Skip to main content

Advertisement

SpringerLink
Log in

Psychosocial Rehabilitation of Persons with Severe Mental Disorders in Rural South India: Learnings from Step Project

  • Review of Rehabilitation Facilities & Services
  • Published:
Journal of Psychosocial Rehabilitation and Mental Health Aims and scope Submit manuscript

Abstract

Psychosocial rehabilitation (PSR) is an important and essential component in the management of persons with severe mental disorders (SMD), along with pharmacological and psychological interventions. PSR is instrumental to bring positive change in the social and occupational functioning of persons with SMD by providing support and addressing their specific psychosocial needs. Here, we provide an overview of the various PSR strategies offered to persons with SMD as a part of the SCARF Telepsychiatry in Pudukkottai (STEP) program in the rural communities of Tamil Nadu. We undertook an analysis of the project data for the period 2010–2019 during which 14,496 individuals had received some intervention under the STEP program and the various PSR activities provided are listed. Our results indicate a range of PSR activities were provided to persons with SMD and their family members including facilitating the receipt of disability and welfare benefits, help with employment, obtaining loans from banks to start private small enterprises, to help with emergency and other admissions. Our experiences have been able to demonstrate that it is eminently possible to incorporate and integrate PSR interventions in community based programmes for persons with severe mental disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Alonso J, Mortier P, Auerbach RP, Bruffaerts R, Vilagut G, Cuijpers P, et al. Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project. Depress Anxiety. 2018, 35(9):802–14.

    Article  Google Scholar 

  2. Hernando-Merino E, Baca-Garcia E, Barrigón ML. Comparison of disability between common mental disorders and severe mental disorders using WHODAS 2.0. Rev Psiquiatr Salud Ment. 2021 Sep 14;S1888–9891(21)00099–9.

  3. Harvey AG, Gumport NB. Evidence-based psychological treatments for mental disorders: Modifiable barriers to access and possible solutions. Behav Res Ther. 2015 May; 68:1–12.

    Article  Google Scholar 

  4. Saha S, Chauhan A, Buch B, Makwana S, Vikar S, Kotwani P, et al. Psychosocial rehabilitation of people living with mental illness: Lessons learned from community-based psychiatric rehabilitation centres in Gujarat. J Fam Med Prim Care. 2020 Feb 28;9(2):892–7.

    Article  Google Scholar 

  5. Tirupati S. The principles and practice of psychiatric rehabilitation. Indian J Ment Health Neurosci. 2018;1(1):8–12.

    Article  Google Scholar 

  6. Iemmi V, Gibson L, Blanchet K, Kumar KS, Rath S, Hartley S, et al. Community-based rehabilitation for people with disabilities in low-and middle-income countries: A systematic review. Campbell Syst Rev. 2015;11(1):1–177.

    Article  Google Scholar 

  7. Moniruzzaman, Saha PC, Habib MM. Community based rehabilitation: Does it really improve the level of productivity among persons with physical disabilities? Work Read Mass. 2015;50(3):395–401.

    Google Scholar 

  8. World Health Organization. Community-based rehabilitation: CBR guidelines. In: Community-based rehabilitation: CBR guidelines. 2010. p. 67–67.

  9. Chatterjee S, Naik S, John S, Dabholkar H, Balaji M, Koschorke M, et al. Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial. The Lancet. 2014;383(9926):1385–94.

    Article  Google Scholar 

  10. Hanlon C, Alem A, Medhin G, Shibre T, Ejigu DA, Negussie H, et al. Task sharing for the care of severe mental disorders in a low-income country (TaSCS): study protocol for a randomised, controlled, non-inferiority trial. Trials. 2016 Feb 11;17(1):76.

    Article  Google Scholar 

  11. Thara R, Padmavati R, Aynkran JR, John S. Community mental health in India: A rethink. Int J Ment Health Syst. 2008;2(1):1–7.

    Article  Google Scholar 

  12. World health Organization. WHO guideline on health policy and system support to optimize community health worker programmes. World Health Organization; 2018.

  13. Thara R, Patel V. Role of non-governmental organizations in mental health in India. Indian J Psychiatry. 2010 Jan;52(Suppl1):S389–95.

    Article  Google Scholar 

  14. Thara R, Sujit J. Mobile telepsychiatry in India. World Psychiatry. 2013 Feb;12(1):84.

    Article  Google Scholar 

  15. Thara R, John S, Rao K. Telepsychiatry in Chennai, India: the SCARF experience. Behav Sci Law. 2008;26(3):315–22.

    Article  Google Scholar 

  16. Tharoor H, Thara R. Evolution of Community Telepsychiatry in India Showcasing the SCARF Model. Indian J Psychol Med. 2020;42(5_suppl):69S-74S.

    Article  Google Scholar 

  17. Ostrow L, Nemec PB, Smith C. Self-employment for people with psychiatric disabilities: advantages and strategies. J Behav Health Serv Res. 2019;46(4):686–96.

    Article  Google Scholar 

  18. Webber M, Fendt-Newlin M. A review of social participation interventions for people with mental health problems. Soc Psychiatry Psychiatr Epidemiol. 2017;52(4):369–80.

    Article  Google Scholar 

  19. Almerie MQ, Okba Al Marhi M, Jawoosh M, Alsabbagh M, Matar HE, Maayan N, et al. Social skills programmes for schizophrenia. Cochrane Database Syst Rev. 2015 Jun 9;2015(6):CD009006.

    PubMed Central  Google Scholar 

  20. Ravilla S, Muliyala KP, Channaveerachari NK, Suresha KK, Udupi A, Thirthalli J. Income generation programs and real-world functioning of persons with schizophrenia: Experience from the thirthahalli cohort. Indian J Psychol Med. 2019;41(5):482–5.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the community level workers (CLWs), who were the backbone of the STEP project, for identifying the psychosocial needs and delivering psychosocial rehabilitation interventions/activities for persons with severe mental disorders in the remote rural communities.

Funding

The SCARF Telepsychiatry in Pudukkottai (STEP) Project was funded by the Tata Education Trust.

Author information

Authors and Affiliations

  1. Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600101, India

    Kotteswara Rao, Sujit John, A. Kulandesu, S. Karthick, S. Senthilkumar, T. Gunaselvi, Vijaya Raghavan & R. Thara

Authors
  1. Kotteswara Rao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sujit John
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Kulandesu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Karthick
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Senthilkumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. Gunaselvi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vijaya Raghavan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. R. Thara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vijaya Raghavan.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Institutional Ethics Committee of SCARF approval was obtained before the start of the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rao, K., John, S., Kulandesu, A. et al. Psychosocial Rehabilitation of Persons with Severe Mental Disorders in Rural South India: Learnings from Step Project. J. Psychosoc. Rehabil. Ment. Health 9, 335–343 (2022). https://doi.org/10.1007/s40737-022-00275-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40737-022-00275-7

Keywords

Search

Navigation