National Mental Health Programme (NMHP)

 

National Mental Health Programme

 

Introduction 

Mental health issues are incredibly common across the world, affecting people from all walks of life. Many adults experience symptoms like anxiety, fatigue, or sleeplessness at some point, and one in seven individuals will face a diagnosable mental health disorder in their lifetime.

 

Burden of Disease 

In 1993, a World Bank report revealed that mental health disorders cause a greater loss of healthy life years than diseases like diarrhea, malaria, worm infestations, and tuberculosis when considered individually. By 2020, mental health conditions were estimated to account for 15% of the global burden of disease.

In India, epidemiological studies over the past 20 years show that psychiatric disorders are as common here as they are globally. The prevalence of these disorders ranges between 18 to 207 per 1,000 people, with a median of 65.4 per 1,000. At any given time, 2-3% of the population is dealing with serious, debilitating mental health conditions or epilepsy. Unfortunately, most of these individuals live in rural areas with limited access to mental health care. Furthermore, a significant percentage of adults visiting general outpatient departments are diagnosed with mental health issues, but many cases go undetected because health care providers often fail to ask about mental health symptoms, leading to unnecessary tests and treatments.

 

The National Mental Health Programme 

Recognizing the significant mental health burden and the lack of adequate services, the Government of India launched the National Mental Health Programme (NMHP) in 1982.

The programme focuses on three key areas:

1. Treatment for people with mental illnesses

2. Rehabilitation for those affected

3. Prevention and promotion of positive mental health

 

Aims 

The NMHP aims to:

• Prevent and treat mental and neurological disorders along with their associated disabilities.
• Integrate mental health care into general health services through the use of mental health technology.
• Apply mental health principles to national development, enhancing the quality of life for all.

 

Objectives 

The main objectives of the NMHP are:

• Ensure that basic mental health care services are available and accessible to all, especially to vulnerable and underserved populations.
• Promote the use of mental health knowledge in general health care and community development.
• Encourage community participation in the development of mental health services, fostering self-help initiatives.

 

Strategies 

To achieve these goals, the programme follows several key strategies:

• Integrating mental health care into primary health care through the NMHP.
• Establishing tertiary care facilities for treating mental disorders.
• Addressing the stigma surrounding mental illness and safeguarding the rights of people with mental health conditions through institutions like the Central Mental Health Authority and State Mental Health Authorities.

 

Mental Health Care 

Mental health treatment is prioritized across various levels of the health care system, including:

1. Village and sub-center primary care
2. Primary Health Centers (PHC)
3. District hospitals
4. Mental hospitals and psychiatric teaching units

 

District Mental Health Programme 

This programme focuses on mental health care at the district level with the following components:

• Training all mental health team members at designated Nodal Institutes in each state.
• Raising public awareness and reducing stigma through education campaigns.
• Providing early diagnosis and treatment through outpatient and inpatient services.
• Collecting data and insights from the community to help improve future planning, services, and research.

 

Support and Funding 

International agencies like the World Bank and WHO have been engaged to support different aspects of the programme. The Government of India provides funding to state governments and nodal institutes for the first five years, covering staff salaries, equipment, vehicles, medicines, and training. After five years, these institutions are expected to become self-sustaining. The Central Mental Health Authority, established by the government, monitors the implementation of the Mental Health Act of 1986. State Mental Health Authorities have also been set up to oversee similar functions at the local level.

 

Monitoring and Oversight 

The National Human Rights Commission, alongside the Government of India, monitors mental hospitals to ensure quality care and compliance with recommendations from joint studies.