National Mental Health Survey of India 2015-16

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Tables Table 1 Demographic characteristics of states selected for NMHS 41 Table 2 Administrative and economic characteristics in NMHS states 42 Table 3 Health Management Information System (HMIS) in NMHS states 42 Table 4 General health care facilities in NMHS states 44 Table 5 Health human resources across the NMHS states 45 Table 6 Coverage of DMHP across the NMHS states 46 Table 7 Mental health care facilities in NMHS states 47 Table 8 Mental health human resources across the NMHS states 50 Table 9 Mental Health Sciences Training in the NMHS states 51 Table 10 Mental Health Policy across the NMHS states 52 Table 11 Implementation of Mental health legislation across the NMHS states 55 Table 12 Mental health workforce in high, middle and low income countries. 69 Figures Figure 1 Health system building blocks 1 Figure 2 Key Components of mental health system 3 Figure 3 NMHS states included for SMHSA 25 Figure 4 Overview of data collection process under SMHSA 35 Figure 5 Dates of State expert consensus meeting 36 Figure 6 State wise DMHP districts covered in NMHS 46 Figure 7 Training programme for mental health 50 Figure 8 Mental Health Action Plan 53 Figure 9 Mental health Co-ordination mechanism 54 Figure 10 Implementation status of legislation 56 Figure 11 Mental Health Financing. 57 Figure 12 IEC materials and health education activities 58 Figure 13 Availability of Drugs 58 Figure 14 Intra and Intersectoral collaboration 59 Figure 15 Monitoring 61 Figure 16 State mental health system assessment scores 62 Figure 17 SMHSA Scores - Assam 62 Figure 18 SMHSA Scores - Gujarat 63 Figure 19 SMHSA Scores - Chhattisgarh 63 Figure 20 SMHSA Scores - Jharkhand 63 Figure 21 SMHSA Scores - Kerala 64 Figure 22 SMHSA Scores - Rajasthan 64 Figure 23 SMHSA Scores - Madhya Pradesh 64 Figure 24 SMHSA Scores - Tamilnadu 65 Figure 25 SMHSA Scores - Manipur 65 Figure 26 SMHSA Scores - Uttar Pradesh 65 Figure 27 SMHSA Scores - Punjab 66 Figure 28 SMHSA Scores - West Bengal 66 Box items Box 1 Sustainable Development Goals (SDGs) 18 Box 2 WHO Mental Health Action Plan 2013–2020 targets 18 Box 3 Domains and sub-domains under MHSA 28 Box 4 Indicators 40 Box 5 National Mental Health Policy of India – 2014 73 Box 6 The Mental Health Care Bill, 2016 74 Box 7 Restrategised NMHP and XII 5-year plan 75 xxii SMHSA
Executive Summary Mental, Neurological and Substance use disorders (MNSUDs), currently included under the broader rubric of Non Communicable Diseases (NCDs) are increasingly recognised as major public health problems contributing for a greater share of morbidity and disability. During the last five decades, the prevalence, pattern, characteristics and determinants of various mental disorders has been examined by research studies. Furthermore, care related issues, service delivery aspects and system issues have been examined in a limited manner. However, scientific extrapolations and estimates to national and state level have not been possible. Recent studies indicate the emergence of several new problems like alcohol and drug abuse, depression, suicidal behaviours and others; information of these at a national level are limited. Recognising the need for good quality, scientific and reliable information and to strengthen mental health policies and programmes at national and state levels, the Ministry of Health and Family Welfare (MOHFW) commissioned National Institute of Mental Health and Neuro Sciences(NIMHANS) to undertake a National Mental Health Survey (NMHS) in a nationally representative population and examine priority mental disorders, estimate treatment gap, assess service utilization, disability and socio-economic impact along with assessing resources and systems. The NMHS was undertaken in 12 states across 6 regions of India [North (Punjab and Uttar Pradesh); South (Tamil Nadu and Kerala); East (Jharkhand and West Bengal); West (Rajasthan and Gujarat); Central (Madhya Pradesh and Chhattisgarh) and North-east (Assam and Manipur)]. In each state, the dedicated team of Investigators included mental health and public health professionals. Methods A uniform and standardised methodology was adopted for the National Mental Health Survey. • A pilot study was undertaken in the district of Kolar, the Public Health Observatory of NIMHANS • The Master Protocol for the study was drafted based on the results from the pilot study and finalised after deliberations with the National Technical Advisory Group (NTAG) and the National Expert Panel and discussions with the state teams. A detailed Operational Guidelines document was developed to conduct the survey. • NIMHANS Institutional Ethics Committee (IEC) approved the study protocol. • The methodology adopted was multi-stage, stratified, random cluster sampling technique, with random selection based on Probability Proportionate to Size at each stage; all individuals 18 years and above in the selected households were interviewed. A sub-sample was included in four states to examine feasibility of methodology for understanding mental morbidity amongst adolescents (13 – 17 years). SMHSA xxiii
Page 1: National Mental Health Survey of In
Page 4 and 5: © National Institute of Mental Hea
Page 6 and 7: 5.5 Coverage of District Mental Hea
Page 8 and 9: NATIONAL INSTITUTE OF MENTAL HEALTH
Page 10 and 11: esults, implications along with rec
Page 12 and 13: We are thankful to all the members
Page 14 and 15: NMHS NIMHANS Team Principal Investi
Page 16 and 17: 7) Manipur: Regional Institute of M
Page 18 and 19: MADHYA PRADESH Mr. Narendra Sinha,
Page 20 and 21: 1. Mr. Vijeta Das, Assist. Gr. II,
Page 22 and 23: PUNJAB 1. Dr. Bhag Mal, Chairman, D
Page 26 and 27: • Both quantitative and qualitati
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Page 35 and 36: 1. Introduction A health system con
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Page 47 and 48: NMHS of mental health systems in Gu
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Page 53 and 54: NMHS Target: The rate of suicide in
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Page 73 and 74: NMHS WestBengal Tamilnadu Punjab 4.
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5. Results The National Mental Heal
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NMHS The Health Management Informat
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NMHS 5.4 Health Human Resources Tab
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NMHS The District Mental Health Pro
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NMHS role and are key resources in
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NMHS Table 9: Mental health science
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NMHS Among the NMHS states, the sta
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NMHS Information provided by States
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NMHS distribution, inadequate utili
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NMHS Drug availability at the PHC l
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NMHS 5.16 Mental Health Monitoring
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NMHS Figure 19: SMHSA Scores - Chha
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NMHS Figure: 27: SMHSA Scores - Pun
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6. Implications The National Mental
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NMHS requires identifying instituti
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NMHS the stepped care model is incr
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NMHS Box 5: National Mental Health
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NMHS Box 7: Restrategised NMHP and
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NMHS mechanisms of integration, dev
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NMHS 8. Drug logistics system at st
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NMHS • Sample surveys on represen
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9. References 1. World Health Organ
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NMHS 40. World Health Organization.
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NMHS Annexure 1: Indicators Quantit
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NMHS 10 11 12 13 Availability of Be
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NMHS Qualitative indicators Sl No D
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NMHS • State Mental Health Author
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NMHS 8 Intra and Intersectoral coll
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NMHS Public sector 3.General Health
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NMHS 10. Suicide rate (Per 1,00,000
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NMHS Public sector 3.General Health
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NMHS Public sector 3. General Healt
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National Mental Health Survey of India 2015-16

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