Principles and Practice of Psychiatric Rehabilitation: An Empirical Approach

Abstract

infrastructure, including standardised training, and more professionals to sustain and expand the model. Another approach could be to train available medical officers to take up the role of the mental health professional in resource-poor rural areas like those covered by the project. The Shifa approach requires devoted families living within supportive villages, which may not always be present , particularly in war-torn areas. The data collected within the project are based on non-standard measures and rating techniques that need validation. Finally, the emphasis on helping people with the most severe disorders-which is necessary due to the scarce resources-inevitably results in less attention to others who also need help. Conclusions Project Shifa demonstrates a cost-effective approach to psychiatric care and rehabilitation in rural India. Other healthcare teams in India and in other low-and middle-income countries, which face similar challenges, might find some of the strategies employed by the project useful. By relying on a lay workforce of health workers and families, using low-cost medications and a home-based approach, the project has demonstrated that psychiatric outreach, treatment and rehabilitation can be effectively implemented at very low cost in a sizeable rural area with only a single available trained mental health professional. et al (2014b) Mental healthcare in low and middle income countries should not replicate the inefficient, inaccessible, ineffective Western model. BMJ, 349, g7086. Kumar A. (2011) Mental health services in India: challenges and prospects. Health, 3, 757-761. Mulley A. G., Richards T. & Abbassi K. (2015) Delivering health with integrity of purpose: Health systems must learn how to co-produce and deliver services that patients and the public value. BMJ, 351, h4448.