression and infiltration and aid the state governments in internal

security, including insurgency, anti-nasalism and counter terrorism. The SPF has been the

forefront of the COVID-19 pandemic in India. Personnel from CAPF (particularly Central

Reserve Police Force & Border Security Force) were also engaged in the pandemic

management, especially during lock-down phase. Police personnel had coordinated local

shutdowns, enforced stay-at-home mandates and at present they are encouraging use of

masks and social distancing in addition to their other usual responsibilities. The study

conducted in 2019 revealed that the police force is understaffed and overburdened. The

COVID-19 pandemic might have exerted tremendous stress and mental pressure on already

strained police personnel. Public health and policing experts acknowledge COVID-19

pandemic as a significant stressor for police personnel which compounds the stress

associated with their professional roles. They are not only vulnerable to infection but are also

at high risk to develop mental health problems. However, their mental health and

psychosocial support care remain neglected. We have reviewed existing literature on

COVID-19 pandemic and its impact on police personnel with an objective to map studies

conducted on police personnel mental health in the context of COVID-19, identify policing

practices, strategies and recommendations to protect police personnel from stress and risk of

infection of COVID-19.

Methods

Rapid scoping review was conducted using Arksey and O’Malley’s scoping review

framework (Arksey & O’Malley, 2005). The empirical studies and grey literature on

Policing and COVID- 19was reviewed. Electronic databases namely PubMed, PsychINFO,

41


and Google Scholar were accessed. The following keywords “police,” “policing” “COVID-

19 pandemic,” “risk of infection,” “prevention,” “protection of COVID-19 transmission,”

“mental health” were used. These key words were combined with Boolean operators to

narrow down the search results. Subsequently, manual searches were executed to identify

additional articles based on the references mentioned in the articles selected for full-text

review.

Initial search yielded articles (PubMed 305; PsychINFO 13; Google Scholar 13000) of

which 13013 were excluded based on title and abstract review. Later 223 articles were

rejected based on abstract review. Finally, 82 full texts were selected for review, of which

total 18 records met the inclusion criteria. The PRISMA chart is presented in Figure 1. Full

text of selected articles was critically appraised and data was synthesized using a meta

ethnography approach (Britten et al, 2002; Hoon, 2003).

Outcome measure

Prevalence of mental morbidity was considered as an outcome measure.

Inclusion criteria

Records were included when they met following criteria:

● Studies carried out on state police or law enforcement or para-military force in the

context of COVID-19.

● Studies focused on mental well-being, occupational stress or mental health problems.

● Studies documented policing practices, strategies or recommendations on policing

during health emergencies.

● Grey literature such as reports, and guidelines.

Exclusion criteria

Records were excluded when studies conducted with defense personnel or military personnel

and those studies published in other than English language.

Data extraction

The literature search was done by one researcher. The results were matched by repeating

search exercises using key words and removing duplicating and unqualified records based

on the exclusion criteria by another reviewer. Initial data extracted from the selected studies

and data synthesis was done by AKP and was reviewed by SS. Full text of selected articles

was critically appraised.

42


Results

Out of total studies reviewed, only one study was conducted on police personnel during

COVID- 19 pandemic as of 30th September 2020. Most studies were conducted in developed

countries such as the USA, and UK indicating lack of research priority on this topic among

researchers and practitioners.

COVID-19 presents a serious risk of infection and harm to police personnel (Alcadipani,

Cabral, Fernandes, & Lotta, 2020). Various incidents during lockdown were noted where

people attacked police personnel. For example, police personnel, beaten up by a group of

people in Punjab, reported one police officer’s hand was chopped off and two were injured

(Ghazali, & Sanyal, 2020). Similar incidents of beating up of police personnel were recorded

in Maharashtra (Deccan Herald, 2020). The risks to physical health of police personnel from

COVID-19 are clear as they continue to work in the COVID-19 environment. As of 21st

September 2020, 99602 police personnel including CRPF personnel were tested positive and

574 personnel succumbed to death (Police Foundation of India, 2020). Furthermore,

incidents of police suicide deaths were also recorded (Times of India, April, 27, 2020).

COVID-19 poses a significant risk of harm to self, which represents one of the most significant

factors linked to poor mental health outcomes following critical incidents, traumas, and

disasters. Fear of COVID-19 infection is widespread among police personnel.

Recent study conducted in Maharashtra, 50 percent of police personnel are mentally

disturbed due to fear of COVID-19 and faces challenges at the workplace (Kokane,

Maurya, & Muhammad, 2020). The current situation of COVID-19 necessitates police

personnel to work under trauma inducing conditions for longer than usual emergency

situations, which may impact their physical and mental health. Thus, tracking the longer-

term psychological outcomes of police personnel is particularly important. Police personnel

who are infected by the virus and/ or who lost someone, or suffer from chronic physical

health or psychiatric conditions should be taken care and protected from adverse effects of

COVID-19.

Impact on Family Members of Police Personnel

Whilst the sustained stress experienced by police personnel themselves may be harmful, the

pandemic has significant implications for police families as well. Studies have not

documented the impact of COVID-19 on families of police personnel; however, few

studies have reported impact of traumatic conditions and emergencies on the families of

police personnel. In the aftermath of Hurricane Katrina, many police had to cope with the

43


impact of the hurricane on themselves and their families (West et al, 2008). Faust and

Vander Ven (2014) described Hurricane Katrina as a worst-case scenario, as police were

both victims and first-line responders. Of relevance to this discussion, research undertaken

by Behere, Basnet and Campbell (2017) found that one family member's threat to life

predicts mental health of family and particularly impacts children’s mental health. Further,

in the context of COVID-19, police personnel are fearful of bringing home the virus to

their families. In turn, it is likely that family members also, at the same time, worry about

their family member who is offering services to the police (Drew & Martin, 2020). Unlike

other public health emergencies, the job of police personnel in the era of COVID- 19 is

directly affecting the mental health of family members. However, research on the

prevalence of mental health problems among family members of police personnel is

lacking. It is assumed that usual levels of stress caused by the “routine” threat of policing

among family members will be significantly increased in the COVID-19 context (Stogner,

2020; Drew & Martin, 2020).

