National Mental Health Survey of India, 2015-16: Mental Health Systems

FOCUS

This is the last of a tripartite report by the National Institute of Mental Health and Neuro Sciences, Bengaluru, in alliance with 15 institutions from across India. It was commissioned by the Ministry of Health and Family Welfare, government of India. It covers 12 Indian states, (and 34,802 individuals) and aims to be a nationally representative survey on mental health issues. Females comprised 52.3 per cent of all respondents in the survey.

These were the 12 states covered: Punjab and Uttar Pradesh (north), Tamil Nadu and Kerala (south), Jharkhand and West Bengal (east), Rajasthan and Gujarat (west), Madhya Pradesh and Chhattisgarh (central India), and Assam and Manipur (north-east).

The report says that nearly 15 per cent of adults in India require treatment for one or more mental health disorders. Yet, most state governments allocate less than 1 per cent of their budget to mental health.

The survey examines the prevalence and patterns of mental health problems in India, their impact on individuals, gaps in mental healthcare, and how existing mental healthcare services are utilised. 

This Part II of the report states that, as of 2016, mental healthcare in India was confined to diagnosis and drug delivery. Mental health promotion, continued community care, rehabilitation, welfare of patients, and integration into other health-related programmes were minimal at best.

    FACTOIDS

  1. The key components of a ‘mental health system’, the report says, include laws and policy, community mental health services, mental health services in primary healthcare, human resources, public education about mental health, and adequate monitoring and research.    

  2. Out of every 100,000 people, mental healthcare facilities were available for 14.85 persons in Uttar Pradesh and 46.45 in Chhattisgarh – among the surveyed states, these represent the lowest and highest rates, respectively.

  3. The government of India’s mental healthcare facilities outnumbered private services in the surveyed states – except in Punjab and Chhattisgarh. The report attributed this to the vast network of primary health centres (PHCs) and sub-centres, and a lack of data from private establishments.

  4. In Punjab, for every 100,000 people, private facilities were available for 18.08 and public facilities for 19.55. In Chhattisgarh, private facilities were available for 17.52 and public services for 28.93 for every 100,000 people.

  5. Citing a 2016 paper in The Lancet, the report notes that there are only 0.3 psychiatrists for 100,000 people in India. They are concentrated in the southern and western regions of the country. This shortage is aggravated by psychiatrists migrating to high-income countries.

  6. The report states that along with the National Mental Health Programme (NMHP, 1982), several programmes by the government of India include mental healthcare, such as the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (2010) and the National Programme for Health Care of Elderly (2010).

  7. The District Mental Health Programme (DMHP) was launched under the NMHP in 1996 to provide mental healthcare services at the district level. Till 2015, the percentage of districts covered by the DMHP ranged from 13.64 in Punjab to 100 per cent in Kerala. Tamil Nadu expanded the programme to all districts in 2016.

  8. However, the DMHP covered less than 50 per cent of districts in 8 of the 12 states surveyed.

  9. The population covered by the DMHP ranged from 14.94 per cent in Punjab to 100 per cent in Kerala. The DMHP covered more than 50 per cent of the population in four of the 12 surveyed states.

  10. Each of the 12 surveyed states had at least one medical college with a psychiatric department, general hospital with a psychiatric unit, and a de-addiction centre.

  11. Among the surveyed states, Kerala had the highest number of clinical psychologists (0.63 per 100,000 people) and Tamil Nadu had the highest number of nurses trained in mental health (10.5 per 100,000 people). Rajasthan had the lowest number of clinical psychologists (0.01 per 100,000 people), while Punjab and Rajasthan had the lowest numbers of nurses trained in mental health – 0.01 per 100,000 people.

    Focus and Factoids by Rounak Bhat.

AUTHOR

National Institute of Mental Health and Neuro Sciences, Bengaluru    

COPYRIGHT

National Institute of Mental Health and Neuro Sciences, Bengaluru    

PUBLICATION DATE

2016

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