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Tamil Nadu

Removing the stigma of mental illness in India

Varalakshmi Vemuru's picture
A report on the economic burden of mental illness argues that depression and anxiety disorders cost the world nearly $1 trillion annually. Conversely, every dollar invested in mental health contributes $4 to the economy. Photo credit: TNMHP

April 7 marked the 70th anniversary of World Health Day. This was an opportunity for the global community to redouble its efforts to ensure that all people can improve their health, including their mental health.
 
When his father died, Gopi, a carpenter in rural Tamil Nadu, India was overwhelmed by an enormous mental and financial burden.

Gopi became depressed, left his job, and isolated himself.

As his condition worsened, Gopi’s two younger sisters dropped out from high school to take on farming jobs to support the family.

However, thanks to medicine, counseling, and livelihood support from the Mental Health Program (TNMHP), Gopi eventually rehabilitated himself and got back to carpentry a year later.

With time, he even took out a Rs. 20,000 loan to start his own carpentry business.

Gopi’s experience—and many others’—illustrate how mental health is integral to well-being.

The World Bank recognizes mental health as a key challenge to sustainable development.

A report on the economic burden of mental illness argues that depression and anxiety disorders cost the world nearly $1 trillion annually. Conversely, every dollar invested in mental health contributes $4 to the economy.

Accordingly, the World Bank-supported the Mental Health Program in the state of Tamil Nadu, India that incorporates best practices in mental health from around the world.

The project is an important instrument in addressing the magnitude of India’s mental health challenges, and provides a successful model for the implementation of the national mental health policy and improve mental health infrastructure and care in Indian states.

By closely involving the community, the project reduced stigma and prejudice attached to mental illness and empowered vulnerable people with mental disabilities to gain respect in their communities.  

People with mental disabilities are diagnosed and treated and provided livelihood support through vocational training, self-help groups, job cards, and identity cards to access social benefits.

The unheard voices of women caregivers for people with mental illness

Varalakshmi Vemuru's picture
SHG meeting of people with mental illness and caregivers. (Photo: TNMHP)

Thirty-year old Vijaya (name changed) spent 10 years of her life not talking to anybody. Her parents were daily wage laborers, scraping together a sparse living in India’s southern state of Tamil Nadu. Unaware of any treatment, and afraid of being stigmatized or shunned by their community, they did not disclose their daughter’s illness to anyone. Instead, Vijaya suffered in silence, confined to the house, and hidden from public view.
 
It was only when the Tamil Nadu government’s Mental Health Program (TNMHP) reached out to their community that Vijaya’s life underwent a dramatic change. After six months of working with the program’s community facilitators, Vijaya’s parents took her for treatment, and within a year, the young woman began interacting with others more frequently.
 
Poor mental health places a huge burden on individuals, families, and society. From developed countries to emerging market economies, mental disability – ranging from common mental disorders such as depression to severe mental illnesses and retardation – has profound impacts on people’s economic and social well-being.
 
As cited in “Out of the Shadows: Making mental health a global development priority” in 2010 alone, depression cost an estimated US$800 billion in lost economic output. What’s worse, these costs are expected to double by 2030.
 

For the differently abled by a differently abled – an inspiration from Tamil Nadu, India

Varalakshmi Vemuru's picture
It’s that time of the year when we look at the blogs we have published over the last 12 months and curate some of the most insightful pieces for you to read.

We also want to thank you for reading, contributing and engaging on what it will take to help governments build capable, efficient, open, inclusive and accountable institutions.

Dawa-Dua: How medical treatment complements prayer for people with mental illness in India

Varalakshmi Vemuru's picture

In Even it Up: Time to End Extreme Inequality, Oxfam has delivered another powerful report making the case that tackling inequality is essential to create a more just world and to eliminate extreme poverty. I was asked to comment on this newly released report at an October 31 event held at the IMF, and was as impressed by the presentation as I was with the report.

Oxfam effectively uses research findings to advocate for policy changes to reduce global inequality. This statistics-laden report also wisely features compelling stories about real people, helping the reader to better understand how vast disparities in wealth adversely affect wellbeing. Oxfam has consistently argued to bring inequality to the fore of policy discussions, and not surprisingly, this report appears to have created a groundswell for their global #Even It Up campaign. While there were instances where I found myself questioning the quality of some references supporting a few statements and estimates, my overall reaction was that the ‘big picture’ claims of the report were well substantiated. In my comments, I suggest that if this report is a call to action, a useful next step for Oxfam or a partner in this work, will be to bring more clarity to what it means to eliminate extreme inequality. Establishing a goal or a measure to monitor progress will help to create better policies, and ensure better collaboration across governments and institutions.

Mental illness is curable, treatable, and preventable: a story of hope from India

Varalakshmi Vemuru's picture
On World Mental Health Day, here’s a fact to reflect on: people with mental illness are among the socially excluded and marginalized groups in society. They are often misunderstood, ignored, or simply invisible.
 
In India alone, an estimated 70 million people—or 5% of the population—suffer from mental illness. The southern state of Tamil Nadu, for instance, has one million people living mental disorders—about 3-5 cases per village. Meanwhile, the country faces a severe shortage of psychiatrists and psychiatrist nurses, and clinical care is scarce in rural India. Due to deep social stigma related to mental illness, such serious issues are largely invisible at the community level.

That’s why, in 2012, we launched a comprehensive social and clinical care program with the government of Tamil Nadu to inform and educate local communities on mental health issues, as well as to encourage families and people affected by mental illness to seek treatment. Working with leading local health practitioners, we based the campaign on a core message that was simple, powerful, and resonated with the community:
   
Through a poster on do’s and don’ts of addressing mental illness, the campaign advised the community to
1) seek help from a psychiatrist, 2) start medication, 3) attend counseling sessions, and 4) join self-help groups. (Image: TNEPRP / World Bank)

Building feedback into project implementation: A visit to the Social Observatory

Ken Chomitz's picture

The very name “brain drain” suggests that high-skilled migration can be nothing but bad for developing countries. Indeed, the prospect of a harmful effect of brain drain is often one of the first concerns raised in policy discussions around migration, and every day the news is filled with statements such as “the Philippines is suffering a crippling brain drain”, “brain drain still a big concern” in India;  and that Bangladesh “must stop brain drain to take the country forward”.

However, recently there has been a surge of more optimistic views of highly skilled migration, ranging from theories of “brain gain” in which the prospect of migration in the future induces people (including those who end up not migrating) to get more education; the idea of “brain circulation”, in which migrants are meant to do wonders for their home countries once they return with knowledge and ideas from abroad; and the “create-your-own Silicon Valley” view of diaspora as a source of trade, investment funds, and inspiration.

On a Recent Trip to Tamil Nadu…

Charukesi Ramadurai's picture



It was around this time a year ago, when I gave away the keys of my newly renovated apartment back to its owner. After having lived in the U.S. for more than 12 years, I had decided to return home, to Jerusalem. I packed my belongings in a rush, afraid that the more I stay, the more time I would have to think about it and never leave.