Founding and managing a mental health establishment under the Mental Healthcare Act 2017

Gowda, Mahesh; Das, Keya; Gowda, Guru S; Karthik, K N; Srinivasa, Preethi; Muthalayapapa, Chandrashekhar

doi:10.4103/psychiatry.indianjpsychiatry_147_19

Cited by 5 publications

(2 citation statements)

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“…The current study showed that the private sector was a major service provider for mental health services with a larger share for outpatient than inpatient care. Since inpatient care requires greater investment in infrastructure, human resources, clinical management and legal aspect than outpatient care, the private sector invest less in inpatient care than outpatient care [ 24 ]. After the Mental Healthcare Act 2017, mental health establishment comes with new legal and healthcare aspects unlike other health conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Recent report of National Human Rights Commission (NHRC), India states deplorable conditions of all 46 Government Mental Healthcare Institutions in the country [ 36 ]. Even with an abysmal psychiatrist – population ratio, 75% of the psychiatrists in India work under the private sector to provide inpatient and outpatient services [ 24 , 37 ]. In the last few decades’ non-governmental organization like Sangath Society, Goa, Schizophrenia Research Foundation, Chennai, and Medico-Pastoral Association, Bangalore, have contributed meaningfully to address mental health needs of the country [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

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Progress towards universal health coverage in the context of mental disorders in India: evidence from national sample survey data

Ranjan,

Crasta

2023

Int J Ment Health Syst

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Background Universal health coverage (UHC) has emerged as one of the important health policy discourses under the current sustainable development goals in the world. UHC in individual disease conditions is a must for attaining overall UHC. This study measures progress towards UHC in terms of access to health care and financial protection among individuals with mental disorders in India. Methods Data from the 75th Round National Sample Survey (NSS), 2017-18, was used, which is the latest round on health in India. Data collected from 555,115 individuals (rural: 325,232; urban: 229,232), from randomly selected 8077 villages and 6181 urban areas, included 283 outpatient and 374 hospitalization cases due to mental disorders in India. Logistic regression models were used for analyses. Results Self-reporting of mental disorders was considerably lower than the actual disease burden in India. However, self-reporting of ailment was 1.73 times higher (95% CI: 1.18–2.52, p < 0.05) among the richest income group population compared to the poorest in India. The private sector was a major service provider of mental health services with a larger share for outpatient (66.1%) than inpatient care (59.2%). Over 63% of individuals with a mental disorder who reported private sector hospitalization noted unavailability or poor service quality at public facilities. Only 23% of individuals hospitalized had health insurance coverage at All India level. However, health insurance coverage among poorest economic class was a meagre 3.4%. Average out-of-pocket expenditure during hospitalization (public: 123 USD; private: 576 USD) and outpatient care (public: 8 USD; private: 37 USD) was significantly higher in the private sector than in the public sector. Chances of facing catastrophic health expenditure at 10% threshold were 23.33 times (95% CI: 10.85–50.17; p < 0.001) higher under private sector than public sector during hospitalization. Expenditure on medicine, as the share of total medical expenditure, was highest for hospitalization (public: 45%, private:39.5%) and outpatient care (public: 74.1%, private:39.7%). Conclusions Social determinants play a vital role in access to healthcare and financial protection among individuals with mental disorders in India. For achieving UHC in mental disorders, India needs to address the gaps in access and financial protection for individuals with mental disorders. Trial registration Not applicable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%