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MHCA mandates monthly reporting to the MHRBs of restraints imposed on the PwMI in the MHEs (Section 97). CB-MH services must be strengthened by effectively implementing DMHP and CB-MH services for ensuring the rights of PwMI to receive treatment in the least restrictive environment. Sir, The Mental Health Care Act, 2017,[1] was implemented in the country for ensuring the rights of persons with mental illness (PwMI).[2] Since its launch, it has been critiqued by the scientific community, highlighting its shortcomings and issues with implementation.[3]-[5] However, such critiques did not explicitly highlight the issues with the implementation of the MHCA in routine clinical discourse. [Extracted from the article]

Background: In India, mental health rehabilitation centers run income generation programs (IGP) for therapeutic engagement, skills training, and income generation of clients. The centers have evolved IGP models relevant to their settings. There is a paucity of published literature on practices employed by the centers. Methods: This paper compiles data gathered from visits to 13 centers between November 2018 and April 2019. Information was collected through observation and interviews with staff involved in IGP, using a semi-structured pro forma designed for study. Results: Most centers were based in south India (n = 11) and urban areas (n = 12). Each center ran two to seven IGP. Each center involved 20–50 clients in IGP. Clients involved in IGP were aged 20–60 years. The centers ran a range of IGP, including the manufacturing of household consumables, paper products, textile products, handicraft products, food products, and jute products; animal husbandry and horticulture initiatives; and running cafeterias and petty shops. IGP were mostly selected based on market demand and sales value of products (n = 11); ease of doing (n = 5); interests, abilities, exposure, and experience of clients (n = 5); and availability of resources (n = 3). Products were priced primarily to cover input and labor costs (n = 8), and many centers sold products below the market rates (n = 5). Running stalls during public events was a common strategy for the sale of products (n = 9). Personal contacts and "word of mouth" publicity were used for advertisement (n = 6). Four centers involved family members in IGP. Conclusion: The nature of IGP varied in terms of setting, available resources, and profile of clients availing the services. Marketing and sales were a challenge. A supportive framework of policies and schemes is essential to promote IGP at mental health rehabilitation centers. This report may be helpful for professionals and centers planning to set up an IGP. [ABSTRACT FROM AUTHOR]

Background: Mental health issues are common among college students, and structured services have been proven to enhance outcomes. Despite increased enrolment for higher education in India, college mental health services remain sparse. JEEVANI is the first structured state-wide college mental health service in India. This paper describes its framework and provides an overview of its functioning during the initial five months. Methods: In 2019–2020, the Directorate of Collegiate Education, Government of Kerala, implemented the program in 66 colleges catering to approximately 60,000 students. Qualified counsellors were trained to identify issues and provide interventions and early referrals, using a stepped-care approach. They conducted awareness programs to promote mental health and reduce stigma. Results: The services were accessed by 2,315 students during the assessment period (October 2019 to February 2020). The beneficiaries were predominantly females (54.1%). Over a third (38.8%) belonged to the lower socio-economic strata, and 2.5% had significant vulnerabilities. Although no syndromal diagnoses were made, anxiety and depression were the most common presentations. The counsellors provided 3,758 individual sessions and facilitated support for students who reported academic difficulties or interpersonal issues. Severe mental illness was detected in 54 students, and referrals for specialist mental health input were initiated in 68. Conclusion: Describing the framework, sharing the technical material, and providing an overview of its functioning from a resource-constrained setting in India may encourage higher education institutions in low- and middle-income countries to consider similar projects. [ABSTRACT FROM AUTHOR]

Background: Problematic use of the internet (PUI) is a growing concern, particularly in the young population. Family factors influence internet use among children in negative ways. This study examined the existing literature on familial or parental factors related to PUI in children. Methods: A scoping review was conducted in EBSCOhost, PubMed, ScienceDirect, JSTOR, Biomed Central, VHL Regional Portal, Cochrane Library, Emerald Insight, and Oxford Academic Journal databases. Studies reporting data on family factors associated with PUI in children, published in English in the 10 years to July 2020 were included. The following data were extracted from each paper by two independent reviewers: methodology and demographic, familial, psychiatric, and behavioral correlates of PUI in children. Results: Sixty-nine studies fulfilled the eligibility criteria. Three themes emerged: parenting, parental mental health, and intrafamilial demographic correlates of PUI in children. Parenting styles, parental mediation, and parent–child attachment were the major parenting correlates. Conclusion: Literature on significant familial and parental factors associated with PUI in children is scarce. More research is required to identify the interactions of familial and parental factors with PUI in children, to develop informed management strategies to address this issue. [ABSTRACT FROM AUTHOR]

