PPt NMHP.pptx on national mental health programme

nhmp

1. Presenter: Dr Vidya Guide: Dr Dinesh Rajaram National Mental Health Policy and Programme 06-May-12 1

2. Acknowledgement Dr Karoor Joint Director , Mental health Directorate office, Anand Rao circle, Bengaluru Dr Sundar Nag Assistant professor, Psychiatry department, MSRMC Dr Nandakumar & Dr Arvind Community Medicine Department, MSRMC 06-May-12 2

3. Contents Introduction History of mental health care in India International classification of mental disorders Burden of mental disorders National mental health policy 06-May-12 3

4. Contents….contd National mental health programme Aims/Objectives/Strategies Organizational framework Current status of the programme SWOT analysis Conclusion References 06-May-12 4

5. Introduction Mental health: “state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” 08-May-12 5

6. Introduction….contd Mental disorders : “ clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., painful symptoms) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or loss of freedom” 08-May-12 6

7. History of mental health care in India In Ayurveda… Bhoot vidhya Gautham Buddhas and Mahavir …due to immoral thought processes The great emperor Asoka….built mental hospital where humane treatment was practised Advancement of christianity …..cleaning of mind and body by prayers 08-May-12 7

8. History…….contd Until independence ..approach was custodial rather than therapeutic Policies relating to primary health care National mental health programme was launched in 1982 08-May-12 8

9. International classification of mental disorders 08-May-12 9

10. ICD…contd 08-May-12 10

11. ICD…..contd 08-May-12 11

12. Burden of disease Global burden : Worldwide as many as 450 million people suffer from a mental or behavioral disorder Four of the six leading causes of years lived with disability are due to neuropsychiatric disorders One in four families has at least one member with a mental disorder 08-May-12 12

13. Burden of disease….contd Burden on family difficult to assess and quantify, and is consequently often ignored DALY’s: DALYs loss due to psychiatric disorders is 11.5% Expected to constitute 15% of the global burden of disease by 2020 08-May-12 13

14. Burden of disease in India Prevalence range from 18 to 207 per 1000population 1% of the population suffers from serious mental disorders 10-15% of the population suffers from minor mental disorders 9% depression, 6% occasional drinkers, 2% addicted to alcohol, 08-May-12 14

15. National mental health policy 08-May-12 15

16. Mental health policy…National health policy NHP – 2002 envisages a network of decentralized mental health services for ameliorating the more common categories of disorders. the policy envisages the upgrading of the physical infrastructure of institutions at Central Government expense so as to secure the human rights of this vulnerable segment of society. 08-May-12 16

17. Need for mental health policy 08-May-12 17 There is a need for, increase in budgetary allocations for mental health. increase the number of mental health services available. inclusion of psychosocial services for improvement in the range and quality of available mental health services Immediate need to improve the conditions of state-run mental hospitals

18. 08-May-12 18 constitute ethical guidelines for best practices in mental health including ECT use shift from a hospital-based model to a community-based model pay attention to and devise strategies for addressing common mental disorders highlight and implement preventive and promotive strategies

19. 08-May-12 19 Need for, Alternative paradigms in mental health need to be explored, researched and utilized for effective service provision ensure equal opportunities for mentally disabled persons in areas of welfare and livelihood pay special attention to advocacy and rights-based agenda in mental health

20. National mental health programme Aims: Prevention and treatment of mental and 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 to improve quality of life. 08-May-12 20

21. Objectives To ensure availability and accessibility of minimum mental health care for all To encourage application of mental health knowledge in general health care and in social development To promote community participation 08-May-12 21

22. Strategies Integrating mental health with primary health care Provision of tertiary care institutions for treatment of mental disorders Eradicating stigmatization 08-May-12 22

23. District mental health program Objectives To provide sustainable basic mental health services to the community Early detection and treatment To see that the patients and their relatives do not have to travel long 08-May-12 23

24. Objectives…..contd To take pressure of mental hospital To reduce the stigma To treat and rehabilitate mental patients To detect, manage and suitably refer cases of epilepsy 08-May-12 24

25. Components Expansion of the DMHP to districts all over the country with some modifications Improving the health manpower Availability of outsourced vehicle for mobility of the DMHP team Availability of all the essential drugs in every primary health centre 08-May-12 25

