National Mental health policy
Policies specify the standards that need to be applied across all programs and services, linking them all with a common vision, objectives and purpose. Without this overall coordination, programs and services are likely to inefficient and fragmented.
The first draft on National mental health policy (NMHP)) was prepared in late 2001 and came into existence in 2003. The NMHP is being energetically implemented with adequate budgetary support in the 10th five year plan.
The National Mental Health Policy outlines the prioritized agenda for extending within a pragmatic time-frame basic mental health care facilities to all sections of the population across the country by the year 2020
a) The District Mental Health Programme (DMHP), redesigned around a Nodal Institution which in most instances will be the Zonal Medical College.
b) Strengthening the Medical Colleges with a view to develop psychiatric manpower (HRD), improve psychiatric treatment facilities at the secondary level and to promote the development of general hospital psychiatry in order to reduce and eventually to eliminate to a large extent the need for big mental hospitals with a huge proportion of long-stay patients.
c) Streamlining and modernization of Mental Hospitals to transform them from the present mainly custodial mode to tertiary care centers of excellence with a dynamic social orientation for providing leadership to research and development (R&D) in the field of community mental health.
d) Strengthening of Central and State Mental Health Authorities in order that they may effectively fulfill their role of monitoring ongoing Mental Health Programmes, determining priorities at the ventral / state level and promoting intersectoral collaboration and linkages with other national programmes.
e) Research and training aimed at building up an extensive database of epidemiological information relating to mental disorders and their course / outcome, therapeutic needs of the community, development of better and more cost-effective intervention models, promotion of intersectoral research and providing the necessary inputs/ conceptual framework for health and policy planning.
f) Focused IEC activities, formulated with the active collaboration of professional agencies such as the National Institute Of Mass Communication and directed towards enhancing public awareness and eradicating the stigma/discrimination related to mental illness, will form an important component of this policy objective.
Subject to availability of resources the following time-frame is visualized for attainment in a phased manner the policy objectives outlined above.
10th Five year Plan (2002-2007)
· District Mental Health Programme (DMHP) will be extended to one district attached to each of the 100-Medical College in Country, thereby covering 100-Districts by the end of the plan period including the 27- districts where DMHP is alreadv in place, thus making a total of 100- districts across the Country.
· Strengthening of Medical Colleges with allocation of Rs.50.00 lakhs each to 100 Medical Colleges preferably located in backward areas for upgrading the departments of psychiatry with the airn of instituting post graduate training courses leading to MD (Psychiatry).
· Streamlining and modernization of Mental Hospitals with the aim of reduction in chronicity through intensive therapeutic intervention using non-conventional antipsychotic medications, promoting care of chronically mentally ill patients in the community using outreach maintenance modalities and reduction of load/rational downsizing to ensure quality mental health care to a manageable number of patients.
· Strengthening of Central and State Mental Health Authorities by facilitating the establishment of permanent secretariats and related machinery and networking of the state authorities with that at the national level to ensure effective coordination in all areas of activity.
· Research and training by sponsoring relevant community based research projects and building up an extensive database which will form the basis for development of intervention models and policy planning.
11 th Five year Plan (2007-2012)
· The district mental health programme will be extended to another 100-districts while consolidating the same in the 100-districts covered at the end of the 10th plan.
· Psychiatry Department of the remaining Medical Colleges will be upgraded and the infrastructure created during the previous plan will be reinforced.
· Based on the results of the disinvestments plan in CIP, Ranchi, the process will be extended to IOmore Mental Hospitals with the aim of/ construction modem buildings and providing state of the art equipment as well as adequate staff.
· The activities of the Central and State Mental Health Authorities will be augmented.
· Qualitative as well as quantitative improvements will be introduced in the areas of research, training and IEC, with more focused attention on epidemiological catchments area surveys on a larger scale.
12th Five year Plan (2012-2019)
· The district mental health programme will be extended to the remaining 161 -districts and the gains made in the previous plans will be consolidated, up gradation of the remaining 39-Medical College Psychiatry Departments will be undertaken and 20-Mental Hospitals will be taken up for
· Disinvestments / reconstruction.
· Non-viable mental hospitals will be closed down or merged with general hospitals to create general hospital psychiatry units (GHPUs).
· Central and State Mental Health Authorities will be further reinforced and technologically more sophisticated long-term research projects will be initiated in selected institutions while continuing support to community based research. IEC activities will be augmented to cover all sections of the population across the whole country.
· A comprehensive, holistic assessment and review of programme performance in the preceding two decades will be undertaken at the national and state levels bv an independent agency to identify achievements, areas of non or poor performance, remedial measures. current needs and future
· The National Mental Health Policy is aimed at doing \”the greatest good to the largest number\” through five interdependent and mutually synergistic strategies, to be implemented in a phased manner over the next two decades.