Impact of COVID-19 on Mental Well-being

COVID-19 pandemic presents challenges for police leadership in supporting personnel in an

environment that has both physical and mental health impacts (Kirby, 2020; Reicher, & Stott,

2020; Shirzad, Abbasi Farajzadeh, Hosseini Zijoud, & Farnoosh, 2020). A recent study

conducted with police personnel in Maharashtra reported that half of the police personnel

had mental disturbance due to fear of COVID-19 virus and one-third police were facing

mental stress due to other reasons related to their occupation (Kokane, Maurya, Muhammad,

2020). This is nearly double than the psychological disturbance indicated among the general

population (28%) in the systematic review conducted (Rajkumar, 2020). The COVID-19

pandemic has affected police personnel as well as their families across the globe (Sriwijitalai,

& Wiwanitkit, 2020; Laufs, & Waseem, 2020)

Knowledge of COVID-19 and Precautionary Measures Used by Police Personnel

Inadequate knowledge and occupational exposure both are attributed as risk factors for

infection among healthcare workers (Jiang, et al, 2020) which is relevant to police personnel

as well. A qualitative research conducted in Maharashtra demonstrated that 50 percent of

police personnel received information about the virus from social media such as WhatsApp

and Facebook (Kokane, Maurya, Muhammad, 2020). Huge gaps in adhering to precautions

were observed in the study. The same study reported that one-third of the total police

professionals were using masks, sanitizer, and gloves in working hours to protect

themselves; about 10 percent of police personnel were taking care of their personal health,

and about half of them (51%) washed their clothes while returning home from the duty. This

44


indicates a need for creating awareness on precautions among police personnel and their

families.

Effectiveness of Mental Health Interventions for Police Personnel

Police leaders must consider what programs and initiatives are needed to support the

psychological outcomes of COVID-19. Literature indicates mixed outcomes of mental health

interventions for police personnel. Among the most recognized interventions in policing is

the Critical Incident Stress Management (CISM), providing an “emotional first aid” to

stabilize and restore pre-crisis functioning (Mitchell, 2003); Critical Incident Stress

Debriefing (CISD), a specific technique designed to assist others in dealing with the

physical or psychological symptoms associated with trauma exposure (Malcolm et al,

2005); Mental Health First Aid (MHFA) training (Intveld, 2016),peer intervention

programs (Aronie, & Lopez, 2017), trauma resilience training (Arnetz, Nevedal,Lumley,

Backman, & Lublin, 2009) and psychological first aid programs, such as Recognize,

Evaluate, Advocate, Coordinate, and Track (REACT) (Marks et al., 2017). While

reviewing these interventions for police personnel deployed during emergencies,

Castellano and Plionis(2006) concluded that interventions lack consistent outcomes and

more rigorous program evaluations are needed. The evidence on effective mental health

programs in COVID-19 context is not definitive, hence, locally suitable short-term and

long-term programs should be implemented in Indian context and effectiveness of such

interventions should be documented.

Addressing Mental Health of Police Personnel: Learning from Previous Emergencies

The prevalence of post-traumatic stress disorder (PTSD) in police and first responders is

associated with critical incidents and disasters. Different types of traumatic experiences

produce different mental health problems. Based on a systematic review of the literature,

prevalence of post- traumatic stress disorder was noted between 8 and 12 percent during

and after 9/11 World Trade Center attacks in USA (Lowell et al., 2018; Laufs, & Waseem,

2020) whereas shortly after Hurricane Katrina, 19 percent of police personnel reported

PTSD symptoms whereas 26% reported symptoms of Major Depressive Disorder (West et

al., 2008). Long-term impacts of emergencies on police personnel mental health have also

been documented. A study on prevalence of PTSD of police involved in 9/11 found that

PTSD rates increased over time (Bowler et al., 2012). PTSD, depression or anxiety can

develop up to six years following disastrous events (Wang et al, 2010). For example, a

study conducted 20 months’ post-earthquake in Nepal revealed prevalence of mental

morbidities among the general population (Kvestad et al, 2019). These indicate long-term

impact of traumatic events on police personnel and highlight the need to address short-term

45


and long-term interventions to address mental health issues of police personnel.

Best Practices on Policing: Positive Policing during the Pandemic in India

Positive policing perhaps one of the most important aspects of law enforcement, but often

neglected as being secondary to the important role of enforcing the law. Positive policing is

potential to transform police organizations by changing negative police subculture, and

negative public perception.

During the pandemic, positive policing can be practiced that can create a lasting impact on

the lives of people and change the image of the police as follow:

● Collaboration between police and public health engagement. There may be a need to

share resources and strengths between the police and health department. For example, the

police had a resource for contact tracing of at-risk people (potential contact with the affected

patient), and helped people in need of urgent healthcare in rural areas where there were no

health facilities. Cyber police helped take actions to "fake and misleading" messages on

social media.