26. 08-May-12 26 The district hospital will have higher drugs like olanzepine , Lithium carbonate and carbamazpine IEC activities in the entire district Health promotion using life skills approach Training program for medical officers and paramedical staff Monitoring, support and supervision

27. 08-May-12 27 Support money for implementing of mental health act and running mental health authorities School mental health programs to be implemented by imparting life skills education Non-governmental agencies have an important role to play

28. Organizational framework 08-May-12 28

29. Current status of the program 08-May-12 29 Progressing very slowly

30. Barriers in implementation of DMHP 08-May-12 30 Administrative barriers Lack of manpower resources Motivational barrier

31. 08-May-12 31 School mental health program : Life skill education Community mental health program Involves community participation through community workers

32. Strengths 08-May-12 32 Existence of the program The program officer is a psychiatrist in many of the DMHP states Decentralization

33. Weaknesses 08-May-12 33 Shortage of man power implemented only in few districts PHCs are providing referral to patients rather than handling their problem then and there only. Guidelines are not clear Equal distribution of money for all districts

34. Opportunities 08-May-12 34 Community mental health program School mental health program

35. Threats 08-May-12 35 The program is not included in National rural health mission The logical connectivity of policy to program to legislation seems to have been ignored no system for annual reporting of mental health data Various misconceptions among young medical professionals. Barriers in implementation of DMHP

36. NGOs….in the field of mental health 08-May-12 36 Child mental health Samadhan Bharti, Newdehli Sangath, Goa The research society , Mumbai Antarnad, Ahmedabad Women’s mental health IFSHA (Intervention for support healing and awareness) Bapu trust, Pune

37. NGOs...in the field of mental health 08-May-12 37 Severe mental disorders SCARF (Schizophrenia Research Foundation ) Chennai Medico-Pastoral Association , Bangalore Richmond Fellowship Society, Bangalore Paripurnata , Calcutta Ashagram Madhya Pradesh Suicide prevention Sneha, Chennai Prerna, Mumbai Substance abuse TTK, Chennai NARC, Mumbai ( National Addiction Research Centre ) Carers of the mentally ill AMEND, Bangalore ARDSI, Cochin ( Alzheimer's and related disorders society of India)

38. Conclusion 08-May-12 38 Mental health care program in India is progressing very slowly. The targets set for the program are not achieved till today even after being operational for more than a decade. This indicates that there is poor commitment of the government, political bodies, psychiatrists, and community at large.

39. References 08-May-12 39 Kishore J. National Health Programs of India. 9 th ed. Century publications. New Dehli.2011. Mental Health .Available from URL; http://www.who.int/mental_health/en/investing_in_mnh_final.pdf .Accessed on 21 st April 2012 Mental health. Available from URL; http://www.cdc.gov/mentalhealth/ . Accessed on 21 st April 2012

40. 08-May-12 40 National mental health programme .Available from URL; MHP. http://www.nihfw.org/NDC/DocumentationServices/NationalHealthProgramme/NATIONALMENTALHEALTHPROGRAMME.html Accessed on 20th April 2012 What is mental health .Available from URL; http://www.who.int/features/qa/62/en/index.html Accessed on 27th April 2012.

41. 08-May-12 41 Definitions: Emergencies. Available from URL; http://www.who.int/hac/about/definitions/en/ Accessed on 26 th April 2012. Mental health atlas. Available from URL; http://whqlibdoc.who.int/publications/2011/9799241564359_eng.pdf Accessed on 28th April 2012

42. 08-May-12 42 Drug de addiction programmes in India. Available from URL; http://www.whoindia.org/LinkFiles/Mental_Health_&_substance_Abuse_Drug_De-Addiction_Programmes_in_India-Manual_for_Nursing_Personnel.pdf . Accessed on 30th April 2012. Gangolli VL, Duggal R, Shukla A. Review of health care in India. Centre for Enquiry into Health and Allied Themes. Mumbai. 2005 Park K. Textbook of Preventive and Social Medicine.21st ed. Jabalpur India: Banarsidas Bhanot ; 2011

43. 08-May-12 43 Thank you

44. 08-May-12 44