Background: The objective of this review was to identify and synthesize the findings of the existing literature that highlighted the psychosocial and mental health issues of the migrants during the COVID-19 pandemic in India. Materials and Methods: An exploration of the PubMed, Google Scholar, Web of Science, ScienceDirect, Google search, and some other manual searches was undertaken so that no relevant study was missed. A search on Indian scientific literature and cross-references retrieved was also conducted to get further information. The period of the search has been one year from March 1, 2020, to March 31, 2021. The database was searched with the terms "migrants," "migrant workers," "COVID-19 pandemic," "lockdown," "migrant population," "mental health issues," "psychosocial issues" to retrieve the published literature. Results: Initially, 48 research articles were retrieved and 10 of them were excluded as they had no sufficient information about mental and psychosocial challenges faced by the migrants. In the remaining 38 articles, 9 articles were original research work (n = 9) published from India related to the impact of COVID-19 on migrants. The second category consisted of editorials or commentary or letters to the editor or policy paper on psychosocial and mental health aspects of migrants during the COVID-19 pandemic (n = 17). The third category was 11 articles on perspectives or opinions or viewpoints (n = 11) related to various psychosocial and mental health issues among migrants in India during the COVID-19 pandemic. Predominantly psychosocial issues found among migrants were living conditions, basic needs, family concerns, and joblessness. The mental health issues found among migrants during the COVID-19 pandemic included psychological distress, depressive disorders, anxiety disorders, substance use disorders. Conclusion: Existing literature from India has shown that the COVID-19 pandemic severely impacted the psychosocial and mental health status of the migrants in India. This review suggests the need for more research work from the affected states of India and the development of psychosocial and mental health intervention strategies to minimize the impact of the COVID-19 pandemic on migrants. [ABSTRACT FROM AUTHOR]

In this brief paper, we will look at whether doctors who experience mental health difficulties require specialist treatment services. This said, we acknowledge that not all would subscribe to the view that doctors are "different", and debating this issue is crucial in answering the question we pose in this paper - "Are specialist treatment services needed for doctors with mental health problems?" 19 Brooks SK, Gerada C, Chalder T. The specific needs of doctors with mental health problems: Qualitative analysis of doctor-patients' experiences with the Practitioner Health Programme. [Extracted from the article]

Psychiatric research has increased remarkably over recent decades to help in understanding the current trends and better therapeutic options for illness. On the other hand, there is also a trend toward higher rates of retraction of published papers in the recent years. Ethics is required to maintain and increase the overall quality and morality of research. Psychiatric research faces several unique ethical challenges. Ethical guidelines are very important tool of research which safeguards participants; however, there is a dearth of such guidelines in India. The present paper aims to review available ethical issues and guidelines pertaining to psychiatric research. A search was conducted on Pubmed using search terms (e.g., "ethics," "psychiatry," "research"). Relevant studies were selected for the review after manual screening of title/abstract. Additional sources were referred to using cross references and Google Scholar. Psychiatric research has several important ethical issues which are different from other medical disciplines. These issues are related to informed consent, confidentiality, conflict of interest, therapeutic misconception, placebo related, vulnerability, exploitation, operational challenges, among others. The current paper has made several recommendations to deal with ethical challenges commonly faced in psychiatric research. The ethical guidelines are utmost needed for Indian psychiatric research. Specific guidelines are lacking pertaining to psychiatric research. The issues and recommendations merit a further discussion and consideration. [ABSTRACT FROM AUTHOR]

Background: India has the second-largest population of elderly in the world. Serious mental illness (SMI) is a subset of the mental disorders that result in significant functional impairment and is usually long term. Persons with SMI face several challenges in their old age that are different from the issues faced by younger people with SMI. Understanding the problems faced by elderly individuals suffering from SMI is fundamental for planning programs to address them. The SENIOR (Support Systems Evaluation of Neuropsychiatric Illness in Old age) project is a study aimed at evaluating the problems faced in obtaining mental health care by elderly persons having SMI in the Kerala state of India. Aim: To describe the scientific methodology of the SENIOR project. Methods: This study employs mixed-methods cross-sectional design among a minimum sample of 768 SMI patients identified through cluster sampling from three districts, and Focus Group Discussion among mental health program officials. Discussion: This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has a profound impact on people with existing mental disorders, augmenting the prevailing inequalities in mental health. Methods: In order to understand the status of telepsychiatry in India and the role of artificial intelligence (AI) in mental health and its potential applications, a scoping review was done between March 2020 and May 2020. The literature review revealed 253 papers, which were used to derive the primary framework for analysis. The information was then reviewed for ideas and concepts, which were integrated with evidence from gray literature and categorized under broader themes based on the insights derived. Finally, a thematic framework was developed for discussion to tailor scientific information for decision-makers' needs. Results: Review findings are summarized under the following headings: changing patterns of health-seeking behavior, origin and evolution of telepsychiatry, possible applications of telepsychiatry and AI, technological features, and AI models in mental health. Conclusions: Though there are several potential opportunities, the time is not yet ripe for telepsychiatry and AI to be adopted fully in the field of mental health care. But it is time that we develop indigenous proprietary technology and test and validate it. With many solutions offered by telepsychiatry and AI, psychiatrists must choose an appropriate tool based on their requirements, availability of resources, and feasibility of deployment. Harmony between conventional care and technology-based care must be reached gradually. [ABSTRACT FROM AUTHOR]