● Becoming an example by actions and positive messaging. Police can play a crucial role

in spreading a message of positivity, community and strength. Many police personnel have

adopted innovative ways to appeal to people to educate and stay home. For example, Tamil

Nadu traffic police devised “corona helmet” to educate people and urge to remain home,

Maharashtra police efforts in creating mass awareness.

Assisting people in need is vital in this crucial time. For example, in the National Capital,

police had helped the elderly in arranging grocery; Meerut police distributed food to the

needy while Bareilly police fed the hungry and poor. Documenting best-practices among

police personnel across the country can be inspiring and motivating not only for peers but

also help spreading positive messages about policing to the public and in turn, can create a

positive image of the police. In this direction, Police Foundation of India has recently

documented best-practices across police forces in the times of COVID-19 which is

appreciable. Disseminating these practices to police personnel across police organizations

would be a welcome step.

46


Discussion

Police organizations play a critical role during public health emergencies (Sharma &

Hossain, 2019; van Dijk, & Crofts, 2017). Recent efforts by police organizations to protect

the country from COVID-19 pandemic must be acknowledged. During enforcement of

lockdown, police personnel went through high risk situations coupled with long hours of duty,

multiple shifts and inadequate personal protective equipment.

Various organizations put forth guidelines for police personnel. However, recommendations

for coping in the longer term are limited. All guidelines lack information about the fact that,

while they may not experience immediate distress, delayed psychological effects can be

expected and they should monitor their psychological health over time and seek support even

following the pandemic.

State Police Force (SPF) and Its Role in Managing Pandemic

The SPF played a central role in responding to COVID-19 pandemic. It is common to

observe negative police-citizen interactions that are characterized by low-levels of trust

with several instances of the police brutality and poor accountability structures (Common

Cause & Lokniti, 2018). Negative public perception of police force severely affects

people’s satisfaction with the rule of law and results in a trust deficit. At the same time

police personnel experience the occupational stress and limited resources (Common Cause

& Lokniti, 2018; Singh & Kar, 2015). These challenging working conditions make police

work even more taxing and it is likely that the COVID-19 pandemic might have

exacerbated their stress. Despite miniscule resources, SPF has taken up the challenge of

enforcing the lockdown and promoting public health. They are playing the role of not only

maintaining public order but also aiding public health officials in ensuring compliance with

state or local public health orders. Even after lockdown is lifted, they are expected to work

closely with the Health department and ensure compliance with state or district or local

corporation’s COVID-19 related public orders. Such additional duties for a longer duration

exert extreme stress. While shortage of personal protective equipment has made the fight

tougher, considering their nature of duty, increasing physical and mental health demands

are more taxing. Despite they are at the risk of contracting COVID-19 and other physical

and mental health ailments, their healthcare needs particularly during pandemic are not

addressed.

This pandemic has perhaps gathered attention from researchers and public health experts on

attending healthcare needs of police personnel to prepare them for the long haul.

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Recommendations for Police Leadership Team

Based on the findings of this review and the key insights drawn, a call to action is urgently

needed to support police personnel as they continue to experience the stresses of an active

COVID-19 environment. At the same time, it is equally important to strategically plan

interventions for post- pandemic situations. Evidence-based guideline on addressing mental

health concerns during and after COVID-19 pandemic for police leadership team is required.

● Police organization leaders should clearly establish how police personnel are to interact

with the community and enforce the rules. The role of police personnel should be focused

on informing the public about the current restrictions and encouraging individuals to

comply with the state and local emergency health declarations.

● It is also critical that police organizations develop a contingency plan for potential staffing

shortages as a result of the spread of COVID-19. It is important to cross-train personnel for

temporary duty reassignment to assure proper coverage of essential duties.

● Police organizations need to develop a methodology for identifying specific groups of

police personnel that may require additional support—those that are at higher risk due to

greater trauma exposure (occupational duties, crisis in the family, sickness, death in the

family), previous medical and psychiatric history. Such at-risk police personnel should be

offered less stressful duties along with mental health intervention.

● Police agencies need to educate their police personnel on the delayed impact of COVID-

19 for themselves and their families, ensuring understanding that mental health concerns are

not necessarily immediate.

● Given the unique nature of COVID-19 compared with other types of trauma experienced by

police, continuing health monitoring of the police personnel is warranted.

● Adequate psychosocial support intervention should be available to assist personnel in

managing their mental health during the active COVID-19 period and provide continued

access to support in the longer term.

● Psychosocial support intervention should recognize psychological issues such as depression

and anxiety and timely link with specialized mental health care services. Such intervention

should also include police families, considering both are impacted.

● Conduct concurrent monitoring and evaluation of interventions and support services,

ensuring that programs and initiatives are evidence-based and serve to maximally impact on

improving police mental health.

● Integrate interventions with the system for sustainability and long-term. There is a need for a

48


holistic support and recovery system for the police personnel so that efficiency of police

force can be utilized effectively in future for such type of public health crisis.

Recommendations for Psychosocial Support Intervention

Strengthening psychosocial support for improving mental health of police personnel have

the potential to play a major role in overall wellbeing. Psychosocial support helpline along

with the low-cost primary prevention model such as “peer counseling” program has potential

to improve the mental health conditions. Further, use of technology such as mobile based

training applications for educating police personnel on coping strategies can be explored.

Self-management Strategies Reported in the Literature

Various national and international organizations have published guidelines and training

manuals for police personnel (CDC, 2020; Inter-Agency Standing Committee 2020; PHFI,

2020; WHO, 2020). We have synthesized key points as follow:

Precautions for protecting from COVID 19 infection during the field duty

● Maintain a physical distance of at least 6 feet.

