Knowledge of and Attitudes Towards Mental Illness Among ASHA and Anganwadi Workers in Vadodara District, Gujarat State, India.

Unmet needs in mental health care are high in low and middle-income countries like India. We propose recruiting community health workers (CHWs) to provide mental health services and address the treatment gap, but there is limited data available on the training needs for this potential role. The aim of this study is to help determine what type of formal mental health training and programming could most benefit CHWs in India. This was a cross sectional study design. Self-administered surveys were conducted amongst CHWs in the villages of Vadodara District, Gujarat, India. Statistical analyses included two tailed t-tests using Microsoft Excel 2011. The most common causes for mental illness were attributed to anxiety (61%) and brain disease (61%) followed by stress (45%) and alcohol use disorder (38%). CHWs were dismissive of faith healers ability to treat mental illness (72.9%) showing a strong approval for recommending psychiatric care for the mentally ill (84.4%). Over 50% of participants believed that mentally ill have a lower IQ and that they were unpredictable, but at the same time asserted that people with mental illness can live in the community (80.8%), and recover if given treatment and support (91.8%). Results are promising with CHWs displaying basic knowledge of the etiology and treatment of disease harboring positive attitudes towards psychiatrist's ability to treat mental illness. Future direction should focus on training CHWs towards minimizing stigmatizing views and increasing their knowledge of mental illness in order to scale up mental health services in these low resource communities.

Impact of a community-based mental health awareness program on changing attitudes of the general population toward mental health in Gujarat, India - A study of 711 respondents.

CONTEXT: In India, there is a large mental illness treatment gap, especially in rural areas. Contributors to this problem include stigma and a general lack of mental health knowledge. The State Health Department of Gujarat, India, released a video tool, in 2003, with the goal being to educate the community on topics related to mental health. AIMS: The aim of this study was to evaluate the ability of the government-developed video tool to improve attitudes toward mental health in rural Gujarat. SETTINGS AND DESIGN: Eight hundred and sixty-five individuals, in 17 villages in Gujarat, agreed to attend a mental health awareness workshop that used the government-developed video tool. One workshop was held in each village. A structured questionnaire evaluating attitudes was administered to the participants before and after the workshop. SUBJECTS AND METHODS: government-developed video tool, standardized questionnaire for attitude evaluation. STATISTICAL ANALYSIS USED: A McNemar's test was used to evaluate the difference between pre- and post-scores. RESULTS: A total of 711 participants completed the pre- and post-questionnaire. Attitudes related to psychosis, suicidal ideation, postpartum depression, learning disability, general mental illness, and perceptions of dangerousness showed significantly favorable improvement (P <.005). Attitudes related to substance abuse worsened (P < 0.005). CONCLUSIONS: Results suggest that a government-developed video tool can successfully improve short-term attitudes. Attitudes toward substance abuse may require a different approach than attitudes toward other types of mental illness.