Mental Health GAP training in kashmir in collaboration with Royal College of Psychiatry and DHServices Kashmir supported by WHO

Table  Feedback results     

 

Week 1	Excellent	Good	Satisfactory	Poor	Unsatisfactory	Types of teaching
Clinical relevance	46%	44%	10%	0	0	x
Structure	21%	75%	4%	0	0	X
Clarity of Teaching and language	77%	20%	0	0	0	x
Overall score	63%	32%	2%	0	0	X
Types of teaching preferred						88% Role-play 64% Group work 62% Case discussion 50% Lecture 46% case presentation
Week 2
Clinical relevance	40%	55%	5%	0	0	X
Structure	45%	45%	9%	0	0	X
Clarity of Teaching and language	50%	43%	7%	0	0	x
Overall score	48%	52%	0	0	0	x
Types of teaching preferred						86% Role-play 60% Group work 50% Lecture 45% case discussion 31% Case presentation
Overall week 1 and week 2
Clinical relevance	43%	47.5%	7.5%	0	0	X
Structure	33%	60%	6.5%	0	0	X
Clarity of Teaching and language	63.5%	31.5%	3.5%	0	0	x
Overall score			0	0	0	x
Types of teaching preferred						86% Role-play 60% Group work 50% Lecture 45% case discussion 31% Case presentation

 

Types of teaching – each feedback form indicated preference for type to training method. 87% had preference for Role –play. 62% had preference for Group work. 53.5% Case discussion. 50% choose Lecture method. 38% Case presentation. The majority of participants choose at least 2 types of teaching

 

Table  preferred training methods

 

Rank of teaching methods	Rank
Role play	1
Group work	2
Case discussion	3
Lecture	4
Case presentation	5

 

What was the best thing about this course?

 

 

 

 

 

 

 

 

Week 1

• Practical teaching and participation of everyone verbally and practically

• Role-play

• Role-play

• It has changed my whole perception and has given me and entirely new way of looking at mental health related issues and the good thing was to get this info by dr. peter hughes

• Feeling of confidence ta PHC level and can be trainer of trainee

• The best every thing I find in the course was everything we learn is applicable because of practical approach

• We can train more people because of the perfect training we receive

• Role-plays

• Best thing was psychosocial intervention section, which is available for every disorder, available in the mhGAP module

• The course was focused, goal orientated and structured. MhGAP will be a useful, easy to use manual for practitioners

• Teaching faculty and participation. Friendly environment

• Excellent

• Teaching and participation

• Role paly was something new to me and I could feel like doing real cases, so appealing the teaching was an interactive which is very nice

• Introducing mental health at primary care level

• Role-plays

• Case discussions

• The lectures were simple, clear and short

• It was associated with group work amend case presentation

• To give mental health activity at primary health level

• To be friendly with patients and psych-education

• The best thing about this training was we had best doctors to teach us regarding psychotherapy with them. We learn so many new things

• The best thing was that we were training by specialized people who trained us in clinical relevance and also enjoyed then training fully with role-plays and feedback etc.

• To interact with and delegates all over London

• Role-plays and theory were blended in an excellent fashion. Our suggestions were actively taken into consideration

• It has given me confidence rather given me new strength which I’m going to use while dealing with my patients at the PHC level

• It made us aware of the importance of psycho-education in the treatment of these patients

• The best thing is that it helps us to understand the mental illness very easily at the primary care unit with the mhGAP now can easily differentiate the mental illness

• The best thing I like in this was an active role-play and mhGAP guidebook is useful and easy to use

• My teacher was among best teachers I have seen

• Simple language

• Role-plays

• The teaching panel along with all the participants were very much cooperative. The information provided is really going to help us especially role-plays were great

• We learned a lot of new things

• The bets thing about the course was the way we were taught and involved in this course. Active participation in the role-plays by all of us was very appreciated.

