A longstanding interest in the mental health of homeless people led one medical student to a research project in India whose results garnered her the Lancet Psychiatry Poster Prize at the University of Oxford’s 2014 Mental Health Conference.
Anita Rao is a third-year student at Loyola University Chicago Stritch School of Medicine. Her father, Murali Rao, M.D., is chair of psychiatry and behavioral neurosciences at the Loyola University Medical Center. Growing up with a psychiatrist stimulated an early interest in mental health and her decision to major in international health at Georgetown University as an undergraduate. She began her pre-med studies only in her senior year at Georgetown.
“She was always very idealistic, even as a little girl,” recalled her father in an interview. “She was always interested in global health from a policy point of view, but I think she wanted to be a physician to be a more effective advocate in that field.”
While at Georgetown, she volunteered at a shelter in Washington, D.C., for homeless men with mental illness. “I loved the experience,” she told Psychiatric News. “It changed my life.”
Rao’s interest in policymaking led her to spend a semester on a Running Start/Walmart Star Fellowship. The program places young women who are college students or recent graduates in the offices of women members of Congress. Rao spent her fellowship working with Rep. Karen Bass (D-Calif.). Rao turned down a position as a legislative correspondent on Bass’s staff to begin medical school.
Her experience at the Washington homeless shelter ultimately led to her poster topic, a study of homeless mentally ill women in India that was the basis of her senior thesis at Georgetown. In India, she worked for five months at the Manasa Transit Care Center, a psychiatric rehabilitation facility outside the city of Mysore.
“Most of the women there arrived in a psychotic state,” she said. “They came from other regions within India and spoke different languages, and as a result, they were physically, socially, and culturally isolated.”
When Rao investigated their cases for her research, she found a striking paradox. In general in India, there is a strong social and family support system for people with mental illness: “The family is expected to care for them, especially for women, who are often unprepared for life outside the home.”
But when she looked at the family structure of the women in her study before, during, and after they became homeless, she found that some breakdown in that pattern had occurred.
“Either their primary caregiver had died, or they were abandoned by family members after family interaction worsened following the onset of illness,” she said.
The women stayed at Manasa for one to 10 months before being returned to their families, perhaps too briefly to achieve full psychiatric remission, she said.
“There appeared to be little psychosocial rehabilitation or education of the family, and so many of the women ended up back on the streets, only to be returned to Manasa again,” she said. “That’s something that needs work.”
Still, she was impressed by the deep social connectedness she saw in Indian society, something she wished was more present in the United States.
Rao was pleased to be awarded the Lancet prize but now is concentrating on her medical school studies. “I just hope I can maintain my idealism in the face of the need to learn so much,” she said. She looks forward to entering a residency program in psychiatry and neurology after graduation. ■