● Use Personal Protective Equipment.

● Wear a mask.

● Practice cough hygiene (While coughing or sneezing, cover the mouth with a handkerchief

or cough or sneeze into the upper sleeve, not your hands.)

● Practice proper hand hygiene. Wash hands with soap and water for at least 20 seconds or

sanitizer. Wash hands after touching surfaces like car handles, door handles or elevator doors

etc. Avoid touching your face, nose or eyes with unwashed hands.

● Disinfect vehicle. All surfaces that may have come in contact with the patient or materials

contaminated during interacting with people (e.g., touching floors, walls and work surfaces)

as well as patrol car equipment, steering wheel, gear shift, a dispatch radio module, door

handles and edges should be thoroughly cleaned and disinfected using soap/detergent and

water or 1% Sodium Hypochlorite solution. Vehicles can be cleaned after every shift.

● Clean essential items/gears. COVID-19-infected droplets may be able to live on nearly any

surface. Clean and disinfect duty belt and other equipment like a gun or stick prior

to reuse. Consider sanitizing items that are frequently touched during a shift such as a phone,

laptop, clipboard, etc.

● Seek help. Seek medical care early if a fever, cough and difficulty breathing are experienced.

49


Precautions during the duty in the camp

Personnel can protect themselves from infection when they are in the camps by following

steps.

● Maintain physical distancing

● Practice proper hand hygiene.

● Practice cough hygiene.

● When you cough or sneeze, cover your mouth with a handkerchief or cough or sneeze into

your upper sleeve, not your hands.

● If you have symptoms like fever, cough, sore throat, or shortness of breath, seek immediate

medical care and inform the supervisor.

Protecting partners, families and friends after shift

Police duties can potentially expose themselves to COVID-19. Before coming back into

direct contact with their family, police personnel should maintain physical distancing

measures. Based on COVID 19 pandemic guidelines for law enforcement published by the

International Criminal Police Organization, follow steps given in the box while returning

home.

Precautions to protect families from infection

● Clean or decontaminate your work equipment, including shoes, avoiding the spread of

particles/dust;

● Take off duty clothes and wash them with laundry soap as soon as feasible. Handle them and

wash them in a way that limits exposure to skin, eyes, environment and other clean clothes

(avoid shaking clothes);

● Take a shower or wash exposed skin with soap and water;

● Self-monitor for signs of illness as well those of family members.

Precautions while enforcing crowd control

Larger gatherings offer more opportunities for person-to-person contact and therefore pose

a greater risk of COVID-19 transmission. Some steps towards positive policing are presented

below.

● Meet with community elders/ religious leaders at the event venue: Explain to them

50


respectfully, try to convince them, be respectful, develop a contingency plan that addresses

various scenarios described below which you may encounter during a COVID-19outbreak.

● Establish relationships with key community partners and stakeholders: When forming

key relationships with local stakeholder for any events, include relevant partners such as the

local public health department, community leaders, faith-based organizations, vendors,

suppliers, hospitals, hotels, airlines, transportation companies, and law enforcement.

Collaborate and coordinate with them on broader planning efforts. Clearly identify each

partner’s role, responsibilities, and decision-making authority. Participate in community-

wide emergency preparedness activities.

● Stay away from uncooperative individuals. When dealing with uncooperative individuals,

limit contact and practice hand hygiene.

● Avoid or limit direct contact with documents. Avoid touching documents and if

documents are touched, wash hands immediately with soap and water or use sanitizer.

● Stay away from uncooperative individuals. When dealing with uncooperative individuals,

limit contact and practice hand hygiene.

● Avoid or limit direct contact with documents. Avoid touching documents and

documents are touched, wash hands immediately with soap and water or use sanitizer.

Stress-management strategies during COVID 19 pandemic

Police personnel engaged in an emergency, and those deployed in the field duties are

facing tremendous stress.

● Avoid information overload and rumours: Limit news consumptions of news from TV or

social media. It creates fear, panic, and anger. Access latest information from the website of

the Ministry of Health and Family Welfare, Government of India, helpline numbers, or from

the WHO.

● Improve eating habits. Eat sufficient, healthy, nutritious food. Eat fruits and keep yourself

and keep yourself hydrated.

● Stay positive. Focus on positive aspects. Talk about the positive incident with colleagues.

● Deep breathing. Sit, close your eyes and take deep breaths. Whenever you are stressed,

angry or affected by overthinking, take a pause, drink water if needed and take a deep

breath for 1 to 5 minutes or more.

● Engage in physical activity. Move around, basic stretching exercises may help. Physical

activities help reduce fear, anxiety and improves mood.

● Stay connected with family. Stay in contact with family and friends through phone or video

calls or email.

51


● Avoid drugs. Avoid using tobacco, alcohol or other drugs. In the long term, these can

worsen mental and physical well-being.

● Develop an attitude of gratitude. Studies show gratitude to improve well-being. Maintain

a gratitude diary. One can write a gratitude journal. Appreciate and thank the Universe by

writing at-least 1 positive thing that happened in a day.

● Follow spiritual or a religious ritual. Studies indicate that it can improve wellbeing, help

in coping with stress and reduce symptoms of mental illness. Based on a person's preferred

spiritual path or religion, engage in prayers, namaaz, yoga, meditation, chanting, mantra

recitation, worship, and so.

● Provide social support to your colleagues. Talk with colleagues, stay connected and

extend personal help if any colleague needs support.