• The training was very communicative, helpful and very supportive and above all was carried on in a very cordial atmosphere

• Successful trainers and created an environment where their trainees feel comfortable and they used mhGAP which I have never had before

• Simplicity of language and insight into the course delivery

• All courses was good

• Role-plays

• Who materials

• Experienced person

• International delegates and discussed her clinical cases with them the way the presented the management cases was really appreciated

• Role-plays

• Module

• Demonstration of role-playing

• The speakers were charismatic and really good

• Booklet was very concise and lucid in language

• Simple to understand

• Easy to follow

• Trainers were dedicated to try to deliver the best in very short time

• What I saw in my group with dr. Sophie and Dr. eleni the art of teaching and clear language was excellent. Best thing was role-play and group work. Punctuality of attendance of our teachers

• The simple and easy to understand IG which is to be used in non-sophisticated health settings surely paves way for bringing the gap in mental health services and delivery 

• the type of training was much needed in this part of this world 

• the trainees the participants, lectures role play 

• A knowledge empowering and clinically orientated course with special emphasis on psychosocial aspect of mental health problems 

• Fruitful not only doctors but also benefits from all walks of life have been involved in our course. We are missing OPD due to lack of knowledge

• The best thing about this course is that it covers very important areas of mental health in a very friendly manner

• Commitment, dedication, exploring abilities to relate psychiatric problems in Kashmir, Meticulous attitude of Dr. Peter Hughes added beauty to training modules

• Interactive and role-play

• The best thing about the course is it will guide and help and train every health care providers even me as a student now a d I will now be able to help my society. This program helps me and every one who participates in it

• Our teacher was best as far as teaching was concerned and seriously receptive to our needs

• Role-plays

• Simple to understand

• Especially mhGAP chart

• Role play and group discussion

• Helps us understand mental illness at primary care unit

• With mhGAP we can easily differentiate mental illnesses

• Role-plays and theory blended in an excellent fashion

• Our suggestions were actively taken and considered

• Interaction with all delegates from London

• Good speakers

• Good venue

• Food good

• Excellent modules

• Very interactive

• Best thing was the role-play and mh gap guidebook

• It is useful and easy to sue

• Course made us aware of psycho-education

• My teacher was among the best teachers I have seen

• Course is giving me confidence and new strength in dealing with my patients

• Learning lots

• Interaction and role-play

• Excellent art of teaching,clear language

• Simple to understand especially mhGAP chart

• Teaching panel was very cooperative as were participants

• Role-plays were great

• Simple language and role-play

• The simple and easy to understand mhGAP –IG ,great need for this type of teaching .

• Trainers, participants, lectures, role- plays

• Very fruitful. Good to have people from all aspects of life.

• Knowledge empowering, clinically orientated, psycho-social

 

WEEK 2

 

1) The best thing was that participants were not only passive listeners but were also involved in role-plays and discussions.

2) It gives more knowledge about mental health, helps us to be patience while interacting with patient.

3) Method of teaching – role-play  

4) Group involvement by role-plays.

5) Teaching language good, teachers good

6) Time management

7) Friendly behavior, clear language, evaluation, role play excellent point

8)  Discussion

9) Structure is easy and to the point. It will surely help the GP’s and health care workers working in the PHC.

10) Well structured, well organized, needs based systematic          presentation

11) It was best attitude of our trainers and their help for making us understand

12) It was very good

13) Role playing and interesting custom

14) Role playing

15) Being a nurse we can manage many mental health disorders at primary level now, after having mhGAP training

16) I learnt many new things from this course. Before I don’t know how to give the treatment and how to identify the patients of depression.

17) It is covering a relevant area of importance in mental health

18) Good explanation, role-playing, small groups

19) Informative about patient care

20) role-playing, small groups, competent experts

21) Role playing, small group, knowledgeable and dedicated workers

22) Role playing was very nice

23) Role plays

24) Role plays

25) Changed my attitude to the depressed children in my school. Well structured and lot of information to my knowledge.

26) We got the information and knowledge in the best way to learn and remember things in less time

27) CATMAP

28) Faculty members, especially Mina madam and Rika madam

29) Role plays were the best

30) Simple language used; feedback was taken; friendly environment; role-playing and group work

31) Relevant and role play

32) Role plays

33) We learnt many new things and misconceptions were cleared

34) Art of interviewing and extracting problems

35) A lot of information and awareness about mhGAP and I can help people in the whole community.

36) On primary level, every person who participates will care for his society

37) I would like to help people at grass-root level. I can take part in primary care of these problems.

38) Informative; gave me confidence for treating this set of people who are beyond my medical know how

39) Discussion and role plays and sharing of experience 40) got much clarity about mental disorders and treatments

 

What was the worst thing about the course?

 

Week 1

 

• Initially technical problems and microphones

• This who were not familiar with mental health issues might have found that they were kind of hurried through

• Nothing worse but I personally thing that there were some key topics which were not present in the course stress PTSD etc.  