The past one decade has witnessed a boom in the availability of Internet-based self-help apps in the field of mental health. Several apps have emerged that aim to provide information and strategies to empower individuals with self-help approaches to deal with issues and concerns related to mental health. A large number of these apps in developing countries are likely to be those which depend entirely on the users to go over the self-help program on their own (unguided internet-based self-help). Only a few apps add a component of periodic professional contact/technical support through phone/email or other means to supplement the self-help strategies suggested in the app that the user is expected to utilize. This scenario poses several challenges in use of unguided self-help apps for mental health. This paper enumerates some of these challenges for potential users of the apps from the perspective of clinicians. These range from difficulties in choosing the right app, limited scope for contextualization, and motivation management to awareness about when to step up to a higher intensity intervention. Despite these challenges, unguided self-help apps can serve important purposes, and hence we propose a few recommendations to address such challenges. [ABSTRACT FROM AUTHOR]

Background: There is growing global interest into the attitudes and clinical management of persons who deliberately self-harm. People who self-harm experience many problems and typically have many needs related to management of their psychological wellbeing. A positive attitude amongst general hospital staff should prevail with people who self-harm. The principal purpose was to determine student staff attitudes towards patients who self-harmed from a professional and cultural perspective, which might influence patient treatment following hospital admission. The focus concentrated upon staff knowledge, attitudes and beliefs regarding self-harm. Methods: A cross sectional survey of the hospital staff using a validated questionnaire was carried out. This paper reports on interdisciplinary staff from two large general hospitals in Mysuru, South India (n=773). Results: Findings suggest that within a general hospital setting there is wide variation in staff attitudes and knowledge levels related to self-harm. Whilst there is attitudinal evidence for staff attitudes, this study investigates interprofessional differences in an attempt to progress treatment approaches to a vulnerable societal group. Very few staff had any training in assessment of self harm survivors. Conclusion: There is an urgent need for training general hospital staff in self harm assessment and prevention in south India. The results allow a series of recommendations for educational and skills initiatives before progressing to patient assessment and treatment projects and opens potential for cross cultural comparison studies. In addition, interventions must focus on current resources and contexts to move the evidence base and approaches to patient care forward. [ABSTRACT FROM AUTHOR]

Background: Mental Healthcare Act 2017 (MHCA) came into force on 29 May 2018. Goa State Mental Health Authority (GSMHA) notified the Mental Health Review Board on 8 February 2022, completing the important process of implementation of the act. The transition comes with challenges. Methods: A qualitative study was conducted with 18 practicing psychiatrists who had worked under Mental Health Act 1987 as well as MHCA 2017 through purposive sampling across Goa. Data was collected through individual interviews; analysis was done by Braune and Clarke's framework of Thematic Analysis. Results: Eighteen psychiatrists participated: 4 private, 3 secondary and 11 from tertiary levels. The themes extracted were work during MHA 1987, transition, and after the implementation of MHCA 2017. Some participants reported difficulties, felt an increase in workload, and had negative emotions, while a few were neutral, indicating mixed perceptions. Conclusion: This study highlights the administrative struggles and moral dilemmas faced by psychiatrists in handling the new legislation. It's imperative that the implementation of new act should be carried out with sufficient resource allocation and monitoring mechanisms. [ABSTRACT FROM AUTHOR]

