National Mental Health Programme

In 2003 the Program was re-strategized to add 2 schemes, that is the Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals.

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National Mental Health Programme

To convey the large burden of mental disorders and shortage of professionals who are qualified in the field of mental health, the Indian Government since 1982 has been implementing National Mental Health Program (NMHP). In 1996 the district Mental Health Program was added to the Program. In 2003 the Program was re-strategized to add 2 schemes, that is the Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals. The Manpower development scheme (Scheme-A & B) in 2009 then became an integral part of the Program.

Also Read: Mental Health Still Not an Important Issue in India; Child Abuse at Its Peak Due To This Mentality

ELEMENTS:

In District Mental Health Program, it anticipates the provision of services of basic mental health care at the level of community:

Service provision: provision of mental health out-patient & in-patient mental health services with a 10 bedded inpatient facility.

Out-Reach Component:

  1. Satellite clinics: 4 satellite clinics per month at CHCs/ PHCs by the DMHP team
  2. Targeted Interventions:
  • Life skills education & counseling in schools,
  • College counseling services,
  • Workplace stress management, and
  • Suicide prevention services

Includes sensitization &even training of health personnel: at both the district & sub-district levels

Awareness camps: for spreading of awareness concerning mental illnesses and stigma related through the involvement of local PRIs, faith healers, leaders, teachers, etc.

Community participation:

  • Linkages with Self-help groups, family and caregiver groups & NGOs working in the field of mental health
  • Sensitization of enforcement officials regarding legal provisions for effective implementation of Mental Health Act

As far as of now, 241 districts have been surrounded under the scheme and it is asked to expand DMHP to all districts in a gradual manner (Annexure-II)

Manpower (on basis of contracts): Psychiatrist, Clinical Psychologist, Psychiatric Nurse, Psychiatric Social Worker, Community Nurse, Monitoring & Evaluation Officer, Case Registry Assistant, Ward Assistant/ Orderly

Financial support of Rs. 83.2 lakhs per DMHP have been allotted.

THE PPP MODEL ACTIVITIES

Financial support of Rs 5 lakh is allotted per NGO.

Under this certain phase, there is a provision for the state governments to accomplish activities related to mental health in partnership with Non-Government Organizations or Agencies as per the guidelines of the NRHM in this matter. The levels and the areas of the partnership of the state government with the Non-Government Organizations or Agencies might be as follows:

AT DISTRICT LEVEL: Local IEC, Day-care, Residential/Long-term Residential Continuing Care Centres, Supplementation or Innovative Mental Health Services, Training/Sensitization of health workers; Hiring of a private Psychiatrist/Clinical Psychologist/Psychiatric Social Worker/Psychiatric Nurse on contract. Psychiatrists @ Rs 2500/- per day (ten days a month + 4 days/ month for outreach activity/training); Clinical Psychologists/Psychiatric Social Worker @Rs 2000/- per day (ten days a month + 4 days/ month for outreach activity/training); Psychiatric Nurse @Rs 1000/- per day.

AT STATE LEVEL: Advocacy, Local IEC, Dedicated Mental Health Help-line, Training/Sensitization of health workers, Ambulance services.

A Day Care Centre, financial support of Rs 50,000 was allotted percenter every month. It provided rehabilitation and services for recovery to people with mental illness so that the starting intervention with drugs & psychotherapy is checked on and relapse is avoided.

It further helps in improving the skills of the family or caregiver in giving better support care. It even provides a good opportunity for people recovering from mental illness for a good community level. Even, financial support of Rs. 6 lakhs is allotted every year percenter.

At Residential or Long-Term Continuing Care Centre, financial support of Rs. 75,000 was allotted percenter every month. Eternally mentally ill individuals, who have achieved stability with respect to their symptoms & have not been able to get back to their families, and are recent residents of the mental hospitals, shall be shifted to these centers. Residential patients in these centers shall go through a well-structured program which shall be executed with the help of a multidisciplinary team including psychologists, social workers, nurses, occupational therapists, vocational trainers, and support staff. Even, financial support of Rs. 9 lakhs is allotted every year percenter.

Services available at Community Health Centers include Outpatient services & inpatient services for emergency psychiatry patients and even counseling services. Medical officers and Psychiatric Social Worker or Clinical Psychologist are there in the centers.

Services available at Primary Health Centers include outpatient services, counseling services in accessing social care benefits and pro-active case findings, and mental health promotion activities. Two Community Health Workers are there in the centers.

Mental health Services even include those activities, state, or district-specific, which need to be added to the package of activities carried out by the district mental health team. Such mental health services will be delivered through government mental hospitals or medical colleges or hospitals with the department of psychiatry. Under the overall supervision of the Head of Psychiatry Department.Financial support of up to Rs. 15.00 lakhs every year per medical college or hospital or mental hospital.

Scheme A. Centers of Excellence in Mental Health include up-gradation of 10 existing mental hospitals or institutes or Med. Colleges shall be taken up to start courses in psychiatry, clinical psychology, psychiatric social work & psychiatric nursing. Financial Support of Rs. 33.70 crore shall be given to each center and would consist of capital work (academic block, library, hostel, lab, supportive departments, lecture theatres, etc.), equipment, faculty induction, and retention during the plan period. As of now, 15 mental health institutes have been funded for developing as Centers of Excellence in Mental Health (Annexure-I).

Scheme B. PG Training Departments of Mental Health facilities including government Medical Colleges/ Government Mental Hospitals will be supported for starting/increasing intake of PG courses in Mental Health. Financial support of up to Rs. 0.86 to 0.99 crore per dept. would be provided. The support includes physical work for establishing /improving departments in specialties of mental health, equipment, tools, and basic infrastructure & for engaging required faculty for starting/ enhancing the PG courses. To date, 39 PG Departments in 15 Medical Colleges/ Mental Hospitals in mental health specialties viz. Psychiatry, Clinical Psychology, Psychiatric Nursing, and Psychiatric Social Work have been provided support for their establishment /strengthening (Annexure-I).

For Research and surveys in various regions of the nations in the field of mental health. It further helps in understanding regional needs and framing plans and strategies in the future for various parts of the country. The budget for the remaining period is Rs. 18.00 crore (Rs. 6.00 annually).

For Monitoring and Evaluation standard formats for recording and reporting have been developed and circulated. These will be used by medical colleges/institutes (under Manpower Development Scheme), District, CHC, and PHC. Continuous evaluation of the activities of the program is being done.

There will be a Central Mental Health Team that would supervise and implement the program and provide support to the Central Mental Health Authority. Budget Provision for Central Mental Health Team for a period of 3 years is Rs 1.17 cr.

Training shall be provided to master trainers from each state/UT who shall further train the DMHP team and other staff working in the field of mental health. The standardized training manuals are being formulated and circulated to all stakeholders. The budget for the remaining Plan period is Rs. 15.00 crores (Rs. 5.00 crore annually).

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National Mental Health Programme
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In 2003 the Program was re-strategized to add 2 schemes, that is the Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals.
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THE POLICY TIMES
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