• It was for 5 days only

• More time, videos, lots of discussion on treatment

• Too short, should have been given earlier

• Course duration

• Audio-visual, seating arrangement, no incentives

• Nothing

• Short duration of course, long duration of teaching periods

• Participates could be informed well before in tie as we are coming from far off places

• The mhGAP is so vast a subject to understand completely so the worst thing is having 5 days to which was very less

• Nothing

• Nothing

• Nothing particularly but definitely the course was of short span that’s something I feel bad about

• The training should include more content on anxiety disorders

• Not much discussed about pharmacological treatment

• Too short

• I don’t find anything bad or negative about this course. The only thing that gives me a low feeling that it is ending so soon. Which it should last for a longer time?

• Nothing

• Nothing

• There is no any worse thing about this course but limited to 5 days

• Exhausting for 5 long days

• Venue was far away

• Time

• Less time

• Videos

• Too short

• Should be month

• Limited time

• Irrelevant questions posed by the audience

• Lack of consensus among the participants

• Limited time to cover so much

• Less discussion on treatment –medicines

• Needed more days

• Need to show videos and case examples

• Short duration 

• WHO should have done these trainings earlier because of conflict 

• Audiovisual systems, seating arrangement, no incentives 

• Nothing 

• Short duration and lot of teaching 

• Needs modification locally

• Less time

• Audiovisual

• Nothing in particular, everything was good.

• Could have avoided chorus talking

• I wanted to interact with all the trainers as I got to see them less

• Time

• Nothing

• Nothing

• Nothing

• Limited time span

• Video needed

• Need incentives

• Talk about drugs, avereudic, yoga, unani, and homeopathy

• Nothing

• Nothing bad about the course

• Short time

• Distance from home

• Too short

• Too short

• Nothing

• What was the worst thing about the course?

• Time too short

• More an anxiety disorders

• Nothing

• More time

• Limited to just 5 days

• Nothing

• Nothing

• Wanted to interact with all the trainers

• Too much audience talking g

• Course too short

• Course too short

• Not enough on medicines treatment advice

• No parenting skills

• Therapies not explained

• No parent skills and therapies were not explained

 

WEEK 2

 

1) It was not actually worse, but I got bored on third day. Because it was more discussion of pharmacological treatment. I am not from that field, so it bored me.

2) Mismanagement of time (not clear!)

3) Distance from city

4) Print material/CD not provided for detail information.

5) Short time – 2

6) Nothing

7) None

8) Was more orientated towards psychiatrists and other medics

9) The so much little time, it should have at least 15 days course

10) Nothing

11) The time for lunch was limited

12) Nothing to find worst

13) Need more time

14) Nothing as such

15) The time for lunch and tea was limited.

16) I heard incentives are not given for the training.

17) Short

18) More detailed information should have been there

19) Short duration; not everything covered

20) Nothing

21) Nothing

22) Short period

23) Nothing

24) Nothing

25) It was more orientated to psychologists and psychiatrists (as a teacher)

26) The location was very far from my home; couldn't get much time to study

27) Nothing was worst

28) Short time

29) There was no arrangement of lunch for non Muslims

30) Nothing

31) Nil

32) I would have preferred a clinician behaving as the patient as he/she understands the disease better

33) Nothing was worse, but for me I would like similar programmes in other districts

34) Short time

35) Other alternative medicines should be considered

36) Nothing was worse about this course

37) Short period

38) Not enough time; would have liked to discuss more things 39) would like videos pertaining to disorders

What type of teaching did you prefer?

 

RP,CP

Rp, gw

RP, CD, GW

Rp, l, cp

Rp, l,cd, gw, cp

cd

RP, L, CD,GW, CP

RP,L, CD,GW, CP

RP

RP

RP

RP, CD,GW,CP

RP, l, GW, CP

RP, l, CD,GW

RP, L, CD,GW, CP

RP, cd,gw,cp

L, GW

Rp, l, gw

rp

Rp,l,cd,gw

Cd,gw

RP, L, cd, gw, cp

Rp, gw

RP,l cd, gw,cp

Rp,l, cd,gw,cp

Rp cd cp

l

Rp, cd,gw,cp

Rp,cd,cp

Rp, cd, gw

Rp, l, cd, gw

CD

RP,cd,gw,cp

Rp, cd,cp 

Rp, cp

RP, L, CD,GW 

RP, L, CD

RP,L, GW 

rp, l, gw 

RP, CD,CP

CP, GW, CD, L, RP

GW

RP,L, GW,CP

RP, L, CD, GW, CP

RP, L, CD, GW, CP

RP, cd

Rp, l,

Rp, L, cd, GW, cp

RP, cd, GW

RP

 

WEEK 2

 

Role plays - 36 Lectures – 21 Case discussion - 19 Group work – 25 Case presentation – 13

How can we make this course better?