● Talk to the supervisor. Talk with a supervisor if you are directly impacted or have a family

member impacted by a stressful event in the family. And prepare a flexible duty schedule.

● Seek mental health help. If you are not able to manage symptoms of stress, sleeplessness,

irritability, fear, seek help. Talk with a medical officer in the camp or use a helpline number

for assistance. For psychosocial support, use psychosocial support helpline.

Precautions and strategies for Supervisors and Administrators

Supervisors and administrators play a vital role in protecting the health (including mental

health) of their subordinates.

● Educate police personnel of hand and cough hygiene.

● Avoid public duty, if police personnel are not well.

● Roll call briefing. Physical distance should be maintained while police attendance in the

evening.

● Flexible schedule for vulnerable staff. If personnel are not well, provide immediate medical

care. If personnel are having a family crisis, provide an alternate schedule that is less

stressful.

● Providing Medical Checks for police personnel. Police personnel should be provided with

guidance on protection from COVID 19 and regular health check-ups. Screening booths

should be set up at police quarters.

Implication for Future Research

Future study can map existing studies (completed and on-going studies) on mental health as

52


well as mental health programs for police personnel in India. This will help assess

effectiveness and scale-up best programs. Prospective research can focus on assessing

prevalence of mental morbidities, resilience and coping mechanisms used by police

personnel of different cadres in the context of COVID-19 pandemic and in general.

Implementation research to create evidence is commanded. It may be perhaps more

pertinent to undertake a clinical and cost effectiveness analysis to see how investing in

mental health can improve health outcomes of the police, their performance and the

policing.

Conclusion

The COVID-19 pandemic has exacerbated stress among both police personnel and their

families. Protecting police personnel during the pandemic such as COVID-19 is essential. In

the absence of mental health service provision within the police force, intervention to prevent

mental health problems and treat mental health conditions among police personnel is

inescapable. In this crucial time, implementation of sustainable mental health interventions

and generating evidence on its effectiveness are needed without delay.

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Experience of Interning in the field of Mental Health Education Manjiri Gokhale

Student intern, Department of Mental Health Education, NIMHANS, Bangalore

*Address of Correspondence: Manjiri Gokhale, Jyoti Nivas College Autonomous,

Bengaluru, India



Gokhale M. Experience of Interning

in the field of Mental Health

Education. Journal of Mental Health

Education. 2021;3(1):58-64.

Abstract

Most of the mental health disorders

(due to their invisibility to the

human eye) have an underlying

stigma and discrimination. This is

largely due to lack of awareness

and sensitivity. Owing to our

cultural boundaries and prejudicial

perspectives, we often blindside our

mental health. Therefore, it is a

need of the house to promote mental

health and raise awareness among

the public. Mental Health

Education and promotion, thus

becomes a critical factor in a

country’s development. This helps

debunk myths, counter the stigma

and promote a healthy environment

for the welfare of the people. It

further helps reduce the socio-

58



economic burden. In a developing country like India, education plays a key role in

converting an individual from a liability to an asset. The purpose of an internship is to

prepare students with realistic expectations of their future careers and to provide them with

opportunities to polish career skills and to gain on-the- job experience. Therefore, internship

opportunities not only serve as a tool to educate and promote community welfare but also

aids to shape an individual to create a better future.

Keywords: Mental Health, Mental Health Education, Internship, Internship Experience

Background

According to a research study conducted by the World Health Organization (WHO), it was

found that an estimated 450 million people globally suffer from mental disorders.

Approximately 80% of the people with mental disorders live in low-middle income countries

(LMICs), where four out of five people with serious mental health problems living in LMICs

do not receive the needed mental health care services. Mental illness accounts for 14% of all

disability adjusted life years (DALYs) lost worldwide, and is one of the major contributors

to the global burden of disease. [1] Mental health is the foundation for well-being and

effective functioning of an individual and for a community. It is more than the absence of

mental illness, it is a state of well-being in which the individual realizes his or her own

abilities, can cope with the normal stresses of life, can work productively and fruitfully, and

is able to make a contribution to his or her community.[2] Despite these known facts, most

of the mental health disorders (due to their invisibility to the human eye) like anxiety,

depression, suicide have an underlying stigma and discrimination which hinder the process

of treatment seeking among patients. This is largely due to lack of awareness and sensitivity.

Owing to our cultural boundaries and prejudicial perspectives, we often blindside our mental

health paying less or no attention and care to it. Therefore, it is a need of the hour to promote

mental health and raise awareness among the public.

The Department of Mental Health Education, NIMHANS- is an integral part of the Institute

and actively involved in teaching, research and training activities in the field of health

education. Its focus is to prepare students, health care professionals, caregivers, and the

community at large to promote health in individual and group settings, and among diverse

populations using culturally appropriate health education methodologies. Its goal is to

facilitate voluntary health-related behavioral and social change through the application

59


of principles of behavioral and social sciences. [4]

Internships involve students working with and for an organization/institute in a fashion that

will make them more acquainted with the real time field work and have a context to apply

the knowledge gained from their classwork to real life situations. Internship in the field of

mental health education is crucial because an individual’s holistic wellbeing is what sets

them apart as assets rather than a liability.

Experience as an Intern

The field of psychology and related studies is vast, but its growth is slow in a country like

India where the societal constructs have a powerful influence over the ever widening

treatment gap. If not dealt with at a grass root level, this field will have no strong base to

develop on. Knowing this, I wished to work in the field of Mental Health Education. The

National Institute of Mental Health and Neurosciences (NIMHANS), is one of the only

institutes in India that has a dedicated department for this cause. The Department of Mental

Health Education is an exclusive department that aims at promoting and educating

individuals and communities to raise awareness, tackle stigma and help bridge the treatment

gap that will add in the exponential growth of this much needed field. When I first applied

to the Department of Mental Health Education, my expectations were to gain an insight to a

mental health setting and also learn more about this field both theoretically and practically.

