National mental health programme

National Mental Health Programme in India presentation helpfull for nursing student

1. NATIONAL MENTAL HEALTH PROGRAM BY : MS RINKAL PATEL

2. Introduction The government of India launched the national mental health program (NMHP) in 1982, keeping in view the heavy burden of mental illness in community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it.

3. Vision The vision of the National Health Policy is to mental health, prevent mental illness, enable recovery from mental illness, promote destigmatization, and ensure socio-economic inclusion of persons affected by mental illness by providing accessible, affordable and quality health and social care to all persons through their life-span, within a rights-based framework. 3

4. Values and Principles Fundamental values and principles representing the ethos of this policy are discussed below: 4

5. Equity Mental health services should be sensitive and relevant to diverse social and cultural situation and groups and, to the need of remote and rural areas. An equitable share of the national health budget should be consist with the burden of mental health problems and mental illness. Non-discrimination and equal opportunities for education, employment, housing and social welfare should be provided to promote inclusion of persons with mental health problems and mental illness. 5

6. Justice The needs of vulnerable and excluded members of the community should receive particular attention. 6

7. Integrated care Mental health services should be provided within the existing health care system using the primary health care approach. Some mental illness are chronic in nature, persons suffering from chronic illness would require provisions for medium and long term, in some cases even life-long the provision of services should keep this requirement in consideration. 7

8. These services should espouse the principles of universal access, equitable distribution, community participation, inter- sectoral coordination and use of appropriate technology. It is essential to make mental health services universally available and accessible in a time bound manner. Mental health services should be comprehensive and address the needs of person with mental illness, their care providers and health care professionals 8

9. Evidence based care Evidence based interventions should inform decisions regarding provision of services. Decision making should be based on various evidences for instance: findings from research, practice based evidence and feedback from clients. 9

10. Quality Mental health services should meet quality standards as mandated globally and perceived suitable by local users and care-givers. 10

11. Participatory and rights based approach Services users and caregivers should be involved in the planning, development, delivery, monitoring and evaluation of mental health services. Human rights and dignity of persons with mental health problems should be respected, protected and promoted. Mental health care should promote and protect the autonomy and liberty of person(s) with mental health problem. The rights of the caregiver and service provides should also be respected by ensuring good working conditions, adequate training and support. 11

12. Governance and effective delivery The union and state governments, have a major role in actions for promotion of mental illness in the country. However governments alone cannot ensure effective delivery. Other stakeholders such as private care providers, civil society organizations, user groups, academic and research institutions also have a cruel role in delivery and guiding policy. 12

13. Services and professionals involved in health care planning and delivery whether in public, private or non-government sector should at all times display the utmost devotion to duty and be responsible for their action. Services and service providers are ultimately accountable to person(s) with mental illness and their care-givers. 13

14. Value base in all training and teaching programs Core values such as quality, integrity, justice, accountability and empathy should be built in to all forms of training and academic teaching. 14

15. Holistic approach to mental health A holistic approach to health including recognition of the relationship between mind, body and soul is more effective in dealing with mental health problems. Cultural ethos, Indian traditions and their impact on behavioral patterns must be recognized and leveraged to achieve policy goals and objectives. 15

16. Aims Prevention and treatment of mental neurological disorders and their associated disabilities. Use of mental health technology to improve general health services. Application of mental health principles in total national development of improve quality of life.

17. Goals and objectives Based on the vision and drawing on the values and principles outlined in the previous Sections, the goals and objectives of the mental health policy are as follows: 17

18. Goals To reduce distress, disability, exclusion morbidity and premature morbidity associated with mental health problems across life-span of the person. To enhance understanding of mental health in the country. To strengthen the leadership in the mental health sector at the national, state, and district levels. 18

19. Objectives To provide universal access to mental health care. To increase to access and utilization of comprehensive mental health services(including prevention services, treatment and care support services) by persons with mental health problems. To increasing access to mental health services for vulnerable groups including homeless person(s), person(s) in remote areas, difficult terrains, educationally/socially/economically deprived sections. To reduce prevalence and impact of risk factors associated with mental health problems. To reduce risk and incidence of suicide and attempted suicide. 19

20. To ensure respect for rights and protection from harm of person(s) with mental health problems. To reduce stigma associated with mental health problems. To enhance availability and equitable distribution of skilled human resources for mental health. To progressively enhance financial allocation and improve utilization for mental health. To identify and address the social, biological and psychological determents of mental health problems and to provide appropriate interventions. 20

21. Strategies Effective governance and delivery mechanisms of mental health Promotion of mental health Prevention of mental illness, reduction of suicide and attempted suicide Universal access to mental health services Improved availability of adequately trained mental health human resources to address the mental health needs of the community Community participation for mental health and development research

22. Approaches Integration of mental health care services with the existing general health services. Utilization of the exiting infrastructure of health services and also deliver the minimum mental health care services. Provision of appropriate task-oriented training to the existing health staff. Linkage of mental

23. Limitation of NMHP The program emphasized more on curative components rather than the preventive and promotives components Role of support of families in the treatment of the patient was not given due importance Short term goals were given priority over the long term planning The administrative structure of the program was not clearly clearly outlined. 23

24. Level of NMHP This program include 3 sub program Tratment sub prog Village level Primary health level At dis 24

25. Mental Health Team A psychiatrist A psychiatric nurse A psychiatric social worker Occupational therapist or activity therapist 25

26. Role of nurse in NMHP Job title: Psychiatric nurse Job requirements/responsibilities 1. To examine and manage healthcare needs of the mentally ill patients 2. To provide inpatient care to the mentally ill patients 3. To do the outreach activity/plan and manage psychiatric Clinics in PHCs/CHCs and other sites periodically 4. To impart training to the health personnel of CHC and PHC as per guidelines issued by the National Mental Health Cell.

27. Job title: Community nurse Job requirements/ responsibilities 1. To keep track of follow-up patients availing treatment At CHC and PHC 2. To do the outreach activity/plan and manage psychiatry Clinics in PHCs/CHCs and other sites periodically 3. To impart training to the health personnel of CHC and PHC as per guidelines issued by the National Mental Health Cell.

28. The way forward for psychiatric nurses in District Mental Health Programe . Opportunities to get involved in PPP model activities Running day center with the support of DMHP Starting of residential/long-term continuing care Center with financial support from DMHP Involvement in teaching activities Life skills education and counseling in schools College counseling services Workplace stress management Suicide prevention services. Conducting independent research in NMHP evaluation

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