National mental health programme

NATIONAL MENTAL HEALTH
PROGRAM
BY: MS RINKAL PATEL

Introduction
◦ The government of India launched the
national mental health program (NMHP)
in 1982, keeping in view the heavy
burden of mental illness in community,
and the absolute inadequacy of mental
health care infrastructure in the country
to deal with it.

Vision
◦ The vision of the National Health Policy
is to mental health, prevent mental
illness, enable recovery from mental
illness, promote destigmatization, and
ensure socio-economic inclusion of
persons affected by mental illness by
providing accessible, affordable and
quality health and social care to all
persons through their life-span, within a
rights-based framework.
3

Values
and
Principles
◦ Fundamental values and
principles representing the
ethos of this policy are
discussed below:
4

Equity
◦ Mental health services should be sensitive
and relevant to diverse social and cultural
situation and groups and, to the need of
remote and rural areas.
◦ An equitable share of the national health
budget should be consist with the burden of
mental health problems and mental illness.
◦ Non-discrimination and equal opportunities
for education, employment, housing and
social welfare should be provided to promote
inclusion of persons with mental health
problems and mental illness.
5

Justice
◦ The needs of vulnerable and
excluded members of the
community should receive
particular attention.
6

Integrated
care
◦ Mental health services should be provided
within the existing health care system using the
primary health care approach.
◦ Some mental illness are chronic in nature,
persons suffering from chronic illness would
require provisions for medium and long term, in
some cases even life-long the provision of
services should keep this requirement in
consideration.
7

◦ These services should espouse the principles
of universal access, equitable distribution,
community participation, inter- sectoral
coordination and use of appropriate
technology. It is essential to make mental
health services universally available and
accessible in a time bound manner.
◦ Mental health services should be
comprehensive and address the needs of
person with mental illness, their care
providers and health care professionals
8

Evidence
based care
◦ Evidence based interventions
should inform decisions
regarding provision of
services.
◦ Decision making should be
based on various evidences for
instance: findings from
research, practice based
evidence and feedback from
clients.
9

Quality
◦ Mental health services should
meet quality standards as
mandated globally and
perceived suitable by local
users and care-givers.
10

Participatory
and rights
based
approach
◦ Services users and caregivers should be involved in
the planning, development, delivery, monitoring and
evaluation of mental health services.
◦ Human rights and dignity of persons with mental
health problems should be respected, protected and
promoted.
◦ Mental health care should promote and protect the
autonomy and liberty of person(s) with mental health
problem.
◦ The rights of the caregiver and service provides
should also be respected by ensuring good working
conditions, adequate training and support. 11

Governance
and effective
delivery
◦ The union and state governments, have
a major role in actions for promotion
of mental illness in the country.
◦ However governments alone cannot
ensure effective delivery.
◦ Other stakeholders such as private care
providers, civil society organizations,
user groups, academic and research
institutions also have a cruel role in
delivery and guiding policy.
12

◦ Services and professionals involved in health
care planning and delivery whether in public,
private or non-government sector should at all
times display the utmost devotion to duty and
be responsible for their action.
◦ Services and service providers are ultimately
accountable to person(s) with mental illness
and their care-givers.
13

Value base in
all training
and teaching
programs
◦ Core values such as quality,
integrity, justice,
accountability and empathy
should be built in to all forms
of training and academic
teaching.
14

Holistic
approach
to mental
health
◦ A holistic approach to health including
recognition of the relationship between
mind, body and soul is more effective
in dealing with mental health
problems.
◦ Cultural ethos, Indian traditions and
their impact on behavioral patterns
must be recognized and leveraged to
achieve policy goals and objectives.
15

Aims
◦ Prevention and treatment of mental
neurological disorders and their
associated disabilities.
◦ Use of mental health technology to
improve general health services.
◦ Application of mental health
principles in total national
development of improve quality of
life.

Goals and
objectives
◦ Based on the vision and
drawing on the values and
principles outlined in the
previous Sections, the goals
and objectives of the mental
health policy are as follows:
17

Goals
 To reduce distress, disability, exclusion
morbidity and premature morbidity
associated with mental health problems
across life-span of the person.
 To enhance understanding of mental health
in the country.
 To strengthen the leadership in the mental
health sector at the national, state, and
district levels.
18

Objectives
 To provide universal access to mental health care.
 To increase to access and utilization of comprehensive
mental health services(including prevention services,
treatment and care support services) by persons with mental
health problems.
 To increasing access to mental health services for
vulnerable groups including homeless person(s), person(s)
in remote areas, difficult terrains,
educationally/socially/economically deprived sections.
 To reduce prevalence and impact of risk factors associated
with mental health problems.
 To reduce risk and incidence of suicide and attempted
suicide. 19

 To ensure respect for rights and protection from harm
of person(s) with mental health problems.
 To reduce stigma associated with mental health
problems.
 To enhance availability and equitable distribution of
skilled human resources for mental health.
 To progressively enhance financial allocation and
improve utilization for mental health.
 To identify and address the social, biological and
psychological determents of mental health problems
and to provide appropriate interventions.
20

Strategies
◦ Effective governance and delivery
mechanisms of mental health
◦ Promotion of mental health
◦ Prevention of mental illness, reduction of
suicide and attempted suicide
◦ Universal access to mental health services
◦ Improved availability of adequately trained
mental health human resources to address the
mental health needs of the community
◦ Community participation for mental health and
development
◦ research

Approaches
◦ Integration of mental health care
services with the existing general
health services.
◦ Utilization of the exiting
infrastructure of health services and
also deliver the minimum mental
health care services.
◦ Provision of appropriate task-
oriented training to the existing
health staff.
◦ Linkage of mental

Limitation of
NMHP
◦ The program emphasized more on curative
components rather than the preventive and
promotives components
◦ Role of support of families in the treatment
of the patient was not given due
importance
◦ Short term goals were given priority over
the long term planning
◦ The administrative structure of the
program was not clearly clearly outlined.
23

Level of
NMHP
◦ This program include 3 sub
program
◦ Tratment sub prog
◦ Village level
◦ Primary health level
◦ At dis
24

Mental Health
Team
◦ A psychiatrist
◦ A psychiatric nurse
◦ A psychiatric social worker
◦ Occupational therapist or activity
therapist
25

Role of nurse in
NMHP
Job title:
Psychiatric nurse
Job
requirements/resp
onsibilities
1. 1. To examine and manage healthcare needs of
the mentally ill patients
2. 2. To provide inpatient care to the mentally ill
patients
3. 3. To do the outreach activity/plan and
manage psychiatric Clinics in PHCs/CHCs
and other sites periodically
4. 4. To impart training to the health personnel of
CHC and PHC as per guidelines issued by the
National Mental Health Cell.

Job title:
Community
nurse
Job
requirements/
responsibilities
◦ 1. To keep track of follow-up
patients availing treatment
◦ At CHC and PHC
◦ 2. To do the outreach activity/plan
and manage psychiatry Clinics in
PHCs/CHCs and other sites
periodically
◦ 3. To impart training to the health
personnel of CHC and PHC as per
guidelines issued by the National
Mental Health Cell.

The way forward
for psychiatric
nurses in District
Mental Health
Programe.
1. Opportunities to get involved in PPP model activities
2. Running day center with the support of DMHP
3. Starting of residential/long-term continuing care Center
with financial support from DMHP
4. Involvement in teaching activities
 Life skills education and counseling in schools
 College counseling services
 Workplace stress management
 Suicide prevention services.
5. Conducting independent research in NMHP evaluation

National mental health programme

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