|BRIEF RESEARCH ARTICLE
|Year : 2021 | Volume
| Issue : 4 | Page : 380-383
Yuva spandana – A youth mental health promotion model in India – Design, methods and progress
Pradeep S Banandur1, Gopalkrishna Gururaj1, Lavanya Garady2, Mutharaju Arelingaiah1, MK Jyoti3, Research team4
1 Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
2 Ramaiah International Centre for Public Health Innovations, Bengaluru, Karnataka, India
3 Department of Management Studies, CMR Institute of Management Studies, Bengaluru, Karnataka, India
|Date of Submission||12-May-2020|
|Date of Decision||27-Jun-2020|
|Date of Acceptance||01-Sep-2021|
|Date of Web Publication||29-Dec-2021|
Pradeep S Banandur
Professor and Head, #211, 2nd Floor, Department of Epidemiology, Dr. M V Govindaswamy Building, National Institute of Mental Health and Neuro Sciences, Hosur Road, Bengaluru - 560 029, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
A unique youth mental health promotion program called Yuva Spandana is implemented and functional across all districts within Karnataka. Trained guidance providers named Yuva Parivarthakas (YPs) and Yuva Samalochakas (YS) provide support to youth having issues at Yuva Spandana Kendras (YSKs). We highlight the process of development of the program “Yuva Spandana” into a sustainable community-based youth mental health promotion model addressing youth issues across Karnataka and describe the profile of beneficiaries attending YSKs in Karnataka between 2017 and 2019. Yuva Spandana has evolved over time and got established in local–self-governments and communities.
Keywords: Mental health promotion, program implementation, youth health
|How to cite this article:|
Banandur PS, Gururaj G, Garady L, Arelingaiah M, Jyoti M K, Research team. Yuva spandana – A youth mental health promotion model in India – Design, methods and progress. Indian J Public Health 2021;65:380-3
|How to cite this URL:|
Banandur PS, Gururaj G, Garady L, Arelingaiah M, Jyoti M K, Research team. Yuva spandana – A youth mental health promotion model in India – Design, methods and progress. Indian J Public Health [serial online] 2021 [cited 2022 Jan 22];65:380-3. Available from: https://www.ijph.in/text.asp?2021/65/4/380/333981
R. Sathya Velu, Durgeshvari Karsh, Sateesh L. Sajjanar,
Basavaraj Hadapad, M. S. Ramesh, K. Srinivas, Kalpana Gopalan
Youth are a potential resource for a country's economic progress and social transformation. The skills learnt and behaviors established during youth determine their future, be it health, education, relationships, or career. This transitional phase has unique physical, social, and psychological needs along with challenges of heightened expectations and pressure to achieve. These tend to impact their adult life such as health, education, self-esteem, relationships, and the consequent ability to bring positive personal and societal changes. The Indian National Mental Health Survey (NMHS) revealed that 8.5% of the youth and adults (18–35 years) in India have current mental morbidity. Changes in social structure, exposure to modern technologies, media, and changing interpersonal relationships contribute further to their challenges and their consequent health. These interfere with their personal growth and development. Both current-day youth and their families need support for handling such demanding situations. With the NMHS revealing a treatment gap of nearly 85%, youth mental health problems often go unrecognized and lack professional help.
Realizing the burden of mental health problems among youth, the relative absence of youth-specific services and to comprehensively address their needs, the Government of Karnataka implemented a youth policy in 2012. Youth policy defines youth as aged between 15 and 35 years. The program Yuva Spandana is a Karnataka youth policy initiative implemented by the department of youth empowerment and sports, the Government of Karnataka with technical support by Department of Epidemiology, Centre for Public Health, NIMHANS. It aims to provide an integrated behavioral, mental, and psychological support services for youth through guidance centers named Yuva Spandana Kendra (YSK) – meaning youth response centres. Trained youth named Yuva Samalochakas (YSs) – meaning Youth counselors and Yuva Parivarthakas (YPs) – meaning youth change agents work at YSK and provide guidance services to any youth with issues attending YSKs across thirty districts of Karnataka. There are mainly six broad issues that are addressed under the program, namely (i) health and lifestyle issues; (ii) education, academic, and career issues; (iii) relationship issues; (iv) personality development and emotional issues; (v) gender, sex, and sexuality issues; and (vi) safety issues.
A combination of review of literature, stakeholder and expert consultations were adopted to develop the program “Yuva Spandana.” Literature review served to identify potential issues that need to be addressed under the program followed by prioritization of youth issues by stakeholders in the stakeholders' workshop. Literature review identified 53 youth issues that could potentially be addressed under the program. Stakeholder consultation categorized these 53 issues into 21 issues and prioritized them for consideration during the expert workshops. The expert workshops further categorized these 21 issues into six broad issues named earlier. In addition, the experts developed these issue-based training modules, outlined the training aspects of the program, and implementation aspects of the program.
The finalized training toolkits included a basic toolkit and issue-specific toolkits. These two toolkits were intended to impart mandatory skills needed for “YPs and YSs” for implementation of the program. Basic toolkits consisted of four modules, namely Yuva Spandana (detailed description of the program), modules on management, supporting (guidance) skills and training, and supervision. Issue-specific modules were developed on the six broad issues identified to be addressed under the program Yuva Spandana.