During my internship course, the department offered the interns with a perfect blend of

theoretical and practical knowledge, where the interns had an opportunity to expand their

network, interact with academicians and also provided a hands-on experience of curating

IEC (Information, Communication and Education) material.

Observing the trend of media and mental health, the Department of Mental Health Education

aimed at adopting the process of developing IEC materials to help reach out to a wider

spectrum of the public to raise awareness about mental health, neurological and

neurosurgical disorders. IEC materials are a combination of brochures, booklets, videos,

posters etc. that consist of health information about various mental and neurological

disorders and mental wellbeing portrayed in an innovative, simplistic and understandable

manner that can be accessed by patients, caregivers and the general public who avail the

services at the Outpatient Department, NIMHANS. To create IEC material, one must

understand that beyond just gathering the “right” information, it requires creativity to make

it appealing to the readers, the material must be well drafted and edited. These factors play

60


a crucial role in dissemination of information. During the internship, I had an opportunity

to enhance content creation and public relations skills. It provided me with an opportunity

to visit specialized clinics and departments to know more about the severe mental health

disorder I wished to curate the content on.

In any field, research work serves as a key to establish facts and reach new conclusions, it is

the reason we investigate limitations and propose new ideas for a progressive growth. The

department of Mental Health Education, has its own journal that provides a platform for

professionals and students working in the broad fields of mental, neurological and

neurosurgical health and promotion to submit their quality work/research/findings in the

journal. [13].

I had an exclusive opportunity to work closely with the faculty members and the editorial

team and work on the journal. This helped me stay connected with the latest findings,

initiatives and progress of this field. It helped me know and understand the current status of

the field so that as a future psychologist I can contribute more to this field. But beyond just

content creation and learning opportunities, the internship program helped me improve my

interpersonal relationship skills, it enhanced my communications skills and boosted my

confidence while I learnt to work in a time bound goal-oriented manner.

Implications / Significance

Mental Health and physical health both play an integral role in a person’s existence. Despite

this, mental health is still portrayed by some as a luxury. [2] Noting the above misconception,

Mental Health Education and promotion becomes a critical factor in a country’s

development. This helps debunk myths, counter the stigma and promote a healthy

environment for the welfare of the people. On the background of oversupply of graduates,

more and more professional-degree postgraduates need to prove their working ability

through internships beyond their degree. [8] An internship courses with the Department of

Mental Health Education, NIMHANS (National Institute of Mental Health and

Neurosciences) has provided me with an exclusive opportunity to bridge the gap between

literacy and education. It helps apply theoretical knowledge to real world problems and gain

the real taste of the field. Working under the Department of Mental Health Education gave

interns a chance to expand their network, interact with academicians and learn from them.

It also helped them get access to many IEC (Information Education and Communication)

materials that served as a key in this learning process.

61


Strengths/Limitations

The internship period at NIMHANS- under the department of Mental Health Education

helped us flourish in two major aspects:

1. Personal Aspect: Working closely with the department made me realize my potential and

inclination towards psychology and mental health education. Understanding the magnitude

of difference between healthy and unhealthy lifestyles, the internship program aided and

helped me learn how to make “better choices’. Highlighting the role of caregivers, it helped

me know the rising need of caregivers and the need to recognize and value mental health.

Engaging in departmental activities boosted my confidence as I got an opportunity to

showcase my skills and enhance my event management skills. It helped me know and value

“teamwork” more and personally it shaped us to be a better fit in the real working world.

All in all, it holistically enhanced the personal growth and development.

2. Professional Aspect: Working with the Department of Mental Health education provided me

with an enriching opportunity to expand our practical knowledge. It further encouraged us

to improve on our interpersonal communication skills and tap into our creative side- helping

us understand the relation between media, creativity and mental health.

More importantly, working on the development of IEC Material on severe mental health

disorder gave us an in-depth insight to the subject that helped us improve academically and

the intensive training helped in converting this theoretical knowledge to application-based

methods that helped promote mental health. The Department of Mental health education

provided me with an opportunity to work closely with the department’s journal: “Journal of

Mental Health Education” to help understand the research and review process. Along with

this, it aided me to understand the importance of deadlines and gave me an insight about

how it feels to be working in a mental health setting in real life.

Conclusion

There is no health without mental health.

The focus of the Department of Mental Health Education is to prepare students, health care

professionals, caregivers and the community at large to promote health in individual and

group settings, and among diverse populations using culturally appropriate mental health

education methodologies. Internships are very useful in acquiring (practical) knowledge,

especially in bridging the theoretical and practical knowledge. Through internship, they can

authentically feel the process of combining two kinds of knowledge, and get to know the

62


defects and scarcity in their own theory study. Beyond just theoretical knowledge, working

closely with the Department of Mental Health Education - NIMHANS, aided in personal and

professional growth- providing me with an array of tasks that helped us enhance our

management skills, communication skills and interpersonal relations and also shaped us to

be a better fit in the real working world.

References

1. Bhumika t Venkatesh. Journal of family medicine and primary care. [Online]. Available

from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535113/ [Accessed 30 March

2021].

2. World Health Organization. Promoting Mental Health. [Online]. Available from:

https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf [Accessed 25

March2021].