 

• More role-plays

• Changed mind-set and approach to mental HEALTH PROBLEMS

• How can we make this course better?

• A little bit of questionnaire role plays

• Supervision after completion of training

• Complimenting at primary level

• Involve ngos mass communication medics

• Slides and video during teaching, more involvement of Kashmiri doctors from London

• Revision of mhGAP, include more people, regular supervision.

• Incentives

• Role-play, Lecture, Group

• Education syllabus in j and k including psycho-education

• Show solved cases through video and discuss in-group discussion

• More on anxiety disorders because ptsd and ocd is common in Kashmir

• More time

• Use role playa and street drama

• To apply at primary level and village level

• MhGAP training good

• Stress module should be more detailed and each disorder taken up separately

• Course should be 10 days and once a year

• Increase understanding of mental health course s at primary care level

• More about bipolar and anxiety disorders

• Continue same and involve more groups

• THIS is the best training I have had in my career

• I want more interaction

• Kashmiris talk a lot

• We want to be heard more

• 10 days

• Role-plays

• Future interactions and further cme

• Include patients

• Should be more clinically orientated

• Need to discuss about commonly used antipsychotic drugs

• Longer

• Contribute to professional development

• Make more effective clinical role

• Provide practical advice

• Make it regular every year and new modules

• Continue trainings

• Connect to specialists for advice

• Regular supervision

• VIDEO

• Role-play for every module

• Encourage case discussion

• Having an interactive environment in trainings

• Some further theoretical and practical orientation would be beneficial

• Stress needed to be introduced

• Follow-ups

• Carry on more such CME

• Match with developed world practice

• Involve all stakeholders

• By involving all sections of society

• Involving more M.O.s and paramedical staff

• Actual patients

• Spread training to all doctors

• Course as better from start to end but this this course can be better if done every year on our Kashmir valley and this programme should be done in every college in Kashmir especially in medical colleges academic colleges and other schools

• By including as many topics related to mental health. Also increasing the duration of programme, besides they can be region specific modifications on the course

• This could be organized often

• If possible at district level too try this

• Same team because they can’t be substituted by anyone

• There was of teaching was fantastic

• We should involve more people in the course

• Making them more often

• Continuing the contact and assistance by trainers even after the course is complete

• Cases solved through video

• Discuss solved cases in-group discussion

• Time

• Continue same and involve other groups

• Stress module should be included in training particularly for Kashmir as it is vulnerable to mental stress by one way or the other

• Increase time

• More clinical

• Discuss commonly used drugs

• Longer duration

• More content on anxiety disorders should be included including OCD, PTSD as common in Kashmir

• Increase understanding of mental health courses at PCH

• Contribute to professional development

• Make more effective vital role provide crucial advice

• Frequent interaction and continued medical education in future

• I think the course has been so aptly crafted that it fulfills the need here in Kashmir. By involving the people of all ages who are suffering at present have suffered in past could be involved for some more real examples

• The course needs to be refreshed in intervals and needs to be accountable

• To look all the things which are happened in the community or society about mental case. So we should have to concentrate all mental illness with mhGAP to prevent their mental disabilities then this course would be better

• More trainee involvement

• Show videos, practical cases

• Visit PHC

• Visit mental health institution

• Better to be in contact with specialists

• More culturally appropriate cases

• Include more clinical cases and how to manage

• More topics needed to be included –anxiety stress and how to manage personality disorders

• Videos

• Role-plays

• Variety of experts

• Video conferences and collaboration of govt needed as well as NGOs more interglobal conferences and meetings

• Refresher course

• Stress and anxiety more

• Community participation

• Slides and videos

• Involvement of local doctors

• Have incentives 

• Carry on as part of CMB use WHO medicines 

• Primary care 

• Duration of course 

• Real patients 

• Repetition 

• Although it was altogether a good programme and best possible efforts have been made to make it more comprehensible still there is room for making it better 

• Revision of mhGAP IG as it misses out many things 

• More people should be included in the programme 

• Regular supervision of the mhGAP trainees 

• More experienced mental health workers

• Anxiety related disorders espec PTSD, ocd, panic,

• Before starting know the ground level experience which would make trainers more wise and effective for improving training

• Give changes for trainers for expressing views to conclude and design training beautiful

• I think it would be better to include some patients and that will give us the summary how exactly we’ll deal with things

• I think this is the best training I have had in my career. Kashmiris talk a lot but I would like more interaction would certainly want to know more that we should be heard more