Background: Systematic data on mental health issues among adults with cataracts are not available from India. This study explored the impact of cataract surgery on depressive and generalized anxiety (GA) symptoms in an adult Indian sample. Methods: A multicenter, prospective, longitudinal cohort study was conducted. Subjects were recruited from four tertiary eye hospitals to assess depression, GA, and associated risk factors. A follow-up survey was carried out at 6 (n = 273, group 1), 12 (n = 198, group 2), or 18 months (n = 105, group 3) post-cataract surgery. Variations in the intensity of depression and GA were assessed using multiple classification analysis (MCA). Results: A total of 576 patients completed both baseline and follow-up assessments. The mean (SD) depression score was 25.6 (8.5) before surgery and 8.6 (7.7), 9.9 (7), and 9.8 (6.8), respectively, post-surgery for the three groups on the Center for Epidemiologic Studies Depression scale (CES-D). The mean GA score was 6.7 (4.2) at baseline and 1.1 (2.3), 1 (1.8), and 0.6 (1.3) after surgery on the Generalized Anxiety Disorder scale (GAD-7). MCA showed that factors with the highest impact on the mean change scores for both depressive and GA symptoms were restoration of vision post-surgery (β = 0.381 and 0.185) in group 1, regaining functional independence and female sex in group 2 (β = 0.192 and 0.23), and the presence of ocular comorbidities in the fellow eye (β = 0.36 and 0.315) in group 3. Conclusion: Mental health symptoms improved significantly post-cataract surgery across the three groups. The urgent need to invest in strategies that enable early cataract case detection and treat ocular anomalies in the fellow eye is highlighted. [ABSTRACT FROM AUTHOR]

Los Angeles, http://smhp.psych.ucla.edu/pdfdocs/nurses/unit1.pdf 31 Andrews FT, Avarachan A, and Daniel J. A descriptive study to assess the availability and utilization of school health services in government schools as reported by the school health nurses working under school health scheme in New Delhi. 8 Parikh R, Michelson D, Sapru M. Priorities and preferences for school-based mental health services in India: A multi-stakeholder study with adolescents, parents, school staff, and mental health providers. Worldwide, an estimated 13% of youth under 18 years of age have significant mental health problems. SP sp [1] SP , sp [2] SP sp Also, a significant percentage of mental health issues have their onset below 25 years of age. School mental health sustainability: Funding strategies to build sustainable school mental health programs: Washington, DC; Technical Assistance Partnership for Child and Family Mental Health. [Extracted from the article]

Background: Mental Health apps (MH apps) could help address the huge unmet mental health care need of developing countries. This study aimed to explore potential ethical, data safety, and privacy issues associated with using MH apps for depression. Methods: A cross-sectional assessment of the top 50 MH apps (by Google Play store search result ordering) for depression available in India was conducted in November 2021. Results: Most apps were listed under the category of health and fitness (54%). The median number of total and dangerous permissions requested at the time of download was nine and three, respectively. Privacy policy in English was available for 76%. The average length of the privacy policy was 2171 words, and the mean Flesch-Kincaid reading grade level was 12 (much higher than the recommended cut-off of eight). Important features relevant to safeguarding consumer confidentiality, including names of third parties with which user data could be shared (42%), explicit consent before sharing data with third parties (16%), and assurance regarding the collection of de-identifiable data (11%), were missing from the majority of privacy policies. Conclusion: There is an urgent need to improve the accessibility and usability of privacy policies by app developers, with the active involvement of other stakeholders. [ABSTRACT FROM AUTHOR]

The increased levels of psychological distress in the population and the disruption of traditional mental health services during the COVID-19 pandemic have widened the mental health treatment gap that already existed even prior to the onset of the pandemic.[2] Additionally, there is significant stigma attached to mental-health-treatment seeking, especially in low- and middle-income countries.[3] The culmination of these different factors has provided a fertile ground for the mushrooming of mobile health apps for mental health disorders and wellbeing.[4] People advocating the use of mental health apps (MHapps) often describe the potential of these apps in delivering mental health services discretely to people living in even remote and rural locations, in turn reducing the huge mental health treatment gap. Rapidly increasing smartphone ownership among the majority of the world's population and increasing internet penetration through relatively cheaper mobile data usage plans have led to the development and popularization of various mobile applications (apps).[1] These apps are third-party software apps that utilize mobile and/or other related devices' hardware (e.g., wearable sensors, such as a smartwatch) along with or without internet communication technology and enable users to perform a wide range of different tasks related to varied fields, such as trade, commerce, education, entertainment, or health, through their smartphones. Do mental health mobile apps work: Evidence and recommendations for designing high-efficacy mental health mobile apps. [Extracted from the article]

