At first glance, Durga is a happy girl. Her bright smile contradicts her flickering yellow saree, and her long, neatly in the sun. A yellow thread lay snuggali around her neck, and a pair of golden earrings smiled against her darker. Her quiet appearance, however, believes to weigh stress on her, and as she remembers her days since last October, smile weakens, and tore bead in her eyes.
Durga, a Dalit, was an assistant in a government school in Kotikalapudi, a village in Ibrahimpatnam Mandal in NTR district. He worked during two years, he and another supporting school complex and cleaned four bathrooms and nine classes every day.
Durga says, “It was difficult,” I would prepare lunch for my husband and children and prepare them for school before going to work, “who felt that it is her responsibility to help her husband, Ravi, but she can be in running a house. And her 6,000 the a month was actually converted to ₹ 400- The 500- The 500- The 500-day earnings, so that her family was turned into a yagnit. Helped.
Therefore, Durga was a crestfollen when she lost her job last year, and the loans, anxiety over the future of their children and a weak poverty took a toll on their mental health. He limited himself indoors and when no one was around, tears broke into tears. He did not eat for days and, while struggling with the ideas of ending his life, made him sleepless.
Reducing any proper education, a 29 -year -old man did not understand what he was suffering. She says, “My head was constantly beating, and my wrath of my anger separated my children and husband.”
Increased his grief, there was a constant fear of pricking the eyes that spinned about him. She is getting branded a “mental” (mentally ill), or worse, ‘pass’. Durga claims that it is common in her village to take such persons to temple, fortune or a church, where detailed rituals are performed to remove the soul “.
About 10 km from Kotikalapudi in Ibrahimpatnam Town, John sits in his old auto-rickshaw outside a tin-hole house. A tall man with manifestations of a child, he wears a confused look on his face. His two lower teeth are missing, and as soon as he speaks, the words were lightly killed.
John says he has been suffering from a mental illness for the last 12 years and believes that his mental health started deteriorating after an accident at a construction site in the city.
In a broken voice with grief and disappointment, 54 -year -old, how he used to use to roam the streets at night, used to blast his head against a wall and shouted at his wife and son. Worried, they took her to a temple and drinking it mixed with vermilion and turmeric for six days, assuming that it would improve her.
“Anything seemed to work. John says, “To advise me which medicine to take or what to drink, I had no one to give advice. His eyes are well up because he remembers his long trips to Vijayawada and seizes countless doctors on Nakla Road in the city, discovering a treatment.
While John does not know the exact nature of his position, the medical officer of a team of Vijayawada -based NGO ‘Vasavya Mahana Mandali’, who examined him as part of a survey, found him to demonstrate the symptoms of schizophrenia.
John rarely runs his auto-rickshaw when he needs money. If he gets a headache, he parks it by road and sleeps, he says. He also earns ₹ 500 a day, but spends most of it on drugs, counseling fees and check-ups, which he passes once in a private hospital in Vijayawada every month. He says that his family has now completely distracted him as he could not give them anything.
“I sleep in my autorickshaw and eat every day from outside … I feel terri, but I want to live and need these drugs,” John says, shed tears. Asked why he never went to a government hospital, he says he did not know where to go in his condition.
A brooing store
Durga and John’s cases can well represent a major problem around the rural landscape of Andhra. The National Mental Health Survey, the National Institute of Mental Health and Neurosciences (NIMhans) was conducted in 12 states in the country in 2016, which found that socio-economic factors played an important role due to mental disorders. This associated poverty, limited education and low social status closely with someone’s mental state.
According to the survey, while the overall mental sickness among men was high, specific mental problems such as depression, anxiety and disorders were more identified in women.
In the survey of NGO Vasavya Mahana Mandali, many villages of Ibrahimpatnam Mandal were worked with ‘The Live Love Laugh Foundation’, named ‘Santwana’ or as part of a pilot project of community mental health program, which found that more than 440 people in 15 villages were suffering from mental disorders. Year.
“No person understood what is happening to them or where to seek help. Dr. Ram Rao says, “When we used to talk to him, he realized that he needed medical care. Among the 440-odd people, 216 are on medicine. Others are on the search for medical care due to the social stigma, presenting mild symptoms.
Indala Ramsuba Reddy, a noted psychiatrist and former president of the Indian Medical Association, says that a lot can be quietly in every mandal or district. Dr. Ramsubba Reddy said, “Lack of awareness, stigma, superstition, unavailability of easy mental health care prevents people from seeking medical help for mental disorders in rural areas.”