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NIMHANS Arogya Jagruti Kendra- A window to Educate Minds and

Empower Communities

Deepika Saini1, Dr. Rajeev Jayaram Paleri1*, Dr. Meena K. S2, Dr. Latha K.3

1 Fellowship Student, Department of Mental Health Education, NIMHANS, Bangalore

2Additional Professor and Head, Department of Mental Health Education, NIMHANS,

Bangalore

3Associate Professor, Department of Mental Health Education, NIMHANS, Bangalore

*Address of Correspondence: Dr. Rajeev Jayaram Paleri, Department of Mental Health

Education, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru,

India



Saini D, Paleri R J, K. S M, K L.

NIMHANS Arogya Jagruti Kendra- A

window to Educate Minds and Empower

Communities. Journal of Mental Health

Education. 2021;3(1):65-71.

Abstract

The purpose of this brief

communication is to examine

innovative ideas as a way

forward in creating Mental

Health Awareness. NIMHANS

Arogya Jagruti Kendra (NAJK),

an initiative by Department of

Mental Health Education,

NIMHANS was put forth to

create awareness on the mental

health & neurological disorders

with the help of brochures short

videos and direct interaction of

mental health professionals with

65



patients and caregivers. IEC materials include a range of products like: infographics, flyers,

leaflets, brochures, short videos and direct interaction of mental health professionals with

patients and caregivers. The initiative will foresee different ways to disseminate information

about mental health and illness to the patients and caregivers attending Outpatient

departments at the institute and to the public. The NAJK is a Learning Resource Centre

where patients and caregivers can access various resources related to various disorders and

health related information. Though it has its own strengths and challenges, the center looks

forward to increasing the flow of patients and caregivers seeking access to information

thereby meeting the objective of service deliverables.

Keywords: Mental Health Education, learning resource center, innovative ideas,

mental illness, mental disorder, caregivers.

Background

Mental health as defined by WHO is “a state of well-being in which the individual realizes

his or her own abilities, can cope with the normal stresses of life, can work productively

and fruitfully, and is able to make a contribution to his or her community. By this definition

one realizes the importance of having a healthy mind and the ability to cope with daily life

stressors. Globally the burden of Mental illness is 13.2%. (WHO, 2000) a. Health

promotion is an approach in improving public health that requires active participation by

the stakeholders. It may be understood as actions and advocacy to address the full range of

potentially modifiable determinants of health, including actions that allow people to adopt

and maintain healthy lives and those that create living conditions and environments that support

health (WHO, 1998a) 1. In India, many initiatives have been taken since the last decade to

improve knowledge and increase awareness relating to mental illness. From traditional

methods of print media to newer mobile technology based and Non-Specialist Mental Health

Programs, each state has come up with newer initiatives to reach the target population. In the

year 2014, the state of Gujarat, trained non-specialist community mental health workers for

screening, tracking and providing mental health care in remote regions of Gujarat.2 They

taught the people to use mobile phones and answer the self-report questionnaire developed

by WHO. They customized and added questions for epilepsy and alcohol abuse to make it

culturally appropriate and target the problem occurring in that area.

Information Education Communication (IEC) is the process of learning that empowers

people to make decisions, modify behaviours and change social conditions.3 IEC materials

include a range of products like: infographics, flyers, brochure, social media posts,

television advertisements, audio spots for radio, posters, billboards or murals. The primary

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goal of the IEC program is to inspire and educate people about prevention, care and/or

treatment of various health issues and for a better understanding of the same in a more

comprehensive way.

The Ministry of Health & Family Welfare, Himachal Pradesh, developed 30 second audio

spots to disseminate information regarding general health issues, mental health and

substance use by broadcasting it on Radio channels. The spots were short, catchy and

informative. The Department of Mental Health Education, NIMHANS started an innovative

initiative in its OPD block which is called the NIMHANS Arogya Jagruti Kendra (NAJK).

This learning resource center in the OPD allows the patients and caregivers to access

varied health information related to mental health, neurological and neurosurgical disorders.

It is a walk-in space and has different kinds of brochures, manuals and a digital display

displaying educational videos for the visitors. The patients & caregivers can also interact

with the students at NAJK who are trained by experts from a multidisciplinary team

including Mental Health Education, Psychiatry, Clinical Psychology, Psychiatric Social

Work, Neurology, Neurosurgery, Nursing and allied fields. This innovative initiative aims

at strengthening the knowledge related to mental health & neurological conditions by

integrating it into the OPD setting, and also disseminates information regarding specific

disorders and well-being through a wide range of resources.

Observation and Experience

The department, in its academic pursuits, receives students from various backgrounds and

trains them in the field of Mental Health Education during their tenure. One of the

objectives of their training includes guiding patients and caregivers to access the resources at

NAJK and to develop the same. In addition, they also learn to disseminate knowledge on

various psychiatric, neurological and neurosurgical disorders among the people who visit

the center. The concept of NAJK is innovative and exciting to explore as many hospitals that

specialize in psychiatric illnesses do not have such spaces where visitors could gain

information about disorders.

For decades, it has been observed that the mentally ill have been treated very badly. It was

believed that mental illness was caused by demonic possession, witchcraft, or an angry God

(Szasz, 1960). For example, in medieval times, abnormal behaviors were viewed as a sign that

a person was possessed by demons.4

On this background, we understand that there lies a strong connection between sociocultural

beliefs and mental health which plays a major role in the way mental health is perceived

67


by people which further affect the treatment of Mental Health Disorders. Culture is an

abstraction, reflecting the total way of life of a society. It is a precipitate of the group’s history

and an expression of its adaptation to the physical environment. Culture is constantly in the

process of change and it is transmitted from one generation to the next. All societies have it

though their styles vary from one group to another.5 Over the years, there has been an

initiative by the government and private organizations to spread awareness, information and

facts related to Mental illnesses and health to bridge the gap between the orthodoxical

perspective and scientific treatment.

