National Mental Health Programme Group I 19092019 1

National Mental Health Programme Group I – 19/09/2019 1

Burden of Mental Disorders • Mental disorders include: depression, bipolar affective disorder, schizophrenia and other psychosis, dementia, intellectual disabilities and developmental disorders. • Key findings of the National Mental Health Survey conducted by Ministry of Health and Family Welfare conducted a through NIMHANS, Bengaluru in 12 States. – Common mental disorders (CMDs), including depression, anxiety disorders and substance use disorders affect nearly 10. 6% of the population – 150 million people in India are in need of intervention for mental disorders. – 1 in 20 person in the country currently suffers from depression out of which 39% suffer from Severe Depression – 0. 9 % of the population at high risk of suicide – 3 out of 4 persons with mental disorders had disabilities affecting their work, family, education and other aspects of life. 2

Interventions in the area of Mental Health • The Mental Healthcare Act, 2017 • National Mental Health Programme Ø District Level Activities Ø Tertiary Level Activities • Digital Academy for Mental Healthcare 3

MENTAL HEALTHCARE ACT, 2017 • Mental Healthcare Act, 2017 came into force w. e. f. 29/05/2018 • In pursuance of the provisions of the Mental Healthcare Act, 2017, Rules under the Act were also framed by the Central Government • Provisions of the Act are however to be implemented primarily by the State Governments. • Priority actions required from the States Governments on : – establishment of State Mental Health Authorities – creation of State Mental Health Authorities Funds – establishment of Mental Health Review Boards – framing of Rules and Regulations 4

MAJOR ISSUES MENTAL HEALTHCARE ACT, 2017 • ISSUES – State Mental Health Authorities yet to be established in the 17 States/UTs, namely, A & N Islands, Arunachal Pradesh. Bihar, Chandigarh, Chhattisgarh, Dadra & Nagar Haveli, Daman & Diu, Delhi, Goa, Haryana, J & K, Lakshadweep, Madhya Pradesh, Meghalaya, Puducherry, Rajasthan, West Bengal. – States/UTs should inform about the action taken on implementation of other provisions of the Mental Healthcare Act, 2017. – Expeditious action needed on: • Establishment of Mental Health Review Boards for a district or group of districts • Creation of State Mental Health Authority Fund • Adoption of the Rules framed by the Central Government/framing of rules by the States/UTs under Section 121 of the Act. • Framing of Regulations by the State Mental Health Authorities under Section 123 of the Act. 5

National Mental Health Programme District Mental Health Program (DMHP) under NHM • Support provided to States/UTs for making provision of basic mental health services for early detection & treatment of mental illness at the District Hospital • support of up-to Rs. 83. 20 lakhs per district. • Till date a total of 655 districts have been covered under the District Mental Health Programme. Core Components of DMHP: • Human Resource Support – engagement of Psychiatrists, Clinical Psychologists, Psychiatric Social Workers, Medical Officer, Psychiatric and Community Nurse, Monitoring & Evaluation Officer, Case Registry Assistant and Ward Assistant • Training of Medical Officers, Community Health Workers, Nurses, Pharmacists of CHC and PHC for integration of mental healthcare in general health care, • Community awareness- Awareness generation to increase help seeking behaviour and address stigma and discrimination faced by mentally ill people. • Inter-sectoral linkages- with schools and colleges and Outreach clinics and camps 6

DISTRICT MENTAL HEALTH PROGRAMME: • ISSUES – DMHP approved for implementation in only 655 districts; need to cover remaining districts. – As per available information, only 535 districts are reported to be functional i. e. they have all required manpower in place, OPD are being held regularly, drugs in sufficient quantities are available and targeted interventions are being carried out by the DMHP team on regular basis. – States/UTs to ensure that all the districts supported under the programme are functional – States/UTs to ensure timely release of funds to the State Program Division – States/UTs with less than 50% operationalization –Bihar, J&K , Jharkhand West Bengal. 7

National Mental Health Programme Activities: - Tertiary Level Manpower Development Schemes • Establishment of Centre of Excellence (Scheme A) – 25 Institutes approved Financial support upto Rs. 36. 96 Cr for construction, technical & equipments, library and faculty salary to the existing Central and State Mental health Institutions for creation of PG Seats (Psychiatry: 4 seats; Clinical Psychology: 16 seats; Psychiatric Social Work: 16 seats; Psychiatric Nursing: 40 seats) – Total 76 PG seats/ Co. E Progress 0 % - 25% State Andhra Pradesh Delhi Goa Himachal Pradesh Telangana 25% - 50 % - 100 % More than 100 % West Bengal J&K Delhi Kerala Odisha West Bengal Institute Hospital for Mental Care, Vishakhapatnam IHBAS, Delhi Institute of Psychiatry and Human Behaviour, Bambolim Dr. Rajendra Prasad Govt. Medical College, Kangra, Tanda Institute of Mental Health, Hyderabad Kakatiya Medical College, Warangal Calcutta National Medical College Psychiatric Diseases Hospital, Govt. Medical College, Srinagar Dr. RML Hospital, Delhi (Central Govt. ) IMHANS, Kozikode SCB Medical College Hospital, Cuttack Institute of Psychiatry, Kolkata 8

