Abstract
Care at Doorstep (CAD) is a home care service that includes medical and social care by skilled professionals. The purpose of this paper is to explore the need for CAD among users of the district mental health programme (DMHP) in Ramanagaram, Karnataka, India who have severe mental illness. The design of this study was descriptive where a qualitative inductive methodology was adopted. Data was collected from interviews of 20 caregivers and 7 mental health service providers linked to the DMHP. Socio demographic information was collected from participants and a semi-structured interview guides were used to explore needs and challenges in delivering care at home by the professionals. The themes that emerged from the manually transcribed and coded data were categorized as needs and challenges and used for developing a CAD model.
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Notes
Several terms have been used in literature to denote home care services, such as home-based care, home care, home health care, and assisted home care. Care at doorstep has been used by authors to indicate the services that come under proposed model of care in this article.
References
Ajlouni, M. T., Dawani, H., & Diab, S. M. (2015). Home health care (HHC) managers perceptions about challenges and obstacles that hinder HHC services in Jordan. Global Journal of Health Science, 7(4), 121.
Brumley, R., Enguidanos, S., Jamison, P., Seitz, R., Morgenstern, N., Saito, S., McIlwane, J., Hillary, K., & Gonzalez, J. (2007). Increased satisfaction with care and lower costs: Results of a randomized trial of in-home palliative care. Journal of the American Geriatrics Society, 55(7), 993–1000. https://doi.org/10.1111/j.1532-5415.2007.01234.x
Chandramouli, C., & General, R. (2011). Census of India 2011: Provisional Population Totals (pp. 409–413). New Delhi: Government of India.
Chatterjee, S., Patel, V., Chatterjee, A., & Weiss, H. A. (2003). Evaluation of a community-based rehabilitation model for chronic schizophrenia in rural India. The British Journal of Psychiatry, 182(1), 57–62.
Chatterjee, S., Pillai, A., Jain, S., Cohen, A., & Patel, V. (2009). Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India. The British Journal of Psychiatry, 195(5), 433–439.
Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research. New York: Sage. https://doi.org/10.1097/00006199-199507000-00011
Dias, A., Dewey, M. E., D’Souza, J., Dhume, R., Motghare, D. D., Shaji, K. S., Menon, R., Prince, M., & Patel, V. (2008). The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: A randomised controlled trial from Goa, India. PLoS ONE. https://doi.org/10.1371/journal.pone.0002333
Genet, N., Boerma, W., Kroneman, M., Hutchinson, A., & Saltman, R. B. (2013). Home care across Europe: case studies.
Grande, G. E., Todd, C. J., Barclay, S. I., & Farquhar, M. C. (2000). A randomized controlled trial of a hospital at home service for the terminally ill. Palliative Medicine, 14(5), 375–385.
Hansen, A., Hauge, S., & Bergland, Å. (2017). Meeting psychosocial needs for persons with dementia in home care services—A qualitative study of different perceptions and practices among health care providers. BMC Geriatrics, 17(1), 211.
Hughes, S. L., Cummings, J., Weaver, F., Manheim, L., Braun, B., & Conrad, K. (1992). A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill. Health Services Research, 26(6), 801.
Jordhøy, M. S., Fayers, P., Saltnes, T., Ahlner-Elmqvist, M., Jannert, M., & Kaasa, S. (2000). A palliative-care intervention and death at home: A cluster randomised trial. Lancet, 356(9233), 888–893. https://doi.org/10.1016/S0140-6736(00)02678-7.
Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of community care for severe mental illness: A review of research on case management. Schizophrenia Bulletin, 24(1), 37–74.
Muijen, M., Marks, I., Connolly, J., & Audini, B. (1992). Home based care and standard hospital care for patients with severe mental illness: A randomised controlled trial. BMJ, 304(6829), 749–754. https://doi.org/10.1136/bmj.304.6829.749
NITI Aayog. (2015). Social sector service delivery: Good practices resource book. India: NITI Aayog.
Pai, S., & Kapur, R. (1983). Evaluation of home care treatment for schizophrenic patients. Acta Psychiatrica Scand., 67(2), 80–88.
Pai, S., Channabasavanna, S. M., & Raghuram, R. (1985). Home care for chronic mental illness in Bangalore: An experiment in the prevention of repeated hospitalisation. The British Journal of Psychiatry, 147(2), 175–179.
Ruggeri, M., Leese, M., Slade, M., Bonizzato, P., Fontecedro, L., & Tansella, M. (2004). Demographic, clinical, social and service variables associated with higher needs for care in community psychiatric service patients. Social Psychiatry and Psychiatric Epidemiology, 39(1), 60–68.
Sebastian, T., & Chenchiliyan, A. (2015). Pain and palliative care services of general hospital, Ernakulam: A case study based on participatory approach. International Journal of Science and Research, 4(11), 2013–2016.
Shepperd, S., Wee, B., & Straus, S. E. (2009). Europe PMC Funders Group Hospital at home: Home-based end of life care. Cochrane Database Systematic Review, 1, 1–40. https://doi.org/10.1002/14651858.CD009231.Hospital
Yee-Melichar, D., Boyle, A. R., & Flores, C. M. (2011). Assisted living administration and management: Effective practices and model programs in elder care. New York: Springer.
Acknowledgement
The authors would like to thank: Patients and their families who consented and participated in the study. Ms. Padmarekha (Psychiatric Social Worker), Ms. Rachavva (Psychiatric Nurse), Ms. Pavitra (Community nurse), Ms. Kamala (data entry operator) of the Ramanagara DMHP for their insights and inputs without which the study could not have been accomplished. The entire DMHP team, Ramanagara district, Karnataka for their tireless efforts in serving the persons with mental illness and their families, and for contributing with their inputs in the data collection process.
Funding
Ms. Sreepriya Menon received the Junior Research Fellowship from University Grants Commission (Ref No. 1412/NET DEC 2015) to conduct this study as part of her M. Phil in the Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.
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Menon, S., Jagannathan, A., Thirthalli, J. et al. Care at Doorsteps for Persons with Severe Mental Illnesses as a Part of District Mental Health Program (DMHP): A Qualitative Needs Assessment and Psychosocial Framework. Community Ment Health J 58, 145–153 (2022). https://doi.org/10.1007/s10597-021-00803-y
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DOI: https://doi.org/10.1007/s10597-021-00803-y