Background: Despite the high prevalence of mental health disorders worldwide, a significant proportion of distressed individuals do not seek professional help. Digital technology can be a potential bridge to reduce the treatment gap for mental disorders. A systematic review was undertaken to examine the technology-based interventions aimed at improving help-seeking attitude, intention, or behavior for mental health concerns. Methods: The literature search was conducted in January–February 2020 through various e-databases using relevant keywords that targeted help-seeking interventions for mental health disorders via different technology modes. Results: 21 studies (15 randomized controlled trials and six non-randomized studies) were reviewed. The included studies were published between April 2006 to February 2020. Majority of the interventions led to an increase in the help-seeking variables. The crucial role of online delivery, participant involvement, and embedded links to professional services in encouraging help-seeking is highlighted. The review emphasizes the need for understanding utility of multicomponent interventions with personalized elements targeting help-seeking behavior, particularly in low-middle-income countries, and studies involving longer duration follow-ups. Conclusion: This systematic review is the first of its kind to examine technology-based interventions to improve help-seeking for mental health and suggests that such interventions play a crucial role in positively impacting help-seeking. The complex interplay between the relevant variables such as mental health literacy, stigma, help-seeking attitude, intention and behavior, and the intervention components that may have a differential bearing on these variables are issues that merit urgent attention in further research. [ABSTRACT FROM AUTHOR]

Background: Bridging the alarming treatment gap for mental disorders in India requires a monumental effort from all stakeholders. Harnessing digital technology is one of the potential ways to leapfrog many known barriers for capacity building. Aim and Context: The ongoing Virtual Knowledge Network (VKN)–National Institute of Mental Health and Neurosciences (NIMHANS)–Extension of Community Health Outcomes (ECHO) (VKN–NIMHANS–ECHO: hub and spokes model) model for skilled capacity building is a collaborative effort between NIMHANS and the University of New Mexico Health Sciences Centre, USA. This article aims to summarize the methodology of two randomized controlled trials funded by the Indian Council of Medical Research (ICMR) designed to evaluate the effectiveness of the VKN–NIMHANS–ECHO model of training as compared to training as usual (TAU). Methods: Both RCTs were conducted in Karnataka, a southern Indian state in which the DMHP operates in all districts. We compared the impact of the following two models of capacity building for the DMHP workforce (a) the VKN–NIMHANS–ECHO model and (b) the traditional method. We use the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement to describe the methods of these two trials. Trial 1 is to evaluate the "Effectiveness of addition of Virtual-NIMHANS–ECHO tele-mentoring model for skilled capacity building in providing quality care in alcohol use disorders by the existing staff of DMHP districts of Karnataka." Hub for trial 1 was set up at NIMHANS and the spokes were psychiatrists and other mental health professionals headquartered in the district level office. Trial 2 assesses the implementation and evaluation of the NIMHANS–ECHO blended training program for the DMHP workforce in a rural south-Indian district of Karnataka state. The hub for trial 2 was set up in the district headquarter of Ramanagaram. Hub specialists are DMHP psychiatrists, whereas spokes are the non-doctor workforce (including auxiliary nurse midwives [ANMs] and accredited social health activists [ASHA] workers) medical officers of primary health centers. The location of the HubHub differs in these two studies. Both trials are funded by the ICMR, Government of India Discussion: Both these trials, though conceptually similar, have some operational differences which have been highlighted. If demonstrated to be effective, this model of telementoring can be generalized and widely merged into the Indian health care system, thus aiding in reducing the treatment gap for patients unable to access care. [ABSTRACT FROM AUTHOR]

Introduction: India's National Mental Health Programme (NMHP) was initiated in 1982. In 2016, the Indian Council of Medical Research (ICMR) organized a Brainstorming Meeting on Prioritization of Mental Health Research. Recognizing the need for improving mental healthcare by building a cadre of mental health researchers based on focus areas of the NMHP, the ICMR organized a research training cum capacity building workshop in collaboration with the Cross-Fertilized Research Training Programme (funded by Fogarty International Centre, NIH, USA) in 2016. The workshop successfully prepared and reviewed 12 single and multicenter research proposals in priority areas of mental health research, which were awarded by the ICMR to middle- and junior-level research faculty and NGO. Methods: A National Coordination Unit (NCU) was set up to mentor investigators and to coordinate, train, and monitor the progress of their projects. Investigators were paired with senior mentors and also participated in four capacity building workshops focusing on proposal-writing, evaluation, and process tracking. Results: Following discussions with ICMR program officers, the NCU formulated standard operating procedures for ethical conduct, data collection, data sharing, progress reporting procedures, and manuscript preparation for all research projects. Regularly scheduled long-distance communications with investigators using social media and group communications were planned. NCU partnered with the ICMR Database Management Unit to build a shared online platform for real-time data entry and storage, and organized two project review meetings where it also coordinated with US faculty to organize public workshops on manuscript writing and qualitative research. Conclusions: The NCU will ensure timely completion of research projects, data entry and analysis, and reports and project publications. It is feasible to evaluate progress with the NMHP through coordinated multisite research that also enables research capacity building. Results from these projects will help in formulating policies by the Ministry of Health Government of India for achieving objectives of the NMHP. [ABSTRACT FROM AUTHOR]