• More about bipolar and anxiety related disorders

• Training the ICDs workers +integrated child development workers

• To apply at PHC level and in village

• This course should be for longer forward

• So that we can learn more and more

• Involving more and more people

• Awareness at school

• Media coverage

• Getting more inputs from grass root workers and helping to solve problems practically there and making govt and social groups aware of the magnitude and importance of mental health so incorporating mental health in NRHM with provision of funds as well

• Discussion of patients

• There should be continuous such courses from you experts at least 6 monthly or yearly and feedback from the people and Internet

• This course could be made better by adding more and more mental issues e.g. stress and by making it more country specific. It is also suggested that more discussions should be encouraged to make this course better

• By including more mental health issues e.g. anxiety on mhGAP and making it more country specific.

• Cme continue

 

WEEK 2

 

1) This course could have been made better because some patients could have been arranged and the role-plays could have been done with them.

2) To arrange the training prog. On time.

3) Organizing in a better way.

4) Having more such prog and getting feedback from participants. Keeping in view of recommendations.

5) More prog.

6) Course better

7) More time, 10 days will be more effective

         8) More modification in the intervention part

9) By practicing applying at our job side

10) Target the doctors/health workers in the PHC’s directly and make the course compulsory for them.

11) By making it more localized and specifically target community

12) By increasing the day of training and start it at primary level

13) Awareness

14) By Participation

15) By adding some more audio visual aids like videos, flash cards etc. 16) By playing role plays so we will feel better

17) Smaller groups

18) Local trainers and outside trainers together in each batch 19) conducting in district levels so that all health workers can participate

20) Increase its duration; cover all topics; tell about recent updates 21) District level so that more health workers can participate

22) District level and regular updating

23) More time

24) More time

25) More duration and district level - it should happen at every district 26) Not needed - it was excellent

27) Awareness and by feedback

28) More frequent courses and longer

29) The interventional part should be in the form of role-play

30) More days

31) More days; interacting directly with patients; more frequent

32) Phobias should be added which is very common

33) Increasing the number of participants and duration (including school children) to make people more aware

34) Run more courses

35) Hold it next year again here

36) By increasing number of days for better understanding of these problems and organize at least one in a year

37) By organizing at district level

38) Longer and involve patients; longer discussions on each topic

39) Deeper clarity of cases by studying the cases; real patients; more knowledge of drugs

COMMENTS

 

• Awareness at community level involvement in government agencies

• Regulate training programmes at secondary college and university level

• Awareness through involvement of respected personalities

• Try to visit PHCs to assess the ground level realities

• Try to be at our place

• Discussing practical cases and continuation of training programme tome to time

• Other mental problems should be included

• Child

• Women

• Conflict

• Including some inventions or scales to be used on daily practice

• Course was really a great experience and has cleared my doubts about mental health and my ability to help patients at PHC level and boost to confidence to be able to treat patients

• The course has made me wiser

• mhGAP is doing a great job as if this is practiced here we are definitely going to help more people and in turn our nation

• Visit to psych hospital

• Video

• More skills training could be incorporated like social skills training, cbt, some behavior modification techniques; anger management techniques could be incorporated

• The way of training was excellent but more case discussion and examples of cases from our scenario, will be more helpful to a great extent

• Excellent but better if extended to 2 weeks. And 1 practical week with real patients

• The course should include as many mental health topics as possible. More of audiovisual type of teaching should be there

• The course duration should be made

• Actual case presentations should be made to discuss that makes it more realistic

• The mhGAP programme was very informative, and valuable for every trainee who participate in it.

• Dr. peter Hughes who told us about clinical principles of case. I personally thank you. It was my pleasure. Dr. Sophie Thomson and dr. eleni Palizadou who train and teach us how to deal with patient and how to recognize the people that was really wonderful so both of you was helpful and well thank you from the core of my heart. Dr. Sajad Yousuf-special thanks from me. Dr. Sally browning Dr. Jane Mounty –I welcome all of you and that for giving us information

• Such training can be organized at district level in collaboration with NGOs on these districts. It should be once organized in Ladakh district as we have so many NGOs and charity trust of course a large group of populations at any times. Help can be sought for this purpose as they have hospital etc.

