Five-year plans and once-in-a-decade interventions: Need to move from filling gaps to bridging chasms in mental health care in India

Murthy, Pratima; Isaac, Mohan

doi:10.4103/0019-5545.192010

Cited by 21 publications

(21 citation statements)

References 8 publications

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“…Moreover, there was a lukewarm response from the psychiatry community. [ 17 ] The program was further affected significantly in the absence of any inherent M and E system, which would ensure the accountability of the service providers. [ 11 13 18 19 ]…”

Section: Issues Facing the Nmhpmentioning

confidence: 99%

National Mental Health Programme-Optimism and Caution: A Narrative Review

Gupta¹,

Sagar²

2018

Indian Journal of Psychological Medicine

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India was one of the major World Health Organization (WHO) member countries to launch its National Mental Health Programme (NMHP) in 1982 in accordance with WHO's recommendations to deliver mental health services to the people under the framework of general health care system in the community. NMHP underwent major strategic revisions over its course, starting from setting a district as the unit for program planning and implementation under the District Mental Health Program (DMHP) to incorporating it with the National Rural Health Mission (NRHM) for effectively scaling up the program. The program also underwent evaluations by government bodies and independent agencies and was reviewed by many researchers. The program has been partly successful in terms of enhancing its reach to community, improving service delivery, and getting increased budgetary allocation, but at the same time, its impact was limited by financial and human resource constraints, lack of community participation, ineffective training, poor NGO/private partnership, and lack of a robust monitoring and evaluation (M and E) system. The latest National Mental Health Policy and the incorporation of its objectives have given a new impetus to the ongoing NMHP, however, its implementation needs to be monitored and the impact is yet to be evaluated. We attempted to review the available literature pertaining to NMHP and DMHP to highlight the determinants of its outcome, with special emphasis on on-going programs and to provide some important future directions.

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Section: Issues Facing the Nmhpmentioning

confidence: 99%

National Mental Health Programme-Optimism and Caution: A Narrative Review

Gupta¹,

Sagar²

2018

Indian Journal of Psychological Medicine

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“…Tragedies like Erwadi and a series of public interest litigations (PILs) that have been filed before the Supreme Court of India have been major drivers of change. [ 15 ] Some of the PILs have not only focused on institutional treatments but also focused on economic, social, and cultural rights of persons with mental illness. A series of reports from the National Human Rights Commission[ 16 17 ] highlights the gross deficiencies that existed in institutional care of persons with mental illness and also demonstrated the positive changes that could be brought about with persistent monitoring, collaboration, and proactive intervention – structural facilities and living conditions improved, budgets improved, voluntary admissions became more frequent than court admissions, there was greater community participation, and the need for rehabilitation of persons with mental illness received greater focus.…”

Section: Mental Health Care Reform In Indiamentioning

confidence: 99%

Mental health and the law: An overview and need to develop and strengthen the discipline of forensic psychiatry in India

Murthy

Malathesh

Kumar

et al. 2016

Indian J Psychiatry

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Human rights and mental health care of vulnerable population need supportive legislations and policies. Both “hard” and “soft” laws relevant to mental health care have been devised internationally and locally. Amendments in laws and the formulation of new laws are often required and have been seen to occur in the area of mental health care in India. So far, reform in mental health care has largely been reactive, but newer legislations and policies carry the hope of proactive reform. The lack of trained human resources is one of the biggest problems in effective mental health care delivery in India. While postgraduate psychiatric guidelines recommend a 2-week training in forensic psychiatry, this is insufficient to develop the necessary competence in the area. There is, thus, a need to develop subspecialty of forensic psychiatry. Forensic psychiatric services also need to be developed, properly structured, and supported. There is a need to set up one or more centers of excellence in forensic psychiatry in India.

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“…The National Human Right Commission (NHRC)-National Institute of Mental Health and Neurosciences (NIMHANS) report of 1999 urged to transform mental hospitals into postgraduate (PG) training institutes and relaxation to start a PG course in psychiatry. 6 In September 2015, World Health Organization (WHO) included mental health in sustainable development goals (SDGs). 7 SDG targets such as universal health coverage and access to safe, effective, quality, and affordable essential health services, including medicines, may not be achieved in some states of India, if data about the unequal distribution of psychiatry trainee seats are not evaluated and if this problem is not addressed adequately.…”

Section: Introductionmentioning

confidence: 99%

“…10 The "ideal" number of psychiatrists is 1 psychiatrist per 100,000 populations. 6,13 However, according to the WHO Global Health Observatory data for 2016, India has 0.292 psychiatrist, 0.796 psychiatric nurse, 0.065 psychiatric social workers, and 0.069 psychologist. 6,13 In 2019, Garg et al reported that India may have 0.75 psychiatrist per 100,000 populations against the "desired" number, that is, more than 3 psychiatrists per 100,000 populations.…”

Section: Introductionmentioning

confidence: 99%

“…6,13 However, according to the WHO Global Health Observatory data for 2016, India has 0.292 psychiatrist, 0.796 psychiatric nurse, 0.065 psychiatric social workers, and 0.069 psychologist. 6,13 In 2019, Garg et al reported that India may have 0.75 psychiatrist per 100,000 populations against the "desired" number, that is, more than 3 psychiatrists per 100,000 populations. 14 However, they asserted that these numbers are not dependable due to the absence of a reliable and unified system for monitoring the numbers of psychiatrists.…”

Section: Introductionmentioning

confidence: 99%

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Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

Ransing¹,

Agrawal

Bagul

et al. 2020

JNRP

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Background The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes (n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst (n = 9), poor (n = 8), fair (n = 9), average (n = 7), good (n = 1), and excellent (n = 2). Conclusion A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.

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Five-year plans and once-in-a-decade interventions: Need to move from filling gaps to bridging chasms in mental health care in India

Cited by 21 publications

References 8 publications

National Mental Health Programme-Optimism and Caution: A Narrative Review

National Mental Health Programme-Optimism and Caution: A Narrative Review

Mental health and the law: An overview and need to develop and strengthen the discipline of forensic psychiatry in India

Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

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