The project is based on the WHO “QualityRights Tool Kit” and builds on its success over the past three years in Spain, Palestine, Greece and Somaliland. In Somaliland, pre- intervention conditions at one hospital included restraining patients with chains and poor hygiene standards. The QualityRights intervention led to long-term patients being released from the hospital, the appointment of more health professionals, improved hygiene standards, and an end to restraining patients with chains.
By working in six facilities — three mental health hospitals, two psychiatric units in general hospitals, and the psychiatric unit at a district general hospital, which together employ 220 mental health staff serving almost 50,000 in patients and out-patients per year, along with a control group of three other facilities for comparison purposes, the Indian Law Society aims to improve facility environments.
Health and Social and Behavior Change
Health and Social and Behavior ChangeSEE LESS
Ending the restraint, seclusion, neglect and abuse — physical, sexual, and emotional — of mental health patients is the goal of a project in India’s Gujarat state.
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This project, nominated for a Grand Challenges Canada grant of $2 million, aims to improve facility environments, train health workers, patients and families on human rights, build support programmes delivered by non-specialists, and introduce policies and mechanisms in the facilities to protect against inhumane, degrading treatment, such as the use of restraints. An Internet-based platform will deliver the training and create areas where service communities can share experiences and results.
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In Spain’s Asturias province, an assessment of 28 facilities highlighted “the failure to obtain informed consent for admission and treatment, failure to use treatment protocols, lack of education for service users and their families, and failure to provide legal advice and information about complaints mechanisms.” The QualityRights intervention in Asturias led to a transformation in the service culture, even to a Bill of Rights for people with mental disorders and a Mental Health Commission.
Says project leader Soumitra Pathare: “Mental health services in India face many similar problems and barriers to quality care as Somaliland and Spain do, and experiences of NGOs and mental health professionals working in Gujarat suggest that, with a sustained QualityRights intervention, outcomes could be substantial.” Adds co-principal investigator Akwatu Khenti :“CAMH has extensive experience and expertise in anti-stigmatizing, evidence-based care that will inform this project."