Mental Health Programme in India: Has the tide really turned?

Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India’s NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.

The Impact Of Mental Health Education On The Knowledge And Attitude Of The Peripheral Health Workers Of Dang.

Background & Objective: Mental health needs of a society are ideally met by integration in primary care. Under the District Mental Health programme, Surat is the nodal centre for Dang, a tribal region. In order to make medical care available to the patients in need, it was vital to train the peripheral health workers of the region. The aim was to provide mental health education to the peripheral health workers of Dang and assess its impact on their knowledge and attitude regarding mental health issues. Methodology: 150 peripheral health workers were posted in the Department of Psychiatry in batches of 20-30 each for a 7-day, extensive, in-house training. The improvement in knowledge and attitude was assessed by a pre-post semi-structured questionnaire and structured feedback. Results: The training resulted in a significant improvement in scores related to clarification of myths. The knowledge and attitude related to mental health issues improved significantly and the participants reported that they were sensitized by the training and would identify and refer patients to the visiting psychiatrist. Conclusion: The training in mental health could bring about improvement in the knowledge and attitude of the peripheral health workers. However, to what extent does this change reflect in actual practice, needs to be ascertained.

Changing Scene of Mental Health Care in Shivpuri District of M.P.

Objectives: To ensure availability and accessibility of minimum mental health care for all in the future; to provide sustainable basic mental health services to the community and to integrate these services with other health services; early detection and treatment of patients within the community itself; to see that patient and their relatives do not have to travel long distance to go to hospitals or nursing homes in the cities; to take pressure off the mental hospitals; to change the attitude of people towards mental illnesses by public education. Methodology: Retrospective analysis of OPD records of GMA and District Mental Health Programme (DMHP) to find out the total numbers of patients in the psychiatric OPD of the Mental Hospital, (GMA) Gwalior and DMHP-Shivpuri. Results/ conclusions: The observation showed that with the implementation of DMHP, higher number of psychiatric patients are availing mental health facilities in the community. It was observed that the number of the patients taking institutional care is going down gradually.