• Needs more awareness programmes

• Continuation

• Monitoring

• Feedback

• Mental illness is nowadays a common problem we should involve teachers, preachers-moulanas, community workers in this training

• We should have such good training in future

• Should ne conducted ta regular intervals

• Should involve people from all over the sections of community

• Should be made more interesting and interactive

• As a consultant homeopath the mhGAP helps me a lot in my private practices well as in primary health care

• In homeopathy to get the best go through the whole case to know the cause. Now mhGAP is very easy for me to use to take whole case talking nicely and precisely, to know the cause behind which the patient suffers, to give psychoeducation to give the best treatment to reach the goal. To cure the patients as a whole

• Video lectures can be integrated into the program by making then available so that we can refresh our knowledge when needed

• Also online availability of video lectures will ensure that any updates in the treatment procedures reach us immediately

• An online portal for the trainees is a must where we can discuss and help each other solve problems and help each other solve problems and in a way it would help to reinforce the training

• It would be very helpful if we could have recorded interviews of some actual patients of video of a serious depression or a bipolar patient

• As a social worker this training PHC mhGAP gave me a lot of knowledge of experience about mental health. Now it has become easy for me to face challenges

• Awareness at community level

• Involve govt agency

• Use programme at all levels

• Awareness through involvement of respected personalities

• Very informative

• Local language

• Visit to pysch hospital

• Thanks to Dr. aqeel. They were very helpful to people of valley and was to be helpful every time. So they organize the programme here. We arte really thankful to them

• Need homeopathy drugs

• I want to be the impact of such courses so as to teach the subject in order to relieve the sufferings of people who are in need of it as the subject is underestimated

• Longer course, include patients, more repetition during course

• First to know the bad problems and situation then begin teaching

• Continuous supervision, supplied by trained people

• Trainees visit PHCs

• Include local forms of therapy, ayeurveda, Unani as they are often first contact point

 

WEEK 2

 

1) Role-plays to be guided, make case scripts, overall it was good.

2) The more information give us the better we can make the course. You could have made it more attractive if it could have involved more trainers from Kashmir so that more information could have been grasped.

3) If it could have involved more social workers and more teachers. Provide written materials, involve locals from primary levels.

4) Very good, teachers good, management good, lack of time. Course very good. learnt a lot, need more days, Vegetarian food needed to be arranged Need of trainings on mental health at all level.

5) Training should be for more days More role-plays to be done to improve the learning More topics to be discussed Overall the programme was good. Learning some good things from the experts. The courses should be started at school level also The course was very good. Dr. Rika and Dr. Mina involved us very much.

6) The course module was very informative. The planning of topics was quite excellent. The teachers used all sorts of communication to enrich the knowledge in the minds of students

7) This training should be for other aspects of health related problems. More practice is needed.

8)The course was very good. The teachers were very mice. Dr. Rika and Dr. Mina treated us very nicely. We enjoyed very well.

9) Should be a more homogenous group

10) Would like training of trainers to be arranged

11) Would like case discussions

12) Excellent programme but short time

13) Would have been better if study material was in colored print

14) Involving equal numbers of trainers from local and outside area

15) More time/days

16) Colored printing

17) More people should be invited from ICDS departments and teachers from downtrodden areas in which psychiatric problems are more

18) This was best course I have been; faculty was awesome. I think this type of training should be given to every doctor; even as a lawyer I can even us it in my legal clinic. Because CATMAP is the basic treatment for every illness.

19) There should be more days

20) There should be no registration fee, especially for primary health care workers.

21) It should be applied on a primary level.

22) Overall course was very well. There should be involvement of communities and should be held more frequently.

23) More days, no fees especially for primary health care providers. This course is an eye-opener

24) If some common people from the community could be added as they could add local knowledge

25) The course is better and more informative but alternative medicine should be included, like Unani, Ayurveda

26) I got inspired by various things; excited to follow the module and lecture overall course was very good and informative as well as helpful You should come with better cases and when and where they come from

27) mhGAP Trainers good

28) Should be at least 10 days

29) Have about 1 training per year

30)CME-continue training us online on a 3 monthly basis

 

31. As this group cant reach to everybody, trainers should be chosen from this group and other group who will train in their districts

32. Personality disorders and more relaxation techniques

 

33. Participation of patients mostly drug addicts both who use drugs and those who are still on them. As it is a really great matters of concern in Kashmir these days.

Most youth should be provided chances to actively participate in this kind of courses

34. Stimulation need in between time. Repeated again at least one a year. 

35. It was excellent experience to be a learner to serve better

36. Attitudinal dimensions of trainers was excellent

37. Beautiful and charming attitude made me emotionally and psychologically sound

38. The course was informative and opened our eyes and changed our mindset and approach towards the patient in primary health care

39. I suggest of making the course available to head of all the social organizations, schools etc. there is a great problem regarding self medication of people of Kashmir who have some physical illness and they prefer exchanging their medicines when they see a doctor. Also domestic violence is a serious issue here so it will be better to involve more women in the course. Come again, we need much more of such knowledge, information

40. The course should be supplemented with the help of our parent department, in the primary set up. Should be monitored by some professional.

