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MR. JAYESH PATIDAR
CONCEPT…

• According to WHO, “Mental Health Policies
  describe the values, objectives & strategies
  of the Government to reduce the Mental
  Health burden & to improve mental health.
• They define a vision for helps the future that
  helps to establish a blueprint for the
  prevention & treatment of mental illness, the
  rehabilitation of people with mental
  disorders, & the promotion of mental health
  in the community.
                                2
Count…
• The first draft of National Mental Health
  Policy (NMHP) was prepared in late 2001 &
  came into existence in 2003.
• The NMHP will provide the necessary
  conceptual framework for achieving goals.
• The NMHP is being energetically
  implemented, with adequate budgetary
  support in the 10th five year plan.


                             3
POLICY OBJECTIVES…
1. The District Mental Health Program
   (DMHP) is redesigned around a nodal
   institution, where most instances will
   be the zonal medical college. School
   mental health programs & dementia
   care services may be gradually
   integrated with the DMHP.



                               4
Count…

2. Strengthening the medical college
   psychiatry departments with a view to
   develop psychiatric manpower, improve
   psychiatric treatment facilities at secondary
   level & to promote the development of
   general psychiatric hospitals in order to
   reduce & eventually to eliminate, to a large
   extent the need for big mental hospitals
   with all their attendant infirmities.

                                5
Count…

3. Streamlining & modernization of
   mental hospitals to transform them
   from the present, mainly custodial
   mode to tertiary care centers to
   excellence with a dynamic social
   orientation for providing leadership to
   Research & Development (R & D) in
   the field of community mental health.


                                6
Count…

4. Strengthening of Central & State
   Mental Health Authorities in order that
   they may effectively fulfill their role of
   monitoring ongoing mental health
   programs, determining priorities at the
   central / state level & promoting
   intersectoral collaboration & linkages
   with other national programs.


                                  7
Count…

5. Research & training aimed at building up
   an extensive database of epidemiological
   information relating to mental disorders &
   their course / outcome, development of
   better & more cost effective intervention
   models, promotion of intersectoral
   research & providing the necessary
   inputs/conceptual framework for health &
   policy planning.

                               8
Count…

6. Focused Information Education &
   Communication (IEC) activities with the
   active collaboration of professional
   agencies such as the Indian Institute of
   Mass Communication & directed towards
   enhancing public awareness & eradicating
   the stigma / discrimination related to
   mental illness, will form an important
   component of this policy objective.

                             9
PRIORITIZED GOALS
TENTH FIVE YEAR PLAN (2002-2007):
• District mental health program will be
  extended to one district attached to each of
  the 100 medical colleges in the country,
  thereby covering 100 district in the first
  phase, & there after expanding to 100
  district more in the second phase, thus
  making a total of 200 districts across the
  country.

                               10
Count…
• Strengthening of medical colleges with
  allocation of Rs. 50 lakhs each to 100 medical
  colleges, for upgrading departments of
  psychiatry.
• Strengthening & modernization of mental
  hospitals with the aim of reduction in chronicity
  through intensive therapeutic intervention using
  non-conventional anti-psychotic medication,
  promoting care of chronically mentally ill patient
  in the community using outreach maintenance
  modalities.
                                 11
Count…
ELEVENTH FIVE YEAR PLAN (2007-2012)
• The DMHP will be extended to another lot of
  200 district while consolidating same in 200
  district covered at the end of 10th plan.
• Qualitative as well as quantitative
  improvement will be introduced in the areas
  of research, training & IEC, with more
  focused attention on epidemiological
  catchment area surveys on a larger scale.

                              12
Count…

TWELTH FIVE YEAR PLAN (2012-2017):
• The DMHP will be extended to the remaining
  193 districts & the gains made in the previous
  plans will be consolidated, further upgradation
  of the psychiatric departments in medical
  colleges will be undertaken & 20 mental
  hospitals will be reconstructed.
• IEC activities will be augmented to cover all
  sections of the population across the whole
  country.
                                13
SPECIAL ISSUES
• Senior citizens suffering from severely
  disabling disease such as Alzheimer’s & other
  types of dementia, Parkinson’s disease,
  depression of late onset & other psycho
  geriatric disorders.
• Victims of child sexual abuse, marital /
  domestic violence, dowry related ill treatment,
  rape & incest.
• Victims of poverty, destitution & abandonment, such
  as women thrown out of the marital home or old &
  infirm parents left to fend for themselves.
                                   14
Count…
• Children & adolescents affected by problems
  of maladjustments or other scholastic
  problems, depression/psychosis of early
  onset, attention deficit hyper activity disorders
  & suicidal behavior resulting from failure in
  examination or other environmental stressors.
• Victims of natural or man-made disasters
  such as cyclones, war, terrorism with special
  attention to the specific needs of children
  orphaned by such disasters.
                                 15
• NHP was formulated in 1983 & revised in 2002
Objectives:
The main objective of NHP-2002 is to achieve an
 acceptable standard of good health amongst
 the general population in the country. The
 approach would be to increase access to the
 decentralized public health system by
 establishing new infrastructure deficient areas &
 by upgrading the infrastructure in the existing
 institutions.
                               16
Special Recommendation with
Regard to Mental Health:
• Upgrading infrastructure of institutions at
  Central Government expense so as to
  secure the human rights of this vulnerable
  segment of society.
• Envisages a network of decentralized
  mental health services for ameliorating the
  more common categories of disorders.