We postulate that sensationalist media coverage and public statements by mental health professionals may also contribute to a potentially volatile situation in the aftermath of a celebrity suicide. With regard to Mr Rajput, statements were made by mental health professionals around the world about his mental health and speculating upon reasons for his suicide, including discussion of personal details and relationships. Several public figures, mental health professionals, and lifestyle advisors have appeared in news coverage, discussing their personal relationship with or proffering a professional opinion of Mr Sushant Singh Rajput. [Extracted from the article]

Background: Health care workers (HCWs) constitute a vulnerable group in terms of physical, mental, and emotional health setbacks during an epidemic. An in-depth understanding of the effects of epidemics on HCWs is of utmost importance, in order to put in place measures for their well-being. The purpose of the review was to compile, compare, and contrast the available information so as to produce a lucid picture of how HCWs are impacted during an epidemic, and the factors that affect their mental health. Methods: A literature search of MEDLINE and Google Scholar databases was conducted to uncover research pertaining to four major epidemic outbreaks over the last two decades. The search was carried out at three levels using pertinent key words. The records thus identified were narrowed down at three further levels, that is, by screening of the title, abstract, and full text, to obtain articles most relevant to the subject matter. Data extraction was done using a spreadsheet to compile the relevant data. Data synthesis was done by studying those factors found to affect psychological well-being of HCWs and separating them into suitable sub-groups. Recommendations to mitigate the psychological impact were proposed. Results: Thirteen factors were identified, which were grouped under the broad categories of socio-demographic variables, individual characteristics, social characteristics, and psychological constructs. Conclusion: Epidemics have a profound impact on psychological well-being of HCWs. There is a pressing need to address the issue of the psychological health of this vulnerable group. [ABSTRACT FROM AUTHOR]

There is a strong body of evidence which points to the utility of psychological interventions in the field of mental health. Innovations in the field of mental health directed at improving access to mental health services have tended to typically focus maximally on supply-side- barriers. These include innovative ways of improving the supply of mental health professionals offering a range of interventions, the supply of trained non-specialists offering basic psychological interventions, early identification and timely referrals in general/primary health services, and reducing structural and organisational barriers. Moreover, about 70% of the users reported that they had no exposure to mental health services at any time in the past, and only about 12% were currently seeking mental health professional services. [Extracted from the article]

Background: Comprehensive satisfaction in life may be considered as a significant contributor to health for everyone, including the aging population (individuals aged 45 years and above). For understanding the comprehensive satisfaction, an assessment measure with various psychometric properties may be useful. During a longitudinal study of aging and geriatric mental health, a 26-item tool was developed in Hindi for the assessment of satisfaction. This article aimed to analyze the items of Comprehensive Satisfaction Index (ComSI) applying Varimax rotation and to find out its association with World Health Organization Quality of Life Brief (WHOQOL-BREF). Methods: Data of 260 subjects were extracted from the longitudinal study to analyze the psychometric properties of the tool named as Comprehensive Satisfaction Index and its association with various domains of WHOQOL-BREF. Varimax rotation was applied after computing Kaiser–Meyer–Olkin and Bartlett's test of sphericity. Furthermore, the association between various components of ComSI and various domains of WHOQOL-BREF was explored. Results: Of the total 26 items of the tool, item no. 17 was excluded due to its –ve/ <0.31 value. A total of three components were generated with >1 eigenvalues; maximum items were loaded in component 1 (19) followed by components 2 (4) and 3 (2). Each of these factors has been significantly correlated with each other. Furthermore, these components also were compared with various domains of WHOQOL-BREF, and positive correlation was obtained for most of them. Conclusion: There is a positive association between ComSI and WHOQOL-BREF. This tool will help in identifying the satisfaction level of the aging subjects promptly and efficiently, which would further help in making strategies for interventions. [ABSTRACT FROM AUTHOR]

