Implementing National Mental Health Program: Local leaders’ perspectives and lessons for national action

Kalaivanan, Rakesh Chander; Basavaraju, Vinay; Sadh, Kamaldeep; Patley, Rahul; Nagabhushana, Shashidhara Harihara; Manjunatha, Narayana; Kumar, Channaveerachari Naveen; Math, Suresh Bada

doi:10.1016/j.ajp.2020.102233

Cited by 1 publication

(3 citation statements)

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“…Recording the partial successful journey for posterity is valuable because of the formulation of many mental health developments in India in the last decade. [17][18][19] In India, the revision of the national health policy in the year 2014, implementation of DMHP District Level Guidelines in the year 2015, national mental health survey in the years 2015-16, new mental health care act in the year 2017, were important milestones in the progression of district mental health programme. [2][3][4][5] In the last three decades, this programme has followed different planned revisions.…”

Section: Discussionmentioning

confidence: 99%

“…The new planning strategy to involve this programme with National Health Mission was the game-changer in the partial success of this national programme. [17][18][19] But the approach of the hierarchy of implementation of this innovative programme is the same from top ministry to bottom district administration for the last 38 years. This programme originated from the community mental health initiatives of two centers Bengaluru and Chandigarh centers.…”

Section: Discussionmentioning

confidence: 99%

“…But certain lacunae in budgetary and human resources, poor grass root level workers involvement and community participation, inadequate training and monitoring, and evaluation are important hindrances in the smooth growth of this programme. [17][18][19] There is now a need for reforms in this DMHP programme on the ground through an infusion of fresh momentum of research inputs, investments, and funds which currently stands at 0.05 percent of the total budget allocated to health annually. Not just the finances, there is also a need for more dedicated trained professionals collaborating with the psychiatry department of medical colleges on the ground, and the availability of feasible mental health care treatment protocols.…”

Section: Discussionmentioning

confidence: 99%

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Comparative Profile of Patients Utilizing District Mental Health Programme (DMHP) and Tertiary Care Teaching Hospital Services: Study from North India

Singh¹,

Sidana²,

Lobana³

2022

TJIMA

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Background: This study reports on the profile of patients seeking services at DMHP setting versus tertiary care institution in north India. The objective was to determine the pattern of psychiatric morbidity among patients utilizing DMHP services in north India and to compare it with the diagnostic profile of psychiatric outpatients seeking treatment from a tertiary health care hospital. Methods: This study was conducted in DMHP setting in a rural and health training center (RHTC), situated in sector 56, Chandigarh. The design was a prospective chart analysis of the recorded data in patients' files and registers. Case record files of new patients registered in the DMHP center and psychiatry outpatients of a tertiary care hospital from January 2016 to December, 2017 were recorded and evaluated in detail. The psychiatric diagnoses were made as per ICD-10 criteria. Results: A total 784 patients at DMHP and 12,388 patients at tertiary care teaching hospital were registered. There was a highly significant difference in the diagnostic profile of patients on the comparison between patients seeking treatment from two different settings (P <0.0001). At the DMHP setting, the majority of patients (64.66%) seeking treatment were diagnosed in the category of mental and behavioral disorders due to psychoactive substance use(F10-19) and were followed by patients (17.21%) with category of mood (affective disorders(F30-39). In psychiatry OPD of tertiary care institution, the majority of patients were diagnosed as neurotic, stress-related, and somatoform disorders followed by mood disorders and difference in diagnostic break-up between two settings was highly significant (P<0.0001). Conclusions: It can be concluded from the study that clinical services at DMHP center at the rural and training center, Chandigarh level attract more number of patients with psychoactive substance use disorders than tertiary care center-based clinical services.

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