Atmiyata: Community-Led Initiative for Mental Health and Social Care in India
摘要
Data from the National Mental Health Survey (2016) showed that 197 million Indians live with a mental health condition, with 70–92% of them unable to access care in India. This large mental health care gap exists due to both demand (stigma, discrimination), and supply (lack of professionals) factors. Despite the evidence of lay health workers bridging the mental health gap, few interventions provide a scalable and evidence-based model. To reduce the large mental health gap, Atmiyata aimed to create an innovative, community-led intervention enabling communities to address their own mental health and social care. Our randomized implementation trial in one district in the state of Gujarat found that persons who received counselling from Atmiyata volunteers were two times more likely to have recovered from a CMD at 3 months and 3 times more likely at 8 months. Further, the intervention had cost offsets due to substantial use of volunteers. Atmiyata has been recognized by the World Health Organization as one of the 25 good practices for community outreach mental health services that aligns with the rights and recovery-based approach. Since its inception in 2013, the intervention has scaled from 41 to 1890 villages across 7 districts and 5 states covering a total rural adult population of 3.5 million, with immense support from 2500 community volunteers in 2024. The intervention annually reaches out to approximately 25,000 persons with mental health needs within 500 villages in one rural district in India. The chapter will expand on the model of Atmiyata, its use in diverse settings, and future directions.