• Strengthening/Establishment of Post Graduate Departments in mental health specialties (Scheme-B) - 47 PG Departments Financial support upto Rs. 2. 90 Cr is provided towards capital works and faculty support to the existing Central and State Mental health Institutions for strengthening/establishment of one or more of the Post Graduate Departments in mental health specialties for creation of PG Seats (Psychiatry: 2 seats; Clinical Psychology: 8 seats; Psychiatric Social Work: 8 seats; Psychiatric Nursing: 20 seats) Progress 0 % - 25% - 50 % - 100 % More than 100 % State Himachal Pradesh J&K Kerala Delhi Jharkhand Tamil Nadu Institute Indira Gandhi Medical College & Hospital, Shimla Sher-i-Kashmir Institute of Medical Sciences, Srinagar Govt. medical College, Trivandrum Dr. RML Hospital, Delhi (Central Govt. ) Ranchi Institute of Mental Health & Neuro Sciences, Ranchi Institute of Mental Health, Chennai 9

TERTIARY LEVEL ACTIVITES UNDER NATIONAL MENTAL HEALTH PROGRAMME: • ISSUES – The Institutes already supported under the Programme are to be made fully operational by March, 2020. – PG courses under each mental health specialty to be conducted/ initiated with the required number of seats – The physical & financial progress under Manpower Development Schemes A & B of National Mental Health Program should be monitored on regular basis. – Utilization certificates, progress report, etc. in respect of the Institutions supported should be furnished to the Ministry of Health and Family Welfare urgently. – As per approval for continuation of the Scheme upto 2020, for the projects to be implemented by States/UTs, first instalment of the approved Central share will be released as an advance to the State/UTs. The remaining funds, are to be released on reimbursement basis after submission of the Utilization Certificates for the funds already released. – Release of funds to the Institutes supported under Manpower Development Schemes would henceforth be on reimbursement basis 10

Digital Academy • • There is a shortage of mental health professional i. e. psychiatrist, psychiatry social worker or psychologist in the country. In order to augment the existing mental healthcare manpower in the country, the Government through NIMHANS, Bangalore, CIP, Ranchi and LGBRIMH, Tezpur, Assam has established a Digital Academy. Through this method of Blended digital learning, NIMHANS, LGBRIMH & CIP are conducting large scale training for service providers Status of trained professionals under the Digital Academy Candidates Enrolled Professionals Total NIMHANS LGBRIMH CIP Medical Officers/ Doctors 1644 21 120 1785 Psychologists 864 56 18 938 Social Workers 633 29 6 668 Nurses 606 38 18 662 Total 3747 144 162 4053 State Governments to encourage their Doctors, Psychologists, Social Workers and Nurses to enroll themselves for courses on mental health in the Digital Academy 11

THANK YOU 12

Seats created in Institutes supported under Scheme-A (Centres of Excellence) S. No. State Name of the Institute Year of initiation PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Psychiatri Social Work c Nursing 1 Andhra Pradesh Hospital for Mental Care, Vishakhapatnam 2017 -18 0 0 0 2 Delhi (Central Govt. ) Dr. RML Hospital, Delhi 2016 -17 8 12 10 20 50 3 Delhi IHBAS, Delhi 2010 -11 0 0 0 4 Goa Institute of Psychiatry and Human Behaviour, Bambolim 2015 -16 8 0 0 0 8 5 Himachal Pradesh Dr. Rajendra Prasad Govt. Medical College, Kangra, Tanda 2016 -17 0 0 0 J&K Psychiatric Diseases Hospital, Govt. Medical College, Srinagar 2009 -10 21 8 0 0 13 29 6

S. No. State Name of the Institute Year of initiation PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Psychiatri Social Work c Nursing 7 Kerala IMHANS, Kozikode 2010 -11 2 24 48 40 114 8 Odisha SCB Medical College Hospital, Cuttack 2010 -11 27 56 24 120 227 9 Telangana Institute of Mental Health, Hyderabad 2009 -10 0 0 10 Telangana Kakatiya Medical College, Warangal 2017 -18 0 0 0 11 West Bengal Institute of Psychiatry, Kolkata 2009 -10 18 72 144 140 374 12 West Bengal Calcutta National Medical College 2017 -18 6 0 0 0 14 6

Seats created in Institutes supported under Scheme-B (PG Departments) S. No. State Name of the Institute PG seats created/enhanced since implementation of the Scheme in the institute Total Psychiatry Clinical Psychology Psychiatric Social Work Psychiatric Nursing 1 Delhi (Central Govt. ) Dr. RML Hospital, Delhi (3 PG Departments in 2009 -10) - 32 18 60 110 2 Himachal Pradesh Indira Gandhi Medical College & Hospital, Shimla (2 PG Departments in 2017 -18) - 0 0 - 0 3 Jammu and Kashmir Sher-i-Kashmir Institute of Medical Sciences, Srinagar, (4 PG Departments in 2015 -16) 0 0 0 Jharkhand Ranchi Institute of Mental Health & Neuro Sciences, Ranchi (4 PG Departmetns in 2009 -10) 10 138 96 382 Kerala Govt. medical College, Trivandrum (4 PG Departments in 2010 -11) 24 0 0 0 24 - 32 - 4 4 5 6 Tamil Nadu Institute of Mental Health, Chennai 15 36

District Mental Health Programme S. No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Name of State Andhra Pradesh Bihar Chhattisgarh DNH Delhi Goa Himachal Pradesh Jammu & Kashmir Jharkhand Kerala Lakshadweep Meghalaya Nagaland Odisha Puducherry Sikkim Tamilnadu Telangana Tripura West Bengal Total Districts approved under DMHP 13 38 27 1 11 2 12 22 24 14 1 11 11 30 2 4 32 33 8 28 13 31 27 1 5 2 12 22 12 14 1 11 11 30 2 4 32 20 8 28 DMHP Functional %age of districts operational among approved 13 13 27 1 5 2 12 4 5 14 1 5 26 2 4 32 20 8 11 100 41. 93 100 100 100 33. 33 20. 83 100 100 86. 66 100 100 100 39. 28