Posted 08 Dec 2016 01:02 PM


Psychiatric symptoms are common in general population in both sides of the globe. These
symptoms - worry, tiredness, and sleepless nights affect more than half of the adults at some
time, while as many as one person in seven experiences some form of diagnosable neurotic
Burden of Disease
The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss
due to neuro-psychiatric disorder is much higher than diarrhea, malaria, worm infestations
and tuberculosis if taken individually. According to the estimates DALYs loss due to mental
disorders are expected to represent 15% of the global burden of diseases by 2020.
During the last two decades, many epidemiological studies have been conducted in India,
which show that the prevalence of major psychiatric disorder is about the same all over the
world. The prevalence reported from these studies range from the population of 18 to 207 per
1000 with the median 65.4 per 1000 and at any given time, about 2 -3 % of the population,
suffer from seriously, incapacitating mental disorders or epilepsy. Most of these patients live
in rural areas remote from any modern mental health facilities. A large number of adult
patients (10.4 - 53%) coming to the general OPD are diagnosed mentally ill. However, these
patients are usually missed because either medical officer or general practitioner at the
primary health care unit does not asked detailed mental health history. Due to the underdiagnosis
of these patients, unnecessary investigations and treatments are offered which
heavily cost to the health providers.
The Government of India has launched the National Mental Health Programme (NMHP) in
1982, keeping in view the heavy burden of mental illness in the community, and the absolute
inadequacy of mental health care infrastructure in the country to deal with it.
1. Prevention and treatment of mental and neurological disorders and their associated
2. Use of mental health technology to improve general health services.
3. Application of mental health principles in total national development to improve quality of
1. To ensure availability and accessibility of minimum mental health care for all in the
foreseeable future, particularly to the most vulnerable and underprivileged sections of
2. To encourage application of mental health knowledge in general health care and in social
3. To promote community participation in the mental health services development and to
stimulate efforts towards self-help in the community.
1. Integration mental health with primary health care through the NMHP;
2. Provision of tertiary care institutions for treatment of mental disorders;
3. Eradicating stigmatisation of mentally ill patients and protecting their rights through
regulatory institutions like the Central Mental Health Authority, and State Mental health
Mental Health care
1. The mental morbidity requires priority in mental health treatment
2. Primary health care at village and subcentre level
3. At Primary Health Centre level
4. At the District Hospital level
5. Mental Hospital and teaching Psychiatric Units
District Mental Health Programme
1. Training programmes of all workers in the mental health team at the identified Nodal
Institute in the State.
2. Public education in the mental health to increase awareness and reduce stigma.
3. For early detection and treatment, the OPD and indoor services are provided.
4. Providing valuable data and experience at the level of community to the state and Centre
for future planning, improvement in service and research.
Agencies like World Bank and WHO have been contacted to support various components of
the programme. Funds are provided by the Govt. of India to the state governments and the
nodal institutes to meet the expenditure on staff, equipments, vehicles, medicine, stationary,
contingencies, training, etc. for initial 5 years and thereafter they should manage themselves.
Govt. of India has constituted central Mental Health Authority to oversee the implementation
of the Mental Health Act 1986. It provides for creation of state Mental Health Authority also
to carry out the said functions.
The National Human Rights Commission also monitors the conditions in the mental hospitals
along with the government of India and the states are currently acting on the recommendation
of the joint studies conducted to ensure quality in delivery of mental care.
Thrust areas for 10th Five Year Plan
1. District mental health programme in an enlarged and more effective form covering the
entire country.
2. Streamlining/ modernisation of mental hospitals in order to modify their present custodial
3. Upgrading department of psychiatry in medical colleges and enhancing the psychiatry
content of the medical curriculum at the undergraduate as well as postgraduate level.
4. Strengthening the Central and State Mental Health Authorities with a permanent
secretariat. Appointment of medical officers at state headquarters in order to make their
monitoring role more effective;
5. Research and training in the field of community mental health, substance abuse and child/
adolescent psychiatric clinics.
1. For the first time in the last 40 years mental health has been chosen as the theme for the
World Health Day 2001: "Mental Health: Stop Exclusion - Date to Care", Why? The recent
evidence for the importance of mental health has been so striking that the WHO decided to
give it a priority during year 2001, the beginning of 21st century.
2. There is no initiative from the mental health professional to take active part in this
programme. Most of them are not aware of the programme.
3. There is shortage of professional manpower and training programmes are not able to meet
the demand in providing all medical private practitioners and medical officers.
4. Appropriate mental health can be provided at the sub centre and village level by minimum
training of the health workers that will help in providing comprehensive health care at the
most peripheral level.
5. The targets set for the programme are not achieved till today after lapse of more than one
decade. This indicates that there is a poor commitment of the government, psychiatrists, and
community at large.
6. The programme has given more emphasis on the curative services to the mental disorders
and preventive measures are largely ignored. More public awareness programmes are
7. The medical care in the hospitals are custodial in nature and this needs to be changed to a
therapeutic approach.
J&K Govt. has implemented the NMHP in the state with Psychiatric Diagnostic and
Treatment facilities at District Hospitals and one day in a week Psychiatric clinic at CHC
The programme is showing a very good response from the general public for which people
had to come to the Apex Hospital for the treatment. Same treatment is being made available
at their door steps and free medicines related to the various Psychiatric Diseases are being

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