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Gangadhar B, Kumar CN, Sadh K, Manjunatha N, Math SB, Kalaivanan RC, Rao GN, Parthasarathy R, Chand PK, Chandra PS, Thirthalli J, Murthy P, Varghese M, Mathur A, Bairy BK, Kishore C, Gowda GS, Basvaraju V, Harihara SN, Isaac MK, Chaturvedi S. Mental Health Programme in India: Has the tide really turned? Indian J Med Res 2023; 157:387-394. [PMID: 37955215 PMCID: PMC10443714 DOI: 10.4103/ijmr.ijmr_2217_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 11/14/2023] Open
Abstract
Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India's NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
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Affiliation(s)
- B.N. Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Kamaldeep Sadh
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rakesh Chander Kalaivanan
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Rajani Parthasarathy
- Department of Health & Family Welfare, Government of Karnataka, Bengaluru, Karnataka, India
| | - Prabhat K. Chand
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Alok Mathur
- General of Health Services, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Bhavya K. Bairy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Chethana Kishore
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Guru S. Gowda
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basvaraju
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | | | - Mohan K. Isaac
- Department of Psychiatry, University of Western Australia, Perth, Australia
| | - S.K. Chaturvedi
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
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Parthasarathy R, Channaveerachari NK, Manjunatha N, Sadh K, Kalaivanan RC, Gowda GS, Basvaraju V, Harihara SN, Rao GN, Math SB, Thirthalli J. Mental health care in Karnataka: Moving beyond the Bellary model of District Mental Health Program. Indian J Psychiatry 2021; 63:212-214. [PMID: 34211211 PMCID: PMC8221212 DOI: 10.4103/psychiatry.indianjpsychiatry_345_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/06/2019] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kamaldeep Sadh
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rakesh Chander Kalaivanan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vinay Basvaraju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Girish N Rao
- Department of Epidemiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India E-mail:
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Rajalu BM, Jacob J, Harihara SN, Kandasamy A, Ramalingaiah AH, Gopalakrishna KN, Holla V, Birua GJ, Bhadrinarayan V, Kesavan M, Gangadhar BN. Adopted COVID Care Centre Model with Mental Health Promotion at a Non-COVID Hospital: NIMHANS Experience. Indian J Psychol Med 2020; 42:584-585. [PMID: 33354091 PMCID: PMC7735247 DOI: 10.1177/0253717620961044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Banu Manickam Rajalu
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jessy Jacob
- Dept. of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Arun Kandasamy
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | | | - Vikram Holla
- Dept. of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gyani Js Birua
- Dept. of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - V Bhadrinarayan
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Muralidharan Kesavan
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - B N Gangadhar
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Abstract
There is no health without mental health. Recently conducted National Mental Health Survey quoted a prevalence of 13.7% lifetime and 10.6% current mental morbidity. To address this mammoth problem, an aspirational law was enacted titled "Mental Healthcare Act, 2017" (MHCA 2017). The act is progressive and rights based in nature. The whole dedicated Chapter 5 on "Rights of the person with mental illness" is the heart and soul of this legislation. However, the act mainly focuses on the rights of the persons with mental illness (PMI), only during treatment in hospital but is not equally emphatic about continuity of treatment in the community. The act fails to acknowledge and foster the role and contribution of family members in providing care to PMI. Although there are many positive aspects to the MHCA 2017, it may impact adversely on the mental health care in India. This article focuses on the shortcomings and challenges of the act and also makes attempts to offer alternatives considering the available resources and ground reality. Concepts such as "Advance directives" and "Nominated representatives" appear to be very attractive, idealistic, and aspirational, but not evidenced based in the Indian context considering the resources. The act fails to make an impact even after 22 months to attain the goal, and will require pervasive efforts to fulfil a purpose that directs its development. This law needs to be amended as per the local resources and requirements of the society.
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Affiliation(s)
- Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vinay Basavaraju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Guru S. Gowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Mahesh Gowda
- Department of Psychiatry, Spandana Health Care, Bengaluru, Karnataka, India
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Basavaraju V, Enara A, Gowda GS, Harihara SN, Manjunatha N, Kumar CN, Math SB. Psychiatrist in Court: Indian Scenario. Indian J Psychol Med 2019; 41:126-132. [PMID: 30983659 PMCID: PMC6436416 DOI: 10.4103/ijpsym.ijpsym_53_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The impetus for practical exposure to legalities that arise in the context of psychiatry and law is minimal in postgraduate training in psychiatry and curriculum. Those who choose to get trained often do not get first-hand exposure to court proceedings. Law and psychiatry often come into each other's interface, and psychiatry is regulated by the legal system more often than the other specialties in medicine. This article is an attempt to equip the psychiatrist in dealing with instances where they will present themselves in court.
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Affiliation(s)
- Vinay Basavaraju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Arun Enara
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Guru S Gowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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