PurposeIn response to the need for more advanced and longitudinal data concerning chronic diseases, behavioural risk factors and social support systems in India, the SWADES (Social Well-being and Determinants of Health Study) was established.ParticipantsAt baseline, 997 adults aged 30 years and over, living in the semi-urban area were interviewed in their home.Findings to dateData collected included self-reports of demographic details, health, depression, morbid conditions and healthcare utilisation, risk factors (physical, behavioural and social) of chronic diseases, common mental disorders, out-of-pocket expenditure, social support network, social cohesion, disability, education and wealth. Objective data for hypertension, diabetes and cognitive function were also collected.Future plansThe first annual follow-up interviews were completed in 2019; the subsequent annual follow-up will be conducted until 2030. The SWADES data are held at the International Centre for Consortium Research in Social Care (ICRS), Rajagiri College of Social Science, Kerala, India. Procedures for data access, information on collaborations, publications and other details can be found at (http://icrs.in).
Resilience building interventions in respect of the children and adolescent population are gaining momentum. In this context, the tools required to measure adolescent resilience are also developed. The dearth of such scales in the Indian context led to the present study on developing a scale. Through this study, interesting insights were achieved about adolescent resilience which is discussed in this paper. The objective of this paper is to discuss the resilience factors among adolescents experiencing adversity. The groups consisted of adolescents from government hostels, institutions, high profile school and those with psychiatric disorders. As the study was primarily on scale development, the methodology followed was related to standard scale construction. The results of the final phase of the study are discussed. Through cluster random sampling, 370 adolescents from Mangaluru District, Karnataka State of South India were chosen from four diverse groups as mentioned above. The results indicated the role of multiple factors in resilience, i.e. the presence of positive coping, life skills, a sense of purpose and competency in the adolescents and positive family, school and community experiences. With regard to the adolescents experiencing adversities, the presence of multiple strengths in self, family, school and community was evident. The results throw light on the aforementioned multiple factors to be considered in resilience building interventions. At a time when sharp focus is on ‘resilience’, this study contributes significantly to the field of mental health.
Community re-integration is an integral part of treating persons with mental illness. Especially in India, presence of family support facilitates the process of community integration. Several initiatives are available now for effective integration for the homeless mentally ill back to their families, people with severe mental illness in the community and long stay in-patients in mental hospitals. However, in the absence of family support and community resources, community re-integration of a person with severe mental illness, like schizophrenia, can be highly challenging. This case reflects the challenges in the process of community re-integration in a person with schizophrenia, who was managed by a multi-disciplinary team at a tertiary care centre in Bengaluru, India. While close monitoring of the case was helpful in maintaining improvement, lack of community resources was one of the major challenges in the process of community re-integration. The case also highlights that if long-stay psychiatric facilities/ hospitals can offer a safe, supportive and stimulating environment, they can be useful to plan effective psychosocial treatments and interventions for community re-integration than just for custodial care.
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