Page 50 - Printing FINAL copy Swsathya 13 Aug

Mental Health

New innovative community-based services, using brief a therapist who was not shocked or disappointed when they
interventions to reduce psychological distress and future self-harm revealed actions or thoughts during the course of the therapy
or suicidal distress, are being delivered in some localities across sessions. Sessions were described as uplifting, positive, being taken
the country. In Liverpool two services offer brief psychological seriously, having somebody who really wanted to listen and help
interventions. One is James Place which is for men in suicidal them work through their crisis or actions, and being treated in a
crisis and is based within the community. The other is the Hospital non-clinical environment away from medical settings. Patients
Outpatient Psychotherapy Engagement (HOPE) service for people revealed other services having left them feeling more distressed
who attend A&E following self-harm. Findings from both services due to the negative reaction from staff and being punished through
indicate significant outcomes for reduced repetition of self-harm, punitive systems as they could not attend if they were still suicidal
reduced suicidality and reduced readmission to hospital. Further or self-harming, suggesting what they are doing is wrong.
feedback revealed that people felt listened to for the first time
and actually believed that there was hope of them feeling better. Community based models that can be accessed by people for
Positives from their experience of attending the therapy included suicide prevention at point of crisis is important and could help in
not forcing them to stop having suicidal thoughts or self-harming, reducing suicides. Tailored services to meet the needs of specific
being able to talk about self-harm and suicidal thoughts in a community groups would be recommend. However, more research
non-judgemental environment, feeling comfortable as they were is needed to fully understand how effective suicide prevention
allowed to talk openly about suicide and self-harm, and having services delivered within community settings are.

Victim of the acid-attack

OUR TRIBUTE TO THE BRAVE HEARTS
WHO SHOUT AT THE DEVIL
Suicide and acid attack –polar extremes of mental health problems.

The current issue of swasthya has two articles by Prof Gupta and Dr Saini addressing two
extremes of mental health problems, and a review of the film-message by Dr Mudholkar.
Severe depression and other mental health issues can result in self harm and even, in
extreme circumstances, suicide. The intentions behind suicidal thoughts, attempts and
self-harm are complex. Suicidal ruminations can be either dormant or apparent and their
trigger point is often difficult to predict or prevent.
Improving mental health and preventing suicide amongst the vulnerable should be key
to any mental health strategy. Support mechanisms on a community, family and individual
scale are therefore necessary to support the vulnerable in times of need, especially in order
to prevent suicide. Dr Saini’s article sheds light on community based models of suicide
prevention.
A joint article by Prof. Gupta and Mr Pandya addresses another extreme of mental health
problems: that of malicious acid attacks. Such attacks involve two groups: perpetrators and Complements
victims. The malicious intent of the perpetrator may be sparked by jealousy, insecurity, Bollywood actress Deepika Padukone produced
power imbalances, a desire for revenge or mental health issues, while an acid attack victim and acted in her ‘Chhapaak’ film. This film based
with previously normal mental health suddenly faces significant mental and physical health on the life of acid attack victim Laxmi Agarwal. We
issues following the acid attack. Addressing issues involving the perpetrator, such as justice, congratulate Deepika Padukone a Ji for dedicating
rehabilitation and the restriction of acid access, involves complex legal problems that need this film to this most important humanitarian cause
to be handled by governments, legislatures and enforcement authorities. Restoring the of the hidden pain of victims.
physical and mental health of the victim, however, is the priority. Timely, appropriate first Review remark
aid responses and early access to specialist help are essential and Prof. Gupta details in the
article the role of plastic and reconstructive surgery in helping acid attack victims. “Literature and art are the reflections of
However, few acid attack victims have the luxury of accessing quality care to address society and much can be learned from it by the
both the physical and mental effects of an acid attack, whose complex consequences were mankind.
addressed at length in the recent bollywood movie Chhapaak. Physical, mental and social The films like Chhapaak are not just measured
rehabilitation of acid attack victims needs a comprehensive approach that factors in the in terms of their ‘box-office’ successes but the
restoration of physical health, appearance, function and self-esteem in addition to the value they bring to provide a true refection
covering the financial cost of these processes. In this area, charities and the third sector can of the society. Beyond it being a show for
play a crucial role in providing holistic care for acid attack victims worldwide. entertainment, ‘Chhapaak’ sends a serious
Swasthya is planning to launching a charity that will aim to provide comprehensive message that touches the core of our emotions.
holistic care for victims of acid attacks worldwide by providing appropriate targeted It prompts us to ‘do something’ to redress the
weaknesses in our communities and offer the
support for physical, psychological and social rehabilitation. We welcome all interested
best support to the victims that is deserved”,
groups to join and support our collective effort and will provide further details in the next
says Dr Santhosh Mudholkar, Consultant
edition. Psychiatrist in the United Kingdom.
Dr Santosh Mudhalkar w Mr C.R. Chandrasekar w Mr Buddhdev Pandya MBE w Dr Satwinder S Basra Buddhdev Pandya MBE
Contact Publisher & Managing Editor
editor.swasthya@gmail.com on behalf of the Editorial Team

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