Regarding the implementation of the program, there were four activities finalized, namely guidance/support services, resource mapping, community mobilization, and monitoring and evaluation. Guidance and support services are provided through “YSK” placed within every district stadium in Karnataka. These YSKs serve as the hub for all program activities in the district. YS and YPs work in these centers to provide guidance, counselling support, and referral services. Resource mapping serves the purpose of identifying youth service providers like experts and organizations working on various youth issues within and outside the district to facilitate referral services. Community mobilization includes conducting sensitization programs for all groups of youth, their caretakers, and others who form the society around youth. A tailor-made real-time computerized data management system collects information on all activities of the program (client registration, visits, referral, sensitization, and resource mapping information). A framework for monitoring under the program Yuva Spandana is developed. The process of development, piloting, and rollout of the program in all thirty districts of Karnataka was completed in 2016. All thirty district YSKs were functional from January 1, 2017. Overall, 8595 beneficiaries (individuals who sought support from YSKs) accessed YSK services between January 1, 2017, and December 31, 2019. Appropriate ethical approvals were obtained from the Institutional Ethics Committee at NIMHANS, Bengaluru.
Majority of the beneficiaries were below 25 years of age (84%), men (55.4%), students (72%), unmarried (90.6%), and found to have education and academic issues (80.1%). Further, almost the same number of beneficiaries reported with personality and health and lifestyle issues (26%) [Table 1]. On an average, there were 286 beneficiaries visiting YSK per district in 2 years. One out of three beneficiaries needed specialist services and were referred. About 14% of beneficiaries had at least one symptom of depression (As per ICD classification). Approximately 22.2% of beneficiaries reported feeling anxious. About 2% and 1% of beneficiaries ever attempted suicide and had suicidal ideation, respectively. Alcohol use was about 4.6% among beneficiaries attending YSKs [Table 2].
|Table 1: Sociodemographic characteristics and reported issues among beneficiaries attending Yuva Spandana Kendras in Karnataka (2017-19)|
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|Table 2: Habits and presence of different mental health issues among beneficiaries attending Yuva Spandana Kendras in Karnataka, 2017-2019|
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To our knowledge, Yuva Spandana is the first youth mental health promotion program in India, developed using an empowerment model through the involvement of stakeholders' right from the stages of conception to implementation and monitoring. Yuva Spandana has evolved over time into a comprehensive public health program with a focus on youth mental health promotion. All issues addressed under the program are known to either directly or indirectly affect mental health of an individual. The contribution of youth, their parents, experts, and other youth representatives from the community through a participatory approach is significant in the process of development and implementation of this program. This is likely to enable the community to own this program and ensure long-term sustainability.
Yuva Spandana program is a unique example of bringing policy into practice. Building healthy public policies, creating supportive environments, strengthening of community action, developing personal skills, and reorienting health services are the health promotion strategies laid down by the Ottawa Charter for Health Promotion. The program “Yuva Spandana” has adapted these strategies in its program development. Yuva Spandana is a consequence of the “Youth Policy of Karnataka-2012,” which aims at empowering youth through overall development. Yuva Spandana also promotes creating supportive environments for youth to access services at YSK. YSKs are mostly established within district stadiums which make them youth-friendly enabling access to the services. This is a step towards reorienting services from a hospital, care-based setting to a community-based health promotion-based setting. The program also enables YPs and YSs to develop skills in supporting youth with issues. This will likely empower them to become responsible citizens in the community. The implementation of the program is not without challenges and limitations. The program requires continued commitment of all program stakeholders and monitoring of program activities within the district. This needs considerable involvement of the district officers of the DYES, the district administration, and all stakeholders. Ensuring this, takes time as officers have many other programs and services to implement and monitor. Continued support and handholding by the technical support team from NIMHANS ensures overcoming this challenge over time. Furthermore, review of the program during the district review and advisory committee meetings ensures their participation.
The YPs and YSs are provided a nominal honorarium for their services. This is likely to make them find better jobs. This results in a large turnover of YPs and YSs within the program. The challenge is to ensure continuous availability of YPs and YSs in the districts as well as ensuring sustainability of the program. Organizing regular training programs for new YPs ensures their continuous availability. Furthermore, the YPs and YSs who move out may continue to act as change agents in the community.
Despite these challenges and limitations, “Yuva Spandana” has evolved over time and got established in local–self-governments and communities. The program has now expanded to all thirty districts of Karnataka. By addressing a range of issues from relationships to educational to issues relating to health and lifestyle, Yuva Spandana program aims to promote mental health among the youth of Karnataka. These issues not only enhance mental well-being of youth but also help in preventing noncommunicable diseases including mental health problems as well as promoting the overall development of an individual through healthy decision-making.
On the research front, this program would help establishing different cohorts of youth and enable us to follow the trend in youth health behavior. In addition, data from this program would help inform different typologies of youth issues prevalent in the state of Karnataka. This will further add to our understanding of youth issues and thereby facilitate programs to better cater to their needs. Empowering them with adequate knowledge and skills through such programs favors healthier, more balanced societies of tomorrow.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]