Voices from the field: Staff perspectives on Manasadhara day-care and its role in strengthening community mental health and family caregiving.

Abstract

Day-care centres provide meaningful engagement to persons with severe mental illness (SMI) and are a key component of community-based psychiatric rehabilitation. 'Manasadhara', a state-funded public-private partnership in Karnataka, offers such day-care services across district centres. To explore staff perspectives on the benefits and challenges of the Manasadhara programme for service users and their caregivers. In-depth interviews were conducted with 12 staff members using a semi-structured interview guide developed through pilot testing and expert review following one focused group meeting. Those with at least 6 months of work experience were included purposively after obtaining informed consent. Interviews were audio recorded, transcribed verbatim and analysed using a combined inductive-deductive content analysis approach. Staff reported multidimensional improvements in persons with SMI: (1) Functional independence-better hygiene, routine adherence. (2) Clinical and behavioural changes-reduced aggression, improved cooperation. (3) Pre-vocational skills-development of work habits, punctuality, and attempts to return to employment or support family businesses. (4) Financial and personal recovery gains. Staff further report that caregivers have reduced supervision burden, improved ability to work and strengthened family relationships. Mechanisms of change included behavioural activation, peer modelling and graded skill exposure. Reported challenges are related to financial, logistics and systemic issues. The Manasadhara programme provides structured engagement to persons with SMI. Staff reported a range of benefits to both persons with SMI and their caregivers, and a few challenges demonstrating its potential as a scalable, public-funded model for community-based psychiatric rehabilitation.