Role of Non-Governmental Organizations in Mental Health in India

Article excerpt

Byline: R. Thara, Vikram. Patel

The paucity of treatment facilities and psychiatrists in the Government sector has widened the treatment gap in mental health. Non-governmental organizations (NGOs) have played a significant role in the last few decades in not only helping bridge this gap, but also by creating low cost replicable models of care. NGOs are active in a wide array of areas such as child mental health, schizophrenia and psychotic conditions, drug and alcohol abuse, dementia etc. Their activities have included treatment, rehabilitation, community care, research, training and capacity building, awareness and lobbying. This chapter outlines the activities of NGOs in India. This is a revised version of the chapter in the book on mental health to be brought out by Government of India.

Introduction

Mental health has for decades been low in the priority of health planners at state and central levels and this is well reflected in the quantity and quality of mental health services in India. The needs of patients and families far outstrip the availability and accessibility of services for those with mental disorders. India's scarce mental health resources, such as mental health specialists, are largely concentrated in some states (mainly in the south) and in urban areas and a large proportion are solely in the private sector. Over half of all inpatient beds are located in 40 odd mental hospitals, most of which were built during the colonial years. It is not surprising, then, that the 'treatment gap' for mental disorders is large all over the country, but especially so in rural areas, northern states and amongst the socially disadvantaged.

While the government or public services are the key providers of care for these populations, and therefore need strengthening, the NGO movement in the country has seen a steady upswing in the last two decades to fill the large gaps. NGOs are driven by a passion towards a certain cause and back it up with commitment and drive. While the reach of their work cannot parallel that of government agencies, the quality of care and their efforts in reaching out to the various stakeholders, particularly those who are discriminated against such as persons with mental disorders, gives them a distinct advantage.

This chapter seeks to provide an overview of the contributions of Mental Health NGOs (MHNGOs) in India. A brief profile of some NGOs working in key and distinct areas should enable the readers to understand better the ways in which NGOs can innovate, replicate and complement state run services.

Historical Aspects

Non-Governmental Organizations (NGOs) are institutions, recognized by governments as non-profit or welfare oriented, which play a key role as advocates, service providers, activists and researchers on a range of issues pertaining to human and social development. Historically, NGOs have played a critical role in promoting and facilitating health and educational activities in India. Prior to independence, religious bodies set up a number of educational institutions, health facilities and other charities. These movements were often led by charismatic individuals, driven by a sense of missionary zeal. Many NGOs were born in response to major disasters and crises with the aim of providing emergency relief and rehabilitation. Since independence, there has been a meteoric rise in the profile, breadth and range of NGOs in the country.

Three key changes have occurred in the evolution of the NGO- first, the greater degree of professionalization of NGO activities; second, the widening of sources of funds for NGOactivities to include major national and international donor agencies; and third, the secular origins of NGOs. The growing professionalization of NGOs led to the evolution, in the 1960s, of NGOs which focused on health issues. These NGOs increasingly filled gaps in healthcare provision, focusing on under-served populations. …