National Mental health program.pptx

National mental health program is a public health approach directed towards prevention, promotion and rehabilitation of mental health.

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2. Mental disorders include : depression, bipolar affective disorder, schizophrenia and other psychosis, dementia, intellectual disabilities and developmental disorders. Ministry of Health and Family Welfare conducted a National Mental Health Survey through NIMHANS, Bengaluru in 12 States. Report of the Survey was released on 10/10/2016. Key findings of the survey are as under: Prevalence of mental morbidity, excluding tobacco use, of individuals above the age of 18 years was 10.6%. 150 million people in India were in need of intervention for mental disorders. 1 in 20 person in the country currently suffered from depression out of which 39% suffered from Severe Depression 0.9 % of the population was at high risk of suicide 3 out of 4 persons with mental disorders had disabilities affecting their work, family, education and other aspects of life. 2 Burden of Mental Disorders

3. 3 Objectives : To provide basic mental health services to the community early detection & treatment of mental illness at the District Hospital Level and below (OPD/ Indoor & follow up) to integrate mental health services with general health services support of up-to Rs. 83.20 lakhs per district. Till date, a total of 692 districts have been supported under the Programme; 625 functional District Mental Health Program (DMHP)

4. 4 Human Resource Support – Support for engagement of Psychiatrists, Clinical Psychologists, Psychiatric Social Workers, Medical Officer, Psychiatric and Community Nurse, Monitoring & Evaluation Officer, Case Registry Assistant and Ward Assistant Training of Medical Officers, Community Health Workers, Nurses, Pharmacists of CHC and PHC for integration of mental healthcare in general health care, for increasing reach of mental healthcare and to facilitate early diagnosis and management and follow-up of chronic cases. Community awareness - Awareness generation to increase help seeking behaviour and address stigma and discrimination faced by mentally ill people. Inter- sectoral linkages- with schools and colleges and Outreach clinics and camps Psychotropic drugs, equipment, IPD services and ambulatory support District Mental Health Program (DMHP) - Core Components

5. Services Provided under DMHP S.No Level Services 1 District Hospital Outpatient services, Assessment Counseling /Psycho-social Interventions, Inpatient treatment (10 bedded) services, Psychotropic Drug 2 3 CHC level PHC level Outpatient services, Counseling services, Continuing care and support to persons with Severe Mental Disorders, Drugs, Ambulance Services

6. SUPPORT UNDER DMHP S.No . Level Support Funds 1 District Hospital Manpower (Psychiatrist, Clinical Psychologist , Psychiatric Nurse, Psychiatric Social Worker, Community Nurse, Monitoring & Evaluation Officer, Case Registry Assistant, Ward Assistants) Equipments, Drugs, Targeted Interventions, Infrastructure of DMHP Centre Upto Rs 83.20 Lakhs (Recurring Rs. 74.20 lakhs for HR, IEC, Drugs, Training etc. Non-Recurring Rs. 9 lakhs Equipments (Rs. 6 lakhs ) and Infrastructure ( Rs. 3 lakhs ) 2 CHC level Manpower (Medical Officer, Clinical Psychologist/ Psychiatric Social Worker Rs.14.40 lakhs 3 PHC level Manpower (Community Health Worker ) Training Rs.5.68 lakhs

7. DISTRICT MENTAL HEALTH PROGRAMME: ISSUES Out of all the districts in the country, States/UTs have sought support for implementation of the DMHP in only 692 districts. States/UTs should submit proposals through their PIPs for extending coverage to all remaining districts . States/UTs to ensure that all districts supported under the programme are functional : Bihar (81.5%), Haryana (86.36%), Jharkhand (41.66%), Telangana (60.60%), West Bengal (39.28%), Tripura (75%), A & N Islands (33.33%) & Puducherry (50%) States/UTs shall ensure timely release of funds to the State Program Division as per RoP . TRAINING OF MEDICAL PROFESSIONALS UNDER NIMHANS DIGITAL ACADEMY State Governments to encourage their Doctors, Psychologists, Social Workers and Nurses to enroll themselves for courses on mental health in the Digital Academy being run by NIMHANS, Bangalore, Lokpriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur & Central Institute of Psychiatry, Ranchi. 7

8. Tertiary Level Activities: The continuation of the Scheme has been approved for implementation till March, 2021 Manpower Development Schemes Establishment of Centre of Excellence (Scheme A) – 25 Institutes Financial support upto Rs . 36.96 Cr is provided towards construction, technical & non-technical equipments, library and faculty salary to the existing Central and State Mental health Institutions for creation of PG Seats (Psychiatry: 4 seats; Clinical Psychology: 16 seats; Psychiatric Social Work: 16 seats; Psychiatric Nursing: 40 seats) – Total 76 PG seats/ CoE 8 Progress State Institute 0 % Delhi IHBAS, Delhi (2010-11) Rajasthan SMS Medical College, Jaipur (2016-17) Madhya Pradesh MGM Medical College, Indore (2016-17) Uttar Pradesh Pradesh King George Medical University, Lucknow (2016-17) Telangana Kakatiya Medical College, Warangal (2017-18) 0 % - 25 % Telangana Institute of Mental Health, Hyderabad (2009-10) Goa Institute of Psychiatry and Human Behaviour, Bambolim (2015-16) Punjab Institute of Mental Health, Amritsar (2015-16) Rajasthan S.P. Medical College, Bikaner (2016-17)