The department of Mental Health Education tries to bridge this gap by creating simple, easily

understandable content in the areas of psychiatric, neurological and neurosurgical disorders.

With various IEC Materials out for display at the entrance of the NAJK, the public is drawn

to have a look at the materials for more information about the disorder they would like to

know about or even about ways to maintain a good mental well-being. Posters and short

videos are displayed on digital signage at the entrance of the OPD block and waiting areas to

educate and expand the visitors’ knowledge regarding disorders and healthy lifestyle. The

department has taken various steps including distributing flyers to other Outpatient

Departments, for the doctors to guide their patients or caregivers to the NAJK for further

information about mental health topics.

The turnout of patients and caregivers in NAJK over the last 3 months has been tremendous.

Ona day to day basis, the fellows interact with patients and caregivers who visit to NAJK

and it was disheartening to realize people have no or very little information regarding the

problems they are going through and it draws our attention towards the bridging the gap

between trying to create awareness using IEC material and how many people actually receive

it. This has been supported in a study by Thakur et al that lack of information is the major

barrier to the effective access to services. Adding to the lack of information is the

inappropriate usage of funds provided by the Government. The funds are underutilized or

used for conventional information material such as print advertisements. A majority of the

IEC materials available at the district level is not relevant as per the local needs and

requirements. The focus should be to develop local context-specific IEC materials. IEC

materials need to be adapted at the state and district levels, and reproduced considering the

sociocultural context and need, and then be disseminated in the community, especially

hard- to-reach areas.6 The curiosity of the visitors often draws them to the NAJK to interact,

know more about their problems and pick up brochures. Patients and caregivers provide

feedback where they suggest improvements in the NAJK and request for other relevant topics

on which IEC material can be created. A lot of patients through the feedback form have

68


expressed a need for starting discussion groups for family and Self-help groups for

patients, as they feel that talking to others who can understand what it is like to deal with a

mental illness and caring for them would prove to be of great help. Self-help groups for

mental health problems are the most prevalent form of self-help. There are several thousand

groups in Australia, the U.K., the U.S. However, in India where there are less trained

mental health professionals, SHGs prove to be essential and beneficial for both rural and

urban populations. Under the “Manam Inidhu” an initiative by Tamil Nadu Corporation for

Development of Women, Schizophrenia Research Foundation (SCARF) and the Institute of

Mental Health, members of self-help groups (SHGs) across Tamil Nadu will be trained as

mental health counsellors.7 NAJK as an initiative, helps to reach out to more audience,

understand the nuances of how mental illness is perceived by the population, the treatment

gap that persists, the need to fill in through educating the masses, and normalizing

discussing and talking about Mental illness.

Implications/ Significance

There has been a very slow progress in understanding mental health and its importance

when compared to physical health. With the arrival of the Pandemic, COVID- 19, people

have begun to understand the importance of Mental Health and seeking treatment for all

mental disorders. The NAJK is crucial in drawing people into the world of knowledge and

thereby spreading awareness among the people about Mental Health which is further

crucial in obtaining the right treatment at the right time, thereby helping to reduce stigma

related to mental health disorders and treatment gap, which are the two main causes of

global burden of mental health disorders. This is achieved through effective dissemination

of booklets and brochures. It also helps the people in identifying mental health disorders,

seeking necessary treatment, self- help and improving mental well-being. The NAJK also

invites emails from people to seek out information from various other authentic sources.

Strengths and Limitations

The location of the NAJK near the entrance proves to be of very crucial strength as it draws

in the attention of a majority of people who enter the OPD as they are passing by to their

respective departments. The availability of various IEC materials and its display on standees

calls in people to read and collect the IEC Materials to improve their knowledge on Mental

Health and its well-being. The NAJK also conducts theme based programs by initiating

exhibitions, public awareness programs, development of IEC materials and undertaking

unique campaigns to generate awareness.

Despite all the strengths, the NAJK has got scope for improvement. Most of the patients

and caregivers come from different part of India and from neighboring countries. The waiting

69


time for consultation deprives the caregivers of visiting the center for accessing the

resources. This can be addressed by the trainees and volunteers reaching out to them in the

waiting halls and making help accessible. Development of newer IEC materials in multiple

languages according to needs can be enforced with interaction with patients and caregivers.

Implementing these in the coming months can strengthen the services of NAJK and

educate and empower the persons seeking services at the hospital.

Conclusion

The NIMHANS Arogya Jagruti Kendra, a learning resource center to disseminate awareness

about mental health, its disorders and well-being, is an innovative strategy brought into

action for patients and caregivers coming to the OPD. The NAJK can be further

strengthened by being provided with space in key locations within the specific Out Patient

Departments, thereby improving dissemination of awareness on mental health and

neurological disorders. The NAJK plays a key role in answering the queries of its visitors and

thus, improving mental health literacy and reducing mental health stigma. The innovative

approach of NAJK started by NIMHANS, not only makes mental health services more

accessible and affordable but also empowering in nature by encouraging patients and

caregivers in early detection, prevention of mental health illness, appropriate treatment

referral to existing primary healthcare services.

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PLHIVs. IOSR Journal of Humanities and Social Science (IOSR-JHSS, 19(3), 53–58.

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