Background: India's Mental Healthcare Act, 2017 (MHCA) greatly restricts the use of electroconvulsive therapy (ECT) in minors and bans unmodified ECT. Indian psychiatrists have raised concerns that these measures may deprive certain patients of life-saving treatment. This study describes the perspectives of Indian psychiatrists on how ECT is dealt with in the legislation. Methods: We conducted nine focus groups in three Indian states. We explored the positive and negative implications of the MHCA and discussed its implementation, especially in relation to ECT. Results: Many of the themes and concerns commonly discussed in relation to ECT in other jurisdictions are readily apparent among Indian psychiatrists, although perspectives on specific issues remain heterogeneous. The one area of near-universal agreement is Indian psychiatrists' affirmation of the effectiveness of ECT. We identified three main areas of current concern: the MHCA's ban on unmodified ECT, ECT in minors, and ECT in the acute phase. Two broad additional themes also emerged: resource limitations and the impact of nonmedical models of mental health. We identified a need for greater education about the MHCA among all stakeholders. Conclusion: Core concerns about ECT in India's new legislation relate, in part, to medical decisions apparently being taken out of the hands of psychiatrists and change being driven by theoretical perspectives that do not reflect "ground realities." Although the MHCA offers significant opportunities, failure to resource its ambitious changes will greatly limit the use of ECT in India. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to develop a structured curriculum for a group-based parenting program for parents/caregivers of children or adolescents treated in the inpatient child and adolescent mental health unit of a national health institute. Methods: Data from group session reports of 3 years of conducting group-based parenting programs in the same setting were analyzed and prominent themes of discussions were shortlisted before finally arriving at a six-session group parenting program module. Results: A six-session intervention module was designed by psychiatric social workers experienced in group work. The content followed combination of various theoretical approaches and methodologies ultimately aiming in improving the overall knowledge and understanding of parents or caregivers on various child and adolescent mental health issues, and enhancing their skills and competence in dealing with various emotional and behavioral problems in children. Conclusion: Group-based parenting programs are found to be effective in improving the over psychosocial health of parents and the emotional and behavioral problems of children and adolescents as a result of better parenting. Development and standardization of culture appropriate group intervention curriculums would help in the development of this cost effective method as a medium of change. [ABSTRACT FROM AUTHOR]

Introduction: Contribution of Indian Psychiatrists as publications in peer-reviewed journals listed with PubMed and their impact has not been studied. The aim of this manuscript is to assess such contribution using a new article level metric measure. The relative citation ratio (RCR) has been used to assess the quality, quantity, and impact of research output of Indian Psychiatrists. Materials and Methods: Publications by Indian psychiatrists in PubMed during 1995-2013 were collected, their RCR and associated factors estimated. The nationality of the journals, type of manuscripts, PubMed Central (PMC) visibility and the type of the journals were factored in. The data collected was analyzed. Descriptive statistics, Chi-square tests, correlations, and linear regression were performed. P ⩽ 0.05 was taken as significant. Results: Using the criteria set, 1914 manuscripts were identified. Of the 1914 manuscripts, 1007 were cited at least once and among this, 40.7% were listed with PubMed while of the 907 non-PMC listed manuscripts, only 180 were never cited (P = 0.000). Of the 1032 manuscripts published in Indian journals, 474 were never cited while 214 of the manuscripts published with non-India based journals were never cited even once (P = 0.000). Discussion: The difference in terms of manuscripts visibility in PMC, nationality of journals and article type in analysis indicate that there exists an innate difference between the cited and noncited manuscripts. The probable explanation behind this and its associated phenomenon are discussed. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is a critical, psychologically traumatic and sometimes life-threatening incident often associated with sequel of adverse physical, behavioral, and mental health consequences. Factors such as developmental age of the child, severity of abuse, closeness to the perpetrator, availability of medico-legal-social support network and family care, gender stereotypes in the community complicate the psychological trauma. Although the research on the effects of CSA as well as psychological intervention to reduce the victimization and promote the mental health of the child is in its infancy stage in India, the global research in the past three decades has progressed much ahead. A search was performed using MEDLINE, PubMed, PsycINFO, and Google Scholar from 1984 to 2015 and only 17 randomized controlled trials (RCTs) out of 96 potentially relevant studies were included. While nonspecific therapies covering a wide variety of outcome variables were prominent till 1999s, the trend changed to specific and focused forms of trauma-focused therapies in next one-and-half decades. Novel approaches to psychological interventions have also been witnessed. One intervention (non-RCT) study on effects on general counseling has been reported from India. [ABSTRACT FROM AUTHOR]