9. Strengthening/Establishment of Post Graduate Departments in mental health specialties (Scheme-B) - 47 PG Departments F inancial support upto Rs. 2.90 Cr is provided towards capital works and faculty support to the existing Central and State Mental health Institutions for strengthening/establishment of one or more of the Post Graduate Departments in mental health specialties for creation of PG Seats (Psychiatry: 2 seats; Clinical Psychology: 8 seats; Psychiatric Social Work: 8 seats; Psychiatric Nursing: 20 seats) 9 Progress State Institute % Maharashtra Regional Mental Hospital, Pune (2015-16) Regional Mental Hospital, Thane (2015-16) Regional Mental Hospital, Nagpur (2015-16) J & K Sher - i -Kashmir Institute of Medical Sciences, Srinagar (2015-16) Madhya Pradesh Shyam Shah Medical College, Rewa (2016-17) Himachal Pradesh Indira Gandhi Medical College & Hospital, Shimla (2017-18) Karnataka Karnataka Institute of Medical Sciences, Hubbali (2017-18)

10. TERTIARY LEVEL ACTIVITES UNDER NATIONAL MENTAL HEALTH PROGRAMME: ISSUES The Institutes already supported under the Programme are to be made fully operational by March, 2021. PG courses under each mental health specialty to be conducted/ initiated with the required number of seats As per approval for continuation of the Scheme upto 2021 , for the projects to be implemented by States/UTs, first instalment of the approved Central share will be released as an advance to the State/UTs . The remaining funds, are to be released on reimbursement basis after submission of the Utilization Certificates for the funds already released. Release of funds to the Institutes supported under Manpower Development Schemes would henceforth be on the basis of submission of UCs for the funds already released and further claims for reimbursement of expenditure incurred by the State Government from its own budget. 10

11. MENTAL HEALTHCARE ACT, 2017 Mental Healthcare Act, 2017 (came into force w.e.f . 29/05/2018) In pursuance of the provisions of the Mental Healthcare Act, 2017, Rules under the Act were also framed by the Central Government Provisions of the Act are to be implemented primarily by the State Governments . Priority actions required from the States Governments : establishment of State Mental Health Authorities creation of State Mental Health Authorities Funds establishment of Mental Health Review Boards framing of Rules and Regulations 11

12. MAJOR ISSUES MENTAL HEALTHCARE ACT, 2017 ISSUES State Mental Health Authorities yet to be established in Bihar, Haryana, Rajasthan, West Bengal, Delhi, A & N Islands, Chandigarh, Dadra & Nagar Haveli and Daman & Diu, Lakshadweep, Puducherry , Jammu & Kashmir, Ladakh Expeditious action needed on : Establishment of Mental Health Review Boards for a district or group of districts Creation of State Mental Health Authority Fund Adoption of the Rules framed by the Central Government/framing of rules by the States/UTs under Section 121 of the Act. Framing of Regulations by the State Mental Health Authorities under Section 123 of the Act. . 12

13. THANK YOU 13

14. 14 S.No . State Name of the Institute Year of initiation PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Social Work Psychiatric Nursing 1 Andhra Pradesh Hospital for Mental Care, Vishakhapatnam 2017-18 2 Delhi (Central Govt.) Dr. RML Hospital, Delhi 2016-17 8 12 10 20 50 3 Delhi IHBAS, Delhi 2010-11 4 Goa Institute of Psychiatry and Human Behaviour, Bambolim 2015-16 8 8 5 Himachal Pradesh Dr. Rajendra Prasad Govt. Medical College, Kangra , Tanda 2016-17 6 J&K Psychiatric Diseases Hospital, Govt. Medical College, Srinagar 2009-10 21 8 29 Seats created in Institutes supported under Scheme-A (Centres of Excellence)

15. 15 S.No . State Name of the Institute Year of initiation PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Social Work Psychiatric Nursing 7 Kerala IMHANS, Kozikode 2010-11 2 24 48 40 114 8 Odisha SCB Medical College Hospital, Cuttack 2010-11 27 56 24 120 227 9 Telangana Institute of Mental Health, Hyderabad 2009-10 10 Telangana Kakatiya Medical College, Warangal 2017-18 11 West Bengal Institute of Psychiatry, Kolkata 2009-10 18 72 144 140 374 12 West Bengal Calcutta National Medical College 2017-18 6 6

