CHRISTIAN MEDICAL COLLEGE MENTAL HEALTH IN INDIA Vellore

CHRISTIAN MEDICAL COLLEGE: MENTAL HEALTH IN INDIA Vellore, India Molly Meagher, KUSON N 4

Christian Medical College ◦ Located in Vellore, Tamil Nadu, India ◦ One of most respected medical destinations in India ◦ Founded in 1900 by American missionary, Dr. Ida S. Scudder ◦ Private, not-for-profit ◦ 2, 858 beds - private and general ◦ Around 2, 600 nurses employed

Psych Clinical Objectives 1. Compare the psychiatric patient populations seen at CMC and the University of Kansas Hospital 2. Understand how nurses play a role in patient wellness at the CMC psychiatric hospital 3. Investigate what patient care techniques CMC utilizes and why *Front of CMC main hospital campus

CMC Mental Health Center ◦ Located on Bagayam Campus ◦ Open, nonrestrictive site ◦ Only psychiatric hospital in India ◦ 125 beds - four units, onsite OT ◦ Electroconvulsive Therapy (ECT) ◦ Internationally known ◦ Bangladesh and Nepal frequently come ◦ Families travel great lengths to receive care here ◦ Staffing: 6 nurse managers, 3 charge nurses, 36 staff nurses * Patient art and outdoor area of long term stay

Psychiatric Hospital Patient Admissions ◦ Patient required to be admitted with family ◦ ◦ Live together during entire stay Better outcomes Educate about illness and needs Help track progress ◦ Inpatient typically stay four to six weeks ◦ Personal living quarters ◦ Cook own food ◦ Independently participate in activities ◦ No patient uniforms ◦ Decrease stigma *Rangoli – images made on door steps that bring good luck into the home

CMC Psychiatric Units ◦ Acute Care ◦ 12 beds ◦ Immediate crisis ◦ Annex ◦ 26 beds ◦ Long term stay ◦ Private and General ◦ 23 beds/ 40 beds ◦ Living arrangements based on income ◦ Child and Adolescent ◦ 24 beds ◦ Nambikkai Nilayam – “to give hope to parents” *Me with Shanti Johnson, a nurse manager at CMC psych hospital

CMC Psychiatric Care Strategies Conditions Treated • • • Depression • Substance abuse • Relationship • problems • Emotional distress Bipolar disorder Schizophrenia Psychosis Anxiety Community Programs OCD • Group Therapy ADHD • Individual Therapy • Parents with Schizophrenic • Occupational Children Club Therapy • Parent/Child • Therapeutic Classes Activities • Various resources • Work Opportunities to cope and be successful • Alcoholics Autism Down’s Syndrome Eating disorders Anonymous

India’s Psychiatric Care Strategies Individual ◦ People tend to consult temples and faith healers, not doctors ◦ Strong stigma against mental illness ◦ Personal and family image stained ◦ Family dynamics hindered when one member is missing ◦ Affects person’s marketability for marriage ◦ Some organizations attempting to combine spiritual healers and medicine to compromise Government ◦ Only 5, 000 psychiatrists in country ◦ Some regional government hospitals offer treatment ◦ Supreme court outlawed mechanical restraints, though chains used ◦ Government doesn’t consider mental illness priority ◦ Lack of money, resources, and knowledge

Conclusions 1. Patient population at CMC very similar to TUKH ◦ Less substance abuse ◦ Alcohol not used socially ◦ Benzo addiction more common 2. Nurses vital to patient progress, organizing therapeutic activities, providing medications ◦ Will not be discharged until nurse OKs ◦ Nursing students required to have clinical at psychiatric hospital 3. Only evidence based practices in treatment of psychiatric patients *Me and CMC nursing student interviewing local villager ◦ Family required to stay with patient ◦ Parent class for developmentally disabled children ◦ Group therapy and support programs

Most Profound Experience Professionally: Parent class for developmentally delayed children ◦ Two month course ◦ Educating and managing children with Autism, Down’s Syndrome, CP ◦ Games and Activities ◦ Sensory– lights, sounds, textured objects ◦ Mentally Stimulating– object permanence, puzzles ◦ Positive reward only ◦ Food, class applause, parent love ◦ Acting out - child removed from current task to exert physical energy on jungle gym *Children at the Balwadie, a village preschool

Most Profound Experience cont. Culturally: Becoming friends with Indians and immersing in the culture ◦ Village of Melminnal ◦ Worked with for community health promotion ◦ Villagers treated us as family and invited us in for coffee and snacks ◦ One lady said we must move into her home and live with her forever! ◦ CMC Staff *KU nursing students with CMC nursing students ◦ Became close friends with various nursing students and staff ◦ Took us shopping, cooked dinners for us, went with us on weekend trips ◦ Helped tie our sarees and explained customs

References ◦ PBS Newshour. (September, 2014). Treating mental illness with medicine and religion in India. Retrieved from: http: //www. pbs. org/newshour/bb/treating-mental-illnessmedicine-religion-india/ ◦ Kennedy, M. (August, 2010) In India, Stimga of Mental Illness Hinders Treatment. Retrieved from: http: //www. npr. org/templates/story. php? story. Id=129091680