TV, trees and deep breathing to fight depression in Goa

by Liz Mermin

Prescribing 15 minutes of television a day may not be the most orthodox method of curing depression, but for Vrunda, a recent widow in Goa, India, who endured months of panic attacks, lack of sleep and loss of appetite, it was a life-saver.

"At first I didn't even have the desire to turn it on," she explains, but after a few weeks of regular sessions she became interested in programmes, and in turn, in her life.

Her counsellor, Subhash Pednekar, was working at a call centre in the region famed for its palm-fringed beaches when he saw an ad posted by a local organisation seeking graduates interested in becoming mental health counsellors.

He was one of 40 chosen to take part in the programme, and from that group, one of 12 selected to work as a counsellor in an innovative projectusing lay people to treat patients with depression.

According to a 2011 study by the World Health Organisation (WHO), India has highest rate of depression in the world, with 36 percent percent of the population reporting a major depressive episode.

Symptoms are a combination of depressed mood, loss of interest, insomnia, fatigue, feelings of worthlessness and suicidal thoughts among others.  

Despite the severity of the problem, India only has around 3,500 trained psychiatrists — one for every 200,000-300,000 people. This is what is referred to in the language of mental health as a "treatment gap".

To deal with this, Dr. Vikram Patel, of the London School of Hygiene & Tropical Medicine, co-founded Sangath – a Goa-based NGO that has piloted a program training anyone with a high-school degree to recognise symptoms of depression and administer counselling treatment.

They operate out of a local health clinic. People who are clearly suffering with no physical cause are sent to mental health workers. They are then screened for depression and offered two months of home-based counselling.

Sangath is part of a global movement towards community mental healthcare as an answer to the developing world treatment gap. With depression on track to be the second leading cause of disability worldwide by 2020, according to the WHO, interest and investment in such programmes is increasing.

Patel believes that developed world practitioners could take lessons from such programmes as well.

This short film introduces the Sangath approach through the experiences of Vrunda and her counsellor, Subhash.