                41. This course was excellent outstanding and much better. In this we learned how to cope with the patient and how to build a rapport of the patient. In this course the successful trainees had used mhGAP which was the best benefit for the trainees to look all the disorders and they use mhGAP for treating the mental illnesses. This course was theoretical as well as practical. The mhGAP is the key structure for the psychiatrists, psychologists, social workers as well as NGOs at the primary level. At last so thankful to all the successful trainers, they taught us about mental health and community social based situations, they are welcomed and I have never see like these trainers before because they covert theory into practical and I hope this will help is in the future

42. Informative and useful for primary care physicians

43. Need for more and for cme programme

44. Have regularly and then help people

45. Emergency cases

46. Kashmir cases

47. MhGAP not enough info

48. I really appreciate this kind of programme, which is very important for Kashmir

49. Case discussion with different professions

50. Duration increased and more clinical cases

51. Include personality disorders

52. Different types of relaxation teachings

53. Workbook

54. Cd of training

55. After this training I feel I am empowered and equipped to deal with mental health cases without too much referral. I had always thought counseling was the job of counselors or psychiatrist –but now I feel I can do it and I plan to concentrate and focus my practice around psychoeducation and problem solving so that I can deliver to do the bit I can do it make difference to the community at large

56. First you should come to know the problems of state according to the teaching may be given

57. We could have had doctors bringing cases from their work or trainees visit primary are

58. It was really a nice experience to be a good part of this programme

59. I would like to put my efforts in the endeavor in the future Also it would be good if this programme is continuously supervised and the trained people supported at regular intervals

60. There should be a common platform for mhGAP trainees where they could effectively put forward their views and service delivery

61. Stress module Better to have copy of module

62. Local language should be used

63. Local psychiatrist should be used and present

64. Visit to psychiatric hospital and clinic

65. Things we like in opd- toys for children attractive environment, separate rooms, resources

66. As a consultant homeopath mhGAP helps me in my private practice as well as primary health care

67. In homeopathy to get the best outcome we should go through the caseto know the cause

68. With mhgap I can take the case nicely and precisely to get the cause

69. To give psycho-education to teach the goal and cure patient as a whole

70. Stress in today’s life everyone is stressed and don’t know how to cope with it mhGAP stress module now getting idea of how to manage stress cases in phc and in our own homes

71. Video lectures could be incorporated into lecture then make available on line so can refresh our knowledge

72. Online availability ensures that any update in treatment can reach us immediately

73. Online portal for trainees is a must so we can discuss and explain each other problems and reinforce this training

74. Would be helpful if recorded interviews with actual patients e.g. video of depression or bipolar

75. Continue training on line at least once every 3 months

76. As a special worker this training gave me knowledge and experience about mental health

77. Now easy to face challenges

78. Lots of thanks

79. Train icds workers integrated child development workers

80. As this group can’t reach everybody trainers should be selected from this group and we will train other groups in their district or blocks

81.Stimulation needed in between time

82. Repeat course once per year

83. Supervision

84. I am really benefited from mhGAP

85. It brought me closer to my field

86. I can serve society in a better way

87. We need to emphasise more communication with patients

88. Participation of patients

89. Drug addicts is the greatest matter of concern in Kashmir today

90. Youth should be provided to participate in this course

91. More on pd and relaxation techniques more

92. We did not know until now how to manage people with mental illness

93. Now that we have attended training we are empowered to make diagnosis and provide treatment for less complex cases and refer those who need more specialist help. Aware not to use benzos or give out vitamins without clinical need

94. This was the best mental health training that I have gad in 5 years of mental health work

95. This was not academic but practical which was what we wanted which will help us

96. Helpful for further training

97. Role plays was new and was a great way of learning

98. I am really benefitted from mhGAP. It brought me closer to my field. I can serve the society also now in abetter way. The things we need to improve, is more communication with experts

5 THINGS to change in my practice from now

1. Separate clinic

2. Toys for children

3. Attractive environment

4.mhGAP should be in assessment Other professions should also be involved might help

5.CATMAP procedure is really best to follow

1. mhGAP should be in assessment

2. Other professions should also be involved might help

3. CATMAP procedure is really best to follow

4. I wont prefer to refer the cases to the general physicians only

5. I would be able to talk freely to people, from any of the age group regarding mental illness

 

1. Use mhGAP all the time

2. Use golden questions

3. Use general principles of care

4. Try to communicate with others

5. Promote mental health on community

 

5 things in OPD

1. Use golden questions

2.  