A solution, neglected
Back in 1996, the Center launched the District Mental Health Program (DMHP) in an attempt to bridge the gap between people and mental healthcare in rural areas. It is a component of the National Mental Health Program (NMHP), which was launched in 1982 to ensure access to mental healthcare for all. Under DMHP, mental healthcare services are integrated at community level by integrating it with a general physical care distribution system.
To achieve this, frontline workers, including recognized social health workers (AShas) and Assistant Nurses Dai (ANMS), are trained to identify individuals with symptoms of mental disorders. Such people will be taken by a particular medical team to a psychiatrist, a clinical psychologist, a social worker and an employee nurse to the nearest primary health centers (PHC) by a special medical team.
Two days a week, this team provides outpatient services in a allotted hospital and visits the area for PHCs in the district in the other four days.
According to the information shared by the Office of Health and Family Welfare Commissioner, the team needs to consult symptomatic people and refer to government general hospitals (GGHS) and people requiring treatment. Under DMHP, at least one member of the team should visit PHC once every 15 days.
DMHP, however, is not working properly in 13 new districts formed in the state in 2022, Dr. Ram Rao says that even in other districts, PHCs’ trips are not regular.
Dr. Ramsubba Reddy also feels that this program has failed to achieve its objective of taking mental healthcare for the people.
According to information received from a PHC doctor in Ibrahimpatnam Mandal in the new district of NTR, who demanded oblivion, the team is not making any tour in its area. However, a PHC doctor in Prakasam district said, trips are being done there. In Tirupati district, a front line worker told the reporter that there has been no journey in the last six months.
Responding to the allegations, an official of the Health and Family Welfare Office said on the condition of anonymity, while a four -member team in each district, 22 -post psychiatrists and clinical psychologists (11 each) should be empty to special teams, and they are all in new districts.
The official said, “The Medical Recruitment Board has been made aware of the vacancies, and we hope that the positions are expected to be filled by next year,” however, saying, saying that there are tele mas -helplines for needy people.
Time matters
During the survey of the NGO, Durga was suffering alone for a month before helping outreach workers. He consulted him and sent him to GGH. She considers what can happen if she does not get help.
Lack of access to mental healthcare affects the contribution of someone’s life quality, productivity, family relations, finance, children and village activities, Dr. Ramsuba Reddy says that delay in treatment can cause alcohol or drug addiction or even people can end their lives. “They should receive immediate treatment,” he warns.
Lakshmi, who is 38 -year -old from Mulpadu village, says that she started feeling alone and depressed after getting married last year. She is single since leaving her husband 20 years ago.
When he took himself back from the society and avoided going out, no one came to check him. “When I told my brother that I had gone to see a doctor, he (his family) asked me, asking me if I was going to the mental hospital. When my own family makes fun of me, what can I expect from others? She asks. He later received consultation with NGO workers.
Kesava, who works for ‘Santwana’, reported that workers of Ashas, ANMS and Anganwadi, who have direct contact with people in rural areas, do not have much understanding of mental health disorders. When asked, an hope from Tirupati, on the situation of anonymity, says, while the newly involved frontliners know about the symptoms of mental disorders, senior people do not. She says, “There is not much awareness between Asha.”
Distance dissection treatment
In cases of mental disorders, it is important that someone completes his medicine, he said. In the absence of DMHP in NTR district, however, the distance of GGH from someone’s village has become a barrier for many people for medical care. Although Durga was placed on a six -maiden medicine, she has stopped it as she has not currently got a chance to meet Vijayawada.
“I never go to the city alone. I wait until other people in the neighborhood feel the need to go to the hospital. Usually, we wait until we are ten of us so that we can share the autorickshaw charge. If I go alone, it will spend me around ₹ 150, but if I am going with others, ₹ 50, ”Durga says, do not feel the results of closing their medicines.
Holding it together
Despite poverty and social stigma, both Lakshmi and Durga have now taken it to themselves to educate the public about mental disorders. Lakshmi recently took a young man, an alcoholic, Vijayawada to the old GGH. “I am also taking my sister, who recently lost my child, to the doctor. When medical care is available for our condition, why should anyone suffer? She asks.
(Names of persons with mental disorders have been changed)
(In crisis, they can dial 14416 Tele Manas for help)
Published – March 07, 2025 11:46 AM IST
