National Mental Health Survey of India 2015-16

NMHS
2.1 National and District
Mental Heatlh
Programme: Origin,
Progress and Status
India was one of the first countries in the
developing world to formulate a National
Mental Health Programme. As early as
1982, the Central Council of Health and
Family Welfare (CCHFW) adopted and
recommended the implementation of a
National Mental Health Programme for
India (NMHP) (15). Earlier, studies from
some parts of the country had highlighted
the burden of mental health problems
and also demonstrated the feasibility of
delivering integrated services. Some major
research and policy efforts that contributed
to the drafting of the NMHP for India during
the early 1980s included the following
1. “The organization of mental health
services in developing countries” – a
set of recommendations by an expert
committee of the WHO.
2. Starting of a specially designated
“Community Mental Health Unit” at
the National Institute of Mental Health
and Neuro Sciences (NIMHANS),
Bangalore – 1975.
3. The WHO Multi-country project:
“Strategies for extending mental health
services into the community” (1976-1981)
4. The “Declaration of Alma Ata”- to
achieve “Health for All by 2000” by
universal provision of primary health
care (1978)
5. Indian Council of Medical Research
(ICMR) – Department of Science and
Technology (ICMR-DST) Collaborative
project on ‘Severe Mental Morbidity
(1987)’
The draft of the NMHP was written by an
expert drafting committee (consisting of some
of the leading senior psychiatrists in India)
(16). During 1981-82, this draft was reviewed
and revised in two national workshops
attended by a large number of mental health
professionals and other stakeholders. These
recommendations were finally adopted by
the CCHFW in August 1982.
The objectives of the NMHP were set out to:
1. Ensure the availability and accessibility
of minimum mental healthcare for all in
the foreseeable future, particularly to the
most vulnerable and underprivileged
sections of the population;
2. Encourage the application of mental
health knowledge in general health care
and in social development; and
3. Promote community participation in
mental health service development and
to stimulate efforts towards self- help in
the community.
The adoption of the NMHP document
in 1982 by the CCHFW (and the
recommendation of its implementation)
was a significant achievement in itself.
However, the implementation of the
programme over the years has faced
numerous challenges. Most importantly,
miniscule budgetary provisions were made
for the implementation of the programme
in the early days. There was lack of clarity
regarding who should fund the programme
– the federal government of India or the
state governments, the latter perpetually
having inadequate funds for health care.
Although the draft of the programme was
discussed in great detail by mental health
professionals and revised before its final
adoption by the CCHFW, there was a very
lukewarm response and in some instances,
almost rejection of the programme by fellow
SMHSA
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