Christian medical college: Mental Health in india Vellore, India Molly Meagher, KUSON N4

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

CMC Mental Health Center * Patient art and outdoor area of long term stay 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

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 Annex Private and General 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 Community Programs Anxiety OCD Depression ADHD Substance abuse Autism Relationship problems Down’s Syndrome Eating disorders Emotional distress Bipolar disorder Schizophrenia Psychosis Group Therapy Alcoholics Anonymous Individual Therapy Parents with Schizophrenic Children Club Occupational Therapy Parent/Child Classes Therapeutic Activities Various resources to cope and be successful Work Opportunities Rounding Grand rounds Twice weekly Psychiatrists, nurses, social workers, clinical psychologists, OT and PT Weekly Conferences Review chart, give report Discuss goals and progress

India’s Psychiatric Care Strategies Individual Government 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 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 Patient population at CMC very similar to TUKH Less substance abuse Alcohol not used socially Benzo addiction more common 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 Only evidence based practices in treatment of psychiatric patients Family required to stay with patient Parent class for developmentally disabled children Group therapy and support programs *Me and CMC nursing student interviewing local villager

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 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 *KU nursing students with CMC nursing students

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

धन्यवाद !! (Thank you!!)