Context: University-based pre-service educational programs do not adequately prepare the teachers to have sufficient knowledge and skill for identifying a wide variety of symptoms related to mental health disorders among children. Aims: To assess the effect of educational module on knowledge of primary school teachers regarding early symptoms of childhood psychiatric disorders. Settings and Design: A pre experimental study on a sample of 35 primary school teachers was done in selected schools of Delhi. Materials and Methods: Self-instructional module on early symptoms of childhood psychiatric disorders (SIM on ESCD) was developed. Data was collected by using standardized tools including the structured questionnaire for 'Demographic and selected variables' and pre-test knowledge questionnaire. The subjects were exposed to SIM on ESCD for a period of 15 days. Knowledge regarding early symptoms of childhood psychiatric disorders was assessed twice, first one being before exposure to module and the next one on 16th day of exposure to module. Statistical Analysis: Data were analyzed using statistical package STATA 9.0 version. Results: Primary school teachers who have been teaching in government schools had high pre-test knowledge score than that in private sector. There was significant difference in mean knowledge score of primary school teachers before (9.71) and after (15.60) the administration of SIM on ESCD. Younger teachers and those who had less years of teaching experience had more knowledge gain score than those who were older and had more teaching experience. Conclusions: In the absence of adequate pre-service and in-service education of primary school teachers on early symptoms of childhood psychiatric disorders, SIM on ESCD is a highly effective and viable method for improving primary school teachers' knowledge on early symptoms of childhood psychiatric disorders [ABSTRACT FROM AUTHOR]

Background: Dropping out of school is a worldwide phenomenon with drastic mental health consequences for children, families and society. Aim and Materials & Methods: This study examines school dropouts in one district in Kerala with an emphasis on looking at multiple reasons for the problem. Results: The most common "reason" was various Physical disorders (80, 21.8%) followed by Mental Retardation (77, 20.9%). Child labour (Employment) came last (30, 8.1%) as a "reason" while financial issues constituted 50 (13.6%). Family issues accounted for 63 (17.1%) and School-related issues 68 (18.5%). Conclusion: This study highlights the need to examine a space of reasons for this phenomenon with active involvement and coordination of multiple agencies to examine and support getting children back to school and prevent dropouts. [ABSTRACT FROM AUTHOR]

This is an experimental study and it discusses the effectiveness of social support in managing academic stress among students. Aim: The purpose of this study is to understand the importance of social support in managing stress. Materials and Methods: Simple random sampling was assigned to a number of 120 students, equally divided into an experimental and a control group. Classes on social support as coping mechanisms were given to the experimental group only. The accumulated data were then analyzed, descriptive statistics were used to interpret and evaluate the prevalence of academic stress, and social support. Correlation analysis was employed in the examination of the relationship between stress and social support. Results: The findings of this study indicate that there are significant differences between the experimental group and the control group in relation to stress and social support. Eventually, the experimental group proved to cope with academic stress better than the control group, and they were satisfied with their academic performance during the experimentation. Conclusion: Hence, it is highly advisable to encourage the students to use social support as coping mechanisms [ABSTRACT FROM AUTHOR]

Over dependence on pharmacotherapy in psychiatry, known as biological imperialism, is a world-wide phenomenon. Some authors have opined that the inadequate and ineffective utilization of psychotherapeutic interventions and only dependence on pharmacotherapy amounts to institutional malpractice. Here is an example of such a case. A young male mainly received multiple psychotropic medicines, including clozapine (and also a failed psychotherapy) over a period of 4 years, without any benefit. His global assessment of function score remained at 30. However, with proper diagnosis and effectively conducted psychotherapy a significant improvement in Global assessment of functioning score of 70 was achieved, over a period of 1½ years. [ABSTRACT FROM AUTHOR]

Globally, telepsychiatry has been around since the 1950s. It is in the COVID era that it has gained the relevance and much-needed momentum amongst mental health care professionals. Given the restrictions imposed by the global lockdown owing to the fear of contracting the virus, the ease of access and safety offered by telepsychiatry makes it both appealing and "the new normal." Despite some hesitation from mental health professionals, there is adequate research to support the role of telehealth services in the management of various mental health disorders. As with any formal system, the practice of telepsychiatry is regulated by professional guidelines to show the way forward to both health provider and seeker. The manuscript examines the ways telepsychiatry is redefining our virtual conduct. It emphasizes the evolving "netiquette" needed to navigate online consultations. It also elucidates the challenges faced by health professionals, and possible ways of maneuvering and circumventing the same. Telepsychiatry, a dynamic process which is interactive and personalized, adds a third dimension to the practice of modern medicine. It is here to stay. So, it is not a question of "if" instead "how soon" we can adapt to and get conversant with this revolutionary mode of connection, communication, and consultation, which will make all the difference. [ABSTRACT FROM AUTHOR]