3. 2. More time to patient

4. 3. Use less benzos especially alprazolam

5. Try to keep up to date with psych illnesses

6. Try to be more gentle

 

5 things in practice

1. mhGAP should be included in assessments

2. People from other professions should be involved by me

3. CATMAP is best to follow

4. I will no longer refer cases to general physicians only

5. I would be able to talk freely to people of any ages about mental illness

 

 

1. 1. I will use mhGAP. I am gonna use mhGAP for the assessment of the several disorders

2. 2. I am gonna follow the CATMAP to the fullest

3. 3. I wont be referring all cases to the general physicians but only where need be

4. 4. I would be in contact with the use of MHGAP guidelines given on their website to enhance my practice

5. I would be involving all the family members and give psychoeducation

 

Advantages and disadvantages of international trainers:

 

Advantages:

1. The participants get opportunity to know about the other culture as well, how they deal with the patient; they see effectiveness and compare it with ours and can change or modify various things. We come to know what is happening in the other part of the world that can happen here also and we can take precautions.

2. It is good to have outsiders as trainers to share their knowledge and expertise with the participants.

3. Learned different style of teachings, actions and language from outsiders. Interaction with outside country and within country discussing various issues of mental disorders.

4. Good to have trainers from outside and from Kashmir

5. Outside were good, we came to know knowledge from them and share their thought

6. Leads to advanced awareness of mental health in primary care settings

7. Knowledge from outside India. Ideas about their practice and experiences.

8. Exploration of new ideas and experiences

9. They have good exposure of knowledge

10.     Provide international information

11.     Mixing of knowledge and experience

12.     Advanced knowledge

13.     Trainers were very cooperative/friendly

14.     We get aware of what’s happening in other places and learn new      things.

15.     Experience new teachings and learning’s

16.     learnt more from outside India as well Kashmir

17.     Innovative methods of teaching

18.     A lot of information and exposure about how mentally ill are being treated outside

19.     Much exposure and advanced technology

20.     People from outside are sometimes taken seriously. Knowing about experiences of people all over the world helps them to believe that the disease is treatable. This also gives them varied ideas about modifying their community beliefs.

21.     They were more informative

22.     To understand foreign language and these persons experience

23.     Got a lot of experience from them and also some information which we are lacking in this part of the world

24.    they also share especially Dr. Sajad their experience that he had got from working here and then after working outside the country

25.    It is very nice to have trainers from outside the country as they gave us more information regarding the course

26.      It is useful to have information regarding other countries and what is ethical there - different social stigma of different countries.

27.     Beneficial to have trainers from outside the country - cultural and social life - I just love to have such kind of trainers.

Disadvantages:

1. Language problems; language is not grasped by everyone.

2. Less chance for our own people, many professionals could be involved keeping in view Kashmir mental disorders.

3. Only dues, which we had to pay, were not comfortable.

4. It is not actually disadvantage what I’m writing; it is their mother tongue what is why they are bit fluent while speaking.

5. Communication gap

6. They don’t have knowledge of India/Kashmir

7. No knowledge of local are

8. Communication problem

9. Nothing

10.    No disadvantages

11.    Language barrier

12.    Pronunciation

13.     needs lot of arrangements and a lot of money is spent for their journey

14.     Locals from the community would understand the disease better 15.     Attitudes and cultural beliefs are well known to people from the community

16.      Pronunciation

17.      Not able to understand

18.      No disadvantages

19.      Advantages of having it from Kashmir: Easily understandable languages. Understanding of local culture We enjoyed because sometimes they make us understand in our local language also

21.      Very good and fortunate that Dr. Sajad was there as he was from Kashmir who helped us understand knowledge and language of outsiders.

 

 

STRESS MODULE

As todays life everybody is stressed. Everybody knows that we are stressed but does not know how to cope from this. Ultimately goes into severe and more severe. After attending mhGAP specially the STRESS module no getting the ideas, how to manage the cases of stress in our primary set up Alonso in our homes too

 

It is better to gave a single copy

 

Stress module –should be more detailed on each disorder taken up

 

It was quite excellent and easily understandable as for the lecture of Dr. peter Hughes Unfortunately it is not in my mhGAP module