16. 16 S.No . State Name of the Institute PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Social Work Psychiatric Nursing 1 Delhi (Central Govt.) Dr. RML Hospital, Delhi ( 3 PG Departments in 2009-10) - 32 18 60 110 2 Himachal Pradesh Indira Gandhi Medical College & Hospital, Shimla (2 PG Departments in 2017-18) - - 3 Jammu and Kashmir Sher - i -Kashmir Institute of Medical Sciences, Srinagar, (4 PG Departments in 2015-16) 4 Jharkhand Ranchi Institute of Mental Health & Neuro Sciences, Ranchi ( 4 PG Departmetns in 2009-10) 10 138 138 96 382 5 Kerala Govt. medical College, Trivandrum (4 PG Departments in 2010-11) 24 24 6 Tamil Nadu Institute of Mental Health, Chennai (3 PG Departments in 2010-11) - 32 - 4 36 Seats created in Institutes supported under Scheme-B (PG Departments)

17. District Mental Health Programme Status update on the conditionalities for implementation of NMHP (Indicators for 2020-21) 17 Sl. No Name of the State /UT % district covered under Mental Health Progrmme and providing services as per framework Action taken for fulfillment of provisions under Mental Healthcare Act, 2017 (MHCA 2017) Total Number of Districts No of Districts Approved 20-21 No of Districts Functional Percentage % Constituted State Mental Health Authority (Yes/No) Constituted State Mental Review Board (Yes/No) Created State Mental Health Authority fund (Yes/No) 1 Andhra Pradesh 13 13 13 100% Yes No No 2 Bihar 38 31 31 81.5% No No No 3 Chhattisgarh 27 27 27 100% Yes Yes Yes 4 Goa 02 02 02 100% Yes No Yes 5 Gujarat 33 33 33 100% Yes Yes Yes 6 Haryana 22 22 19 86.36% No No No 7 Himachal Pradesh 12 12 12 100% Yes Yes Yes 8 J&K Jammu 10 10 10 100% No No No J&K Kashmir 10 10 10 100% No No No 9 Jharkhand 24 12 5 41.66% Yes Yes No 10 Karnataka 31 31 31 100% Yes Yes Yes 11 Kerala 14 14 14 100% Yes No No 12 Madhya Pradesh 51 51 51 100% Yes No No 13 Maharashtra 36 34 34 100% Yes No No 14 Odisha 30 30 30 100% Yes No Yes 15 Punjab 22 22 22 100% Yes Yes Yes 16 Rajasthan 33 33 33 100% No No No 17 Tamil Nadu 37 32 32 100% Yes Yes Yes 18 Telegnana 33 33 20 60.60% Yes No Yes

18. District Mental Health Programme Status update on the conditionalities for implementation of NMHP (Indicators for 2020-21)… 18 Sl. No Name of the State /UT % district covered under Mental Health Progrmme and providing services as per framework Action taken for fulfillment of provisions under Mental Healthcare Act, 2017 (MHCA 2017) Total Number of Districts No of Districts Approved 20-21 No of Districts Functional Percentage % Constituted State Mental Health Authority (Yes/No) Constituted State Mental Review Board (Yes/No) Created State Mental Health Authority fund (Yes/No) 19 Uttar Pradesh 75 75 75 100% Yes 13 Yes 20 Uttarakhand 13 13 13 100% Yes Yes Yes 21 West Bengal 27 28 11 39.28% No No No 22 Arunachal Pradesh 25 09 06 66.33% Yes No Yes 23 Assam 27 27 27 100% Yes No Yes 24 Manipur 16 16 16 100% Yes Yes Yes 25 Meghalaya 11 11 11 100% Yes Yes No 26 Mizoram 9 9 9 100% Yes No Yes 27 Nagaland 11 11 5 100% Yes No No 28 Sikkim 4 4 4 100% Yes Yes Yes 29 Tripura 8 8 6 75% Yes Yes Yes

19. District Mental Health Programme Status update on the conditionalities for implementation of NMHP (Indicators for 2020-21)… 19 Sl. No Name of the State /UT % district covered under Mental Health Progrmme and providing services as per framework Action taken for fulfillment of provisions under Mental Healthcare Act, 2017 (MHCA 2017) Total Number of Districts No of Districts Approved 20-21 No of Districts Functional Percentage % Constituted State Mental Health Authority (Yes/No) Constituted State Mental Review Board (Yes/No) Created State Mental Health Authority fund (Yes/No) 30 A& N Islands 3 3 1 33.33% No No No 31 Chandigarh 1 1 1 100% No No No 32 D&N Haveli 1 1 1 100% No No No Daman & Diu 2 1 1 100% No No No 33 Delhi 11 5 5 100% No No No 34 Ladhak 2 2 2 100% No No No 35 Lakshadweep 1 1 1 100% No No No 36 Pondicherry 4 2 1 50% No No No