TLLLF Training Program for Physicians Brings Mental Health Awareness to Primary Care in India
Bengaluru: The Live Love Laugh Foundation (TLLLF), a charitable trust set up in 2015 to give hope to every person experiencing stress, anxiety and depression, has announced the completion of the first cycle of the Certificate Course in Common Mental Disorders (CCCMD). The program, delivered in partnership with the Public Health Foundation of India (PHFI) and Association of Healthcare Providers (India), trains primary care physicians to identify and manage common mental health disorders. TLLLF is the knowledge and grant partner, PHFI, the implementation partner and, AHPI, the strategic partner.
According to a Lancet Psychiatry report, India had 197.3 million people with mental disorders in 2017 (including 45.7 million with depressive disorders and 44.9 million with anxiety disorders). In terms of both the number of professionals and training quality, the need gap in mental health in India poses a substantial challenge. Physicians often are the primary healthcare providers for communities across the country and may frequently encounter psychiatric comorbidities in their patients. This observation prompted TLLLF to develop the program along with PHFI and AHPI.
Anisha Padukone, CEO of TLLLF, commented on the critical need for more advanced training, stating, “Mental health is a complex need affected by several factors and stakeholders. Awareness is one part of the paradigm alongside other areas such as treatment, funding, training, and access. With the CCCMD, our goal was to empower physicians to identify common mental health disorders, so those with mental illness can receive timely access to care. I am delighted to see the impact of the first program and look forward to building on our partnership with PHFI and AHPI to address the need-gap in mental health.”
The first cohort, comprising 143 physicians, began in June 2020 and completed a comprehensive training program split into five modules that ended last November:
Module 1 – Introduction to Common Mental Disorders
Module 2 – Depression, Anxiety Disorders, and Suicide
Module 3 – Psychosomatic Disorders, Neurocognitive Disorders, and Psychosis
Module 4 – Alcohol and Other Substance Use Disorders
Module 5 – Childhood Mental and Behavioural Disorders, National Policies, and Long-term Mental Health Care
A baseline study of participants conducted by PHFI at the start of the course pointed to several areas of development, with nearly 30% of participants unable to determine the behaviours that warrant a mental health evaluation while about half of them were unaware of the link between anxiety disorders in men and its effect on their risk of alcohol abuse. The early results of the program deliver encouraging news for future editions, with participants showing a 1.1 basis point improvement in their test scores after the course. The entire cohort reported high levels of satisfaction with the course across parameters including content, delivery, interaction, and resources. More important, however, is the self-reported observation from nearly half of all participants, which states that they have noticed an increased number of patients with common mental disorders in their daily clinical practice. With an average clinical experience of 16 years, this first batch of participants offered valuable insight into the needs and potential impact of mental health training on medical professionals in the country, a commitment that PHFI and AHPI are determined to tackle with the help of credible knowledge partners.
Speaking about the importance of mental health training to healthcare delivery systems, Dr. Pushkar Kumar, Sr. Public Health Specialist & Acting Head, Training Division, PHFI said, “As frontline care providers, it is imperative for healthcare delivery systems to make the right diagnoses and timely referrals to tackle the rising incidence of depression and other mental health challenges. The challenge is global, but the approach needs to be customized to the local context, and that’s what we believe our training has done. With the first batch of 143 physicians complete, we look forward to training a similar number in the next cohort this year.”
The response has been stellar, with the cohort’s average 16 years of experience providing a valuable barometer of the quality and comprehensiveness of the program. Dr Sowmya G Dath, who completed the program at the Bengaluru centre, commented on the importance of knowledge in this field, saying, “In a field like psychology that relies heavily on the practitioner’s skill, unlike others where investigative tools are available for help, knowledge is everything.”
In a country where problems of access and training are exacerbated by stigma, such training plays a significant part in better understanding. Dr Alexander Thomas, President, Association of Healthcare Providers, talked about the urgency of the matter, saying, “Mental health is a critical aspect of better primary care. Unfortunately, especially in LMICs (lower middle-income countries), social stigma can lead to further neglect. Our partnership with PHFI and TLLLF is a significant step towards addressing this challenging situation. We believe that with enough reach, our training has the potential to bring relief to millions of patients and their families. The overwhelming success of the first batch furthers our determination to train even larger numbers soon.”
The enrollment numbers and impact of the first batch offer promising evidence of India’s healthcare community’s drive to address the country’s mental health challenge. In what is a nuanced and complex problem, this intent could be the most crucial component of a robust solution.