National Mental Health Survey of India 2015-16

NMHS
employment, ownership of assets, travel
benefits, right to marriage and a complete
family life. The committee also highlighted
the need to provide special focus on children,
the elderly, gender-related mental health
needs, homeless and destitute persons with
mental illness, persons in correctional and
other custodial locations and persons with
severe psychological distress. The need to
strengthen centre - state collaboration, central
institute/state collaboration, inter-agency
collaboration, public - private collaboration
for optimal service delivery in the present
context was also highlighted.
The committee also provided key
recommendations to the member states
to (1) develop a comprehensive mental
health action plan, (2) develop mechanisms
for regular monitoring and reporting, (3)
augment mental health human resources, (4)
sensitise and train all its health care providers
in mental health, (5) sensitise and train
undergraduates, (6) integrate mental health
evaluation and care components into many
of the communicable and non-communicable
disease programmes, (7) recognize and
assist NGOs, (8) train lay counsellors and
community health workers, (9) conduct
sensitisation and training programmes
for judicial officers, administrators in the
departments of health, social services and
other relevant departments, (10) facilitate
the formation of associations of persons
with mental disorders, (service users) and
their families, (11) augment mental health
promotion strategies, and (12) develop the
budget and identify the sources of funding
for each activity.
2.2.10 DMHP Experiences
In addition to large scale national and state
reviews, a few small scale evaluations of
the DMHP have also been carried out.
In 2003, Krishna Murthy et al (34) from
Hyderabad reported that DMHP in its
present form caters only for patients with
severe mental disorders and is not of much
benefit to the large segment of population
with minor mental health problems like
anxiety, depression etc.’It also highlighted
the need to effect changes in the training and
modalities of involving medical officers in
the implementation of the DMHP, if better
mental health care was to be delivered in the
rural areas.
Similarly, an in-depth qualitative study by
Ananth Kumar (2005) (35) in the DMHP
clinic at Jahangirpuri in Delhi, observed
that there was no provision for guidance
and counselling nor a comprehensive
approach or teamwork with the inclusion
of professionals like clinical psychologists
and physicians. The lack of coordination
between the facilities and various agencies,
especially the NGOs working in the area
was also noted. There was no integration of
mental health care with primary health care
nor was there any provision for the early
detection and treatment of patients within
the community. The other shortcomings
included the absence of awareness
programmes to reduce the stigma attached
to mental illness through change of attitude
and public education; failure to treat and
rehabilitate mentally ill patients discharged
from mental hospitals, failure to undertake
community surveys on mental illnesses
and other associated factors, even when
feasible. At times, some medicines were not
available and patients had to buy them from
the market and there was no provision for
reimbursement’.
Experience of the DMHP for six months
by Warraich et al (2003) (36) in Chandigarh
reported that decentralisation of services was
a felt need of the community and required
not only in rural but in urban areas as well.
SMHSA
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