                               17
Special discussion regarding mental
health…
• Mental health disorders are actually much
  more prevalent than is apparent on the
  surface. While such disorders do not
  contribute significantly to mortality, they have
  a serious bearing on the quality of life of the
  affected persons & their families.
• Mental health institutions are woefully
  deficient in physical infrastructure & trained
  manpower. NHP-2002 will address itself to
  these deficiencies in the public health sector.
                                 18
19

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National mental health polic vis à-vis national health policy

  • 2. CONCEPT… • According to WHO, “Mental Health Policies describe the values, objectives & strategies of the Government to reduce the Mental Health burden & to improve mental health. • They define a vision for helps the future that helps to establish a blueprint for the prevention & treatment of mental illness, the rehabilitation of people with mental disorders, & the promotion of mental health in the community. 2
  • 3. Count… • The first draft of National Mental Health Policy (NMHP) was prepared in late 2001 & came into existence in 2003. • The NMHP will provide the necessary conceptual framework for achieving goals. • The NMHP is being energetically implemented, with adequate budgetary support in the 10th five year plan. 3
  • 4. POLICY OBJECTIVES… 1. The District Mental Health Program (DMHP) is redesigned around a nodal institution, where most instances will be the zonal medical college. School mental health programs & dementia care services may be gradually integrated with the DMHP. 4
  • 5. Count… 2. Strengthening the medical college psychiatry departments with a view to develop psychiatric manpower, improve psychiatric treatment facilities at secondary level & to promote the development of general psychiatric hospitals in order to reduce & eventually to eliminate, to a large extent the need for big mental hospitals with all their attendant infirmities. 5
  • 6. Count… 3. Streamlining & modernization of mental hospitals to transform them from the present, mainly custodial mode to tertiary care centers to excellence with a dynamic social orientation for providing leadership to Research & Development (R & D) in the field of community mental health. 6
  • 7. Count… 4. Strengthening of Central & State Mental Health Authorities in order that they may effectively fulfill their role of monitoring ongoing mental health programs, determining priorities at the central / state level & promoting intersectoral collaboration & linkages with other national programs. 7
  • 8. Count… 5. Research & training aimed at building up an extensive database of epidemiological information relating to mental disorders & their course / outcome, development of better & more cost effective intervention models, promotion of intersectoral research & providing the necessary inputs/conceptual framework for health & policy planning. 8
  • 9. Count… 6. Focused Information Education & Communication (IEC) activities with the active collaboration of professional agencies such as the Indian Institute of Mass Communication & directed towards enhancing public awareness & eradicating the stigma / discrimination related to mental illness, will form an important component of this policy objective. 9
  • 10. PRIORITIZED GOALS TENTH FIVE YEAR PLAN (2002-2007): • District mental health program will be extended to one district attached to each of the 100 medical colleges in the country, thereby covering 100 district in the first phase, & there after expanding to 100 district more in the second phase, thus making a total of 200 districts across the country. 10
  • 11. Count… • Strengthening of medical colleges with allocation of Rs. 50 lakhs each to 100 medical colleges, for upgrading departments of psychiatry. • Strengthening & modernization of mental hospitals with the aim of reduction in chronicity through intensive therapeutic intervention using non-conventional anti-psychotic medication, promoting care of chronically mentally ill patient in the community using outreach maintenance modalities. 11
  • 12. Count… ELEVENTH FIVE YEAR PLAN (2007-2012) • The DMHP will be extended to another lot of 200 district while consolidating same in 200 district covered at the end of 10th plan. • Qualitative as well as quantitative improvement will be introduced in the areas of research, training & IEC, with more focused attention on epidemiological catchment area surveys on a larger scale. 12
  • 13. Count… TWELTH FIVE YEAR PLAN (2012-2017): • The DMHP will be extended to the remaining 193 districts & the gains made in the previous plans will be consolidated, further upgradation of the psychiatric departments in medical colleges will be undertaken & 20 mental hospitals will be reconstructed. • IEC activities will be augmented to cover all sections of the population across the whole country. 13
  • 14. SPECIAL ISSUES • Senior citizens suffering from severely disabling disease such as Alzheimer’s & other types of dementia, Parkinson’s disease, depression of late onset & other psycho geriatric disorders. • Victims of child sexual abuse, marital / domestic violence, dowry related ill treatment, rape & incest. • Victims of poverty, destitution & abandonment, such as women thrown out of the marital home or old & infirm parents left to fend for themselves. 14
  • 15. Count… • Children & adolescents affected by problems of maladjustments or other scholastic problems, depression/psychosis of early onset, attention deficit hyper activity disorders & suicidal behavior resulting from failure in examination or other environmental stressors. • Victims of natural or man-made disasters such as cyclones, war, terrorism with special attention to the specific needs of children orphaned by such disasters. 15
  • 16. • NHP was formulated in 1983 & revised in 2002 Objectives: The main objective of NHP-2002 is to achieve an acceptable standard of good health amongst the general population in the country. The approach would be to increase access to the decentralized public health system by establishing new infrastructure deficient areas & by upgrading the infrastructure in the existing institutions. 16
  • 17. Special Recommendation with Regard to Mental Health: • Upgrading infrastructure of institutions at Central Government expense so as to secure the human rights of this vulnerable segment of society. • Envisages a network of decentralized mental health services for ameliorating the more common categories of disorders. 17
  • 18. Special discussion regarding mental health… • Mental health disorders are actually much more prevalent than is apparent on the surface. While such disorders do not contribute significantly to mortality, they have a serious bearing on the quality of life of the affected persons & their families. • Mental health institutions are woefully deficient in physical infrastructure & trained manpower. NHP-2002 will address itself to these deficiencies in the public health sector. 18
  • 19. 19