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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 37  |  Issue : 4  |  Page : 452-453

Creating comprehensive youth mental health services in low-resource settings: Schizophrenia research foundation experience


Youth Mental Health program, Schizophrenia Research Foundation (I), Chennai, Tamil Nadu, India

Date of Submission18-Dec-2020
Date of Decision19-Apr-2021
Date of Acceptance14-Jul-2021
Date of Web Publication25-Nov-2021

Correspondence Address:
Dr. Shiva Prakash Srinivasan
Schizophrenia Research Foundation (I), R/7A, North Main Road, Anna Nagar (W), Chennai - 600 091, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_451_20

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How to cite this article:
Srinivasan SP, Mohan G, Rabiya S, Chandrasekar S, Raghavan V. Creating comprehensive youth mental health services in low-resource settings: Schizophrenia research foundation experience. Indian J Soc Psychiatry 2021;37:452-3

How to cite this URL:
Srinivasan SP, Mohan G, Rabiya S, Chandrasekar S, Raghavan V. Creating comprehensive youth mental health services in low-resource settings: Schizophrenia research foundation experience. Indian J Soc Psychiatry [serial online] 2021 [cited 2021 Dec 3];37:452-3. Available from: https://www.indjsp.org/text.asp?2021/37/4/452/331138



Dear Editor,

With nearly one-fifth of the total population under 25 years of age, India has the world's highest number of 10–24-year-old persons (242 million).[1] The World Health Organization reports that one in five youths would be suffering from some form of mental illness, including depression, anxiety, or substance use.[2] This is further exemplified by a recent national mental health (MH) survey of 2016 which described MH conditions such as depression (6.9%), anxiety (15.5%), and suicidal ideas needing urgent interventions (5.5%) of individuals between the ages of 15 and 24 years in India.[3] This calls for a collaborative, multisectoral, and comprehensive program to address the MH needs of the young people of India, including promotion, prevention, treatment, and aftercare.

India under the Rashtriya Kishor Swasthya Karyakram has a program to address the health and well-being of the youth but is limited by patchy implementation of the program, limited engagement of teachers/educational institutions and parents, no representation from the youth, limited access and availability of health services, and insufficient health professionals trained to address the MH needs of young people.[4],[5] To overcome the challenges around MH for the youth, we describe our model of Youth MH (YMH) at Schizophrenia Research Foundation (SCARF-YMH), and its multiple components, ranging from community to clinic, in Chennai, India, run with limited resources.

The SCARF-YMH program was initiated with a goal of creating a sustainable, reproducible, evidence-based, and comprehensive program with active involvement of the youth. As a model, the program envisions to integrate and link the different levels of intervention starting from health promotion (primordial prevention) to tertiary level of care (tertiary prevention). The clinical care is streamlined to reduce the barriers to young people from seeking MH help in the clinic at SCARF. A dedicated case manager and psychiatrist provide a need-based structured assessment and treatment for the youth and their families. Furthermore, telemedicine consults have been initiated to engage the youth at times when they are not in their areas of academics and work. Referrals are received by the youth themselves through the social media handles operated for SCARF-YMH.

SCARF-YMH also aims to sensitize the individuals who are in contact with the youth, and this is done by training pediatricians, educators in schools and colleges, and parents of the youth with difficulties on the MH needs of the youth. We have also upskilled MH professionals to work with a school-based MH care system and linked them with schools. We also envision an ongoing interaction with pediatricians to help identify, refer, and manage on an ongoing basis the youth with common MH difficulties in the community. We are developing educational modules for working with the youth with MH difficulties and also with communities for early identification and referral of the youth in distress.

Health promotion and youth empowerment is one of the key components of work done by the SCARF-YMH program. This is achieved through the Resource Center for YMH by SCARF (rYMs), a youth safe space codesigned and maintained by youth volunteers. The rYMs is an inclusive space run and maintained by the youth volunteers who curate and organize various programs promoting MH with feedback from the youth. They have leveraged social media (Instagram, Facebook, and Twitter) to not only disseminate information about the various programs but also continue to support the youth during the pandemic and collaborate with other youth-facing organizations like the National Youth Council. They have also rolled out a “Y4Y (youth 4 youth) warmline” to assist the youth in venting out to trained volunteers regarding their concerns. Extending the idea of the youth being empowered and proactive, we have also developed a cohort of trained peer support volunteers in an academic institution to provide support to their peers. The overall YMH model as implemented currently is summarized in [Table 1].
Table 1: Components, levels of intervention, and activities in youth mental health services provided under Schizophrenia Research Foundation-Youth Mental Health model

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The need for better MH for the youth in India cannot be overemphasized. The existing MH services are not geared to address the full spectrum of MH needs of the youth. Moreover, the existing services are more illness oriented and confined to hospitals and clinics, with little or no room for the promotion of positive MH among the youth.[6] A holistic change with better YMH service models is needed to address the growing needs of the youth and create a more resilient youth of India.[7] Through our experience with this model of YMH, we demonstrate the feasibility of expanding the YMH services from the clinics to the community with minimal resources and cost by involving the youth as a key component of these services and empowering them to lead the community-based activities for the promotion of YMH and youth development, at large.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chandramouli C, General R. Census of India 2011. Provisional Population Totals. New Delhi: Government of India; 2011. p. 409-13.  Back to cited text no. 1
    
2.
Organization WH, Health WHODoM, Abuse S, Association WP, Child IAf, Psychiatry A, et al. Atlas child and adolescent mental health resources global concerns: implications for the future. Geneva, Switzerland: World Health Organization, 2005.  Back to cited text no. 2
    
3.
Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K, Singh L, et al. National Mental Health Survey of India, 2015-16: Summary. Bengaluru: National Institute of Mental Health and Neurosciences; 2016.  Back to cited text no. 3
    
4.
Sivagurunathan C, Umadevi R, Rama R, Gopalakrishnan S. Adolescent health: Present status and its related programmes in India. Are we in the right direction? J Clin Diagn Res 2015;9:E01-6.  Back to cited text no. 4
    
5.
Kansara K, Saxena D, Puwar T, Yasobant S, Trivedi P, Savaliya S, et al. Convergence and outreach for successful implementation of rashtriya kishor swasthya karyakram. Indian J Community Med 2018;43:S18-22.  Back to cited text no. 5
    
6.
Colizzi M, Lasalvia A, Ruggeri M. Prevention and early intervention in youth mental health: Is it time for a multidisciplinary and trans-diagnostic model for care? Int J Ment Health Syst 2020;14:23.  Back to cited text no. 6
    
7.
Hossain MM, Purohit N. Improving child and adolescent mental health in India: Status, services, policies, and way forward. Indian J Psychiatry 2019;61:415-9.  Back to cited text no. 7
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