Atmiyata

In India, close to 14.3% of our population, i.e., 197 million people live with some form of a mental health condition.

The National Mental Health Survey (2016) shows that there exists a large mental health care gap wherein 76-85% of people with mental health conditions in need of mental health care and treatment cannot access the necessary care. This is primarily due to both, demand and supply-related factors.

Demand-related factors: These include stigma, discrimination as well as other structural and social barriers that make it difficult for people to access mental health care.

Supply-related factors: These include the lack of specialised professionals, poor quality of available services, high costs, services that are inaccessible as they are located far away, and a purely bio-medical approach that does not take into account socio-cultural factors that influence an individual’s mental health.

This mental health care gap is particularly large in rural areas as many individuals are trapped in a cycle of poverty, social isolation, ill-health, disability, and social exclusion.

While there are evidence-based interventions that involve non-specialised health workers to deliver psycho-social interventions, there are few scalable models to reduce this significant mental health care gap.

Atmiyata is a low cost, high impact, sustainable and scalable intervention that complements the public mental health system. It aims to reduce the care gap for people with mental health conditions in rural India.

The Atmiyata intervention employs a stepped care approach, using community-based volunteers knowns as Champions, who are identified, trained, and mentored to:

1. Provide psychosocial support: Champions provide 4-6 counselling sessions using evidence-based techniques to those with common mental health conditions such as depression and anxiety.
2. Make referrals: Refer persons with severe mental health conditions to public mental health services when required.
3. Facilitate access to social benefits: Enable access to social care benefits such as pension, disability support, etc. to increase financial stability.
4. Build awareness: Raise community awareness by using the Atmiyata App to show films based on social determinants of mental health to a small group of 3-4 community members.

Built on the tenets of empathy and volunteerism, Atmiyata equips rural communities to meet their own mental health and social care needs.

Atmiyata aims to assist people with common mental health conditions lead productive and healthy lives, breaking the vicious cycle of poverty and mental ill-health. It strives to create a shift in the mental health systems in low-middle-income contexts through its community-led approach.

As a mental health intervention, Atmiyata’s seeks to reduce the treatment and psychosocial care gap for both common and severe mental health conditions, improve access to benefits and quality of life, and reduce levels of disability.

The effectiveness of the Atmiyata intervention has been evaluated through a Stepped Wedge Cluster Randomised Controlled Trial (SW-CRCT) with a nested economic evaluation from 2017–19. The SW-CRCT results showed that:

1. Persons with common mental health conditions receiving the Atmiyata intervention are 3 times more likely to show reduction in symptoms of depression and anxiety, with a sustained effect.
2. The Atmiyata intervention is effective in reducing symptoms of depression and anxiety, improving quality of life and social participation.
3. Champions (trained community-volunteers) are skilled to identify persons with common mental health conditions with an accuracy of 58%, which improves over time.

To read the detailed results of the evaluation, please click here.

Our preliminary results show that Atmiyata is also an economically viable model with a return of $9.35 on every $1 invested, we will soon publish the results of the economic evaluation.

From piloting the intervention across 40 villages in a district in Nasik, the intervention was scaled up to cover an entire rural district in Mehsana, Gujarat. Currently, the intervention is being implemented in 525 villages in rural Mehsana, covering 0.8 million adult population. The intervention continues to expand its reach and coverage, to particularly reach out to marginalised and vulnerable communities.

As of October 2021, our community volunteers have reached out to 28,509 people with common mental health conditions by providing 4-6 mental health support sessions. In addition, 2,782 people with severe mental health conditions have been linked to public mental health services, 6,638 families were linked to social benefits and welfare schemes, and 63,438 people viewed Atmiyata’s films.

In 2019, the intervention expanded its reach by collaborating with a partner to cover 71 villages, covering one lakh adult population in Ahmednagar district, Maharashtra.

In 2021, we partnered with Ambuja Cement Foundation to extend Atmiyata’s reach across 101 villages in Maharashtra, Chhattisgarh, Uttarakhand & Himachal Pradesh.

In 2022, we entered into a partnership with Hasiru Dala, a social impact organisation working with waste pickers, to pilot the Atmiyata intervention in Bangalore’s urban slums.

Co-leads

Kaustubh Joag, Centre for Mental Health Law & Policy, ILS, Pune

Jasmine Kalha, Centre for Mental Health Law & Policy, ILS, Pune