NCPA - National Center for Policy Analysis


February 23, 2006

The Schizophrenia Research Foundation (SCARF) in Chennai, India, has developed an international reputation as a leader in schizophrenia treatment, says Science magazine. Although patients may take antipsychotic drugs, its focus is on the healing power of social interventions. The clinic's success at rehabilitating patients -- many of whom recover enough to hold down a full-time job, marry and otherwise lead fairly normal lives -- offers a powerful lesson on the benefits of going beyond the standard biomedical approach:

  • At the Foundation, finding a job is viewed as essential to a patient's recovery; family members are advised to bribe employers -- typically friends or relatives -- if necessary.
  • About 99 percent of Indians with schizophrenia live with their families says psychiatrist R. Thara, Foundation director; in developed countries, most patients either live alone or in a hospital or assisted-living facility.
  • Schizophrenic patients in India and other developing countries are more likely to have long-term remission of symptoms and fewer relapses than patients in the developed world, according to a long string of studies, beginning with the 1967 World Health Organization's International Pilot Study of Schizophrenia.

Programs such as those at SCARF are rare in the United States, in part because of lingering memories of involuntary institutionalization. Another big impediment to weaving social interventions into care is the unbridled enthusiasm for drugs in developed countries, say observers.

The World Bank's Benjamin Loevinsohn concluded in a review in Lancet last August that nongovernmental organizations often provide higher quality service at lower cost than governments do. He thinks this would apply to mental health NGOs, too.

Source: Greg Miller, "A Spoonful of Medicine--And a Steady Diet of Normality," Science, January 27, 2006.

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