DIRECTORATE GENERAL OF HEALTH SERVICES

National Mental Health Programme

Background:

To address the huge burden of mental disorders and shortage of qualified professionals in the field of mental health, Government of India has been implementing National Mental Health Program (NMHP) since 1982. The district Mental Health Program was added to the Program in 1996. The Program was re-strategized in 2003 to include two schemes, viz. Modernization of State Mental Hospitals and Up-gradation of Psychiatric Wings of Medical Colleges/General Hospitals. The Manpower development scheme (Scheme-A & B) became part of the Program in 2009.

Objectives

1. To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future;
2. To encourage the application of mental health knowledge in general healthcare and in social development;
3. To promote community participation in the mental health service development; and
4. To enhance human resource in mental health sub-specialties.

Components:

1. District and sub-district level activities under NHM:

1. District Mental Health Program:

1. Envisages provision of basic mental health care services at the community level:

1. Service provision: provision of mental health out-patient & in-patient mental health services with a 10 bedded inpatient facility.

2. Out-Reach Component:

• Satellite clinics: 4 satellite clinics per month at CHCs/ PHCs by DMHP team
• Targeted Interventions:

• Life skills education & counselling in schools,
• College counselling services,
• Work place stress management, and
• Suicide prevention services

3. Sensitization & training of health personnel: at the district & sub-district levels

4. Awareness camps: for dissemination of awareness regarding mental illnesses and related stigma through involvement of local PRIs, faith healers, teachers, leaders etc

5. Community participation:

• Linkages with Self-help groups, family and caregiver groups & NGOs working in the field of mental health
• Sensitization of enforcement officials regarding legal provisions for effective implementation of Mental Health Act

2. As of now, 241 districts have been covered under the scheme & it is proposed to expand DMHP to all districts in a phased manner (Annexure-II)

3. Manpower (on contractual basis): Psychiatrist, Clinical Psychologist, Psychiatric Nurse, Psychiatric Social Worker, Community Nurse, Monitoring & Evaluation Officer, Case Registry Assistant, Ward Assistant/ Orderly

4. Financial support @ Rs. 83.2 lakhs per DMHP

2. PPP Model Activities (financial support @ Rs. 5 lakhs per NGO):

Under this component, there is a provision for the state governments to execute activities related with mental health in partnership with Non-Government Organizations/Agencies as per the guidelines of the NRHM in this regard. The levels and the areas of partnership of the state government with the Non-Government Organizations/Agencies may be as follows:

1. Day Care Centre (financial support @ 50,000 per centre per month):

• Provides rehabilitation and recovery services to persons with mental illness so that the initial intervention with drug & psychotherapy is followed up and relapse is prevented.
• Helps in enhancing the skills of the family/caregiver in providing better support care.
• Provides opportunity for people recovering from mental illness for successful community living.
• Financial support of Rs. 6.00 lakhs is earmarked per centre per year.

2. Residential/ Long Term Continuing Care Centre (financial support @ 75,000 per centre per month):

• Chronically mentally ill individuals, who have achieved stability with respect to their symptoms & have not been able to return to their families and are currently residents of the mental hospitals, will be shifted to these centers. 
• Residential patients in these centers will go through a structured program which will be executed with the help of multidisciplinary team consisting of psychologists, social workers, nurses, occupational therapists, vocational trainers and support staff.
• Financial support of Rs. 9.00 lakhs is earmarked per centre per year.

3. Community Health Centers:

1. Services available:

• Outpatient services & inpatient services for emergency psychiatry patients;
• Counseling services.

2. Manpower:

• Medical Officer;
• Clinical Psychologist or Psychiatric Social Worker

4. Primary Health Centers:

1. Services available:

• Outpatient services;
• Counseling services in accessing social care benefits;
• Pro-active case findings and mental health promotion activities

2. Manpower:

Community Health Workers (Two)

5. Mental Health Services:

• For those activities, state or district specific, which need to be added to the package of activities carried out by the district mental health team.

 Such mental health services will be delivered through government mental hospitals or medical colleges/hospitals with department of psychiatry.

• Under the overall supervision of the Head of Psychiatry Department.
• Financial support of up-to Rs. 15.00 lakhs per year per medical college/hospital/mental hospital

6. Mental Health Helpline:

• A country wide 24 hours dedicated help-line to provide information to public on mental health resources, emergency situation and crisis management, information pertaining to destitute mentally ill patients, registration of complaints on Human Rights Violation of mentally ill and assistance on medico-legal issues.

• Linked with district hospitals, medical college/hospitals, mental hospitals, private mental health facilities, NGOs and all other mental health service providers of the state.

1. Tertiary level activities:

1. Manpower Development Schemes (Centre of Excellence or Scheme-A & Scheme-B):

Scheme A. Centers of Excellence in Mental Health

• Up- gradation of 10 existing mental hospitals/ institutes/ Med. Colleges will be taken-up to start/ strengthen courses in psychiatry, clinical psychology, psychiatric social work & psychiatric nursing.
• Financial Support of upto Rs. 33.70 cr will be provided to each centre and would include capital work (academic block, library, hostel, lab, supportive departments, lecture theatres etc.), equipments, faculty induction and retention during the plan period.
• As of now, 15 mental health institutes have been funded for developing as Centers of Excellence in Mental Health (Annexure-I).

Scheme B. PG Training Departments of Mental Health facilities

• Government Medical Colleges/ Government Mental Hospitals will be supported for starting / increasing intake of PG courses in Mental Health.
• Financial support of upto Rs. 0.86 to 0.99 cr per dept. would be provided. The support includes physical work for establishing /improving department in specialties of mental health, equipments, tools and basic infrastructure & for engaging required faculty for starting/ enhancing the PG courses.
• Till date, 39 PG Departments in 15 Medical Colleges/ Mental Hospitals in mental health specialties viz. Psychiatry, Clinical Psychology, Psychiatric Nursing and Psychiatric Social Work have been provided support for their establishment /strengthening (Annexure-I).

2. Up-gradation of two Central MH Institutes to provide Neurological and Neuro-surgical Facilities on the pattern of NIMHANS (CIP, Ranchi & LGB, Tezpur):

• LGB Regional Institute of Mental Health, Tezpur and Central Institute of Psychiatry, Ranchi to be up-graded.
• Basic Neurological & Neurosurgical facilities to be included on the pattern of NIMHANS.
• Support involves physical work for establishing departments in Neurology & Neurosurgery, equipments & tools and for engaging required faculty.

3. Support to Central and State Mental Health Authorities:

• Central Mental Health Authority (CMHA) & State Mental Health Authority (SMHA) are meant for regulation & co-ordination of mental health services under the central & state governments respectively.
• Support to be provided for purchase of infrastructure (non-recurring) and Office and Professional Expenses (recurring).
  • Non-Recurring support to CMHA & each SMHA: Rs. 2.0 lakh
  • Recurring support to CMHA & each SMHA: Rs. 7.0 lakh

4. Research & Survey:

• For carrying out research & survey in different regions of the country in the field of mental health.
• Help in understanding regional needs and framing plan and strategies in future for various parts of the country.
• Budget for the remaining period is Rs. 18.00 cr (Rs. 6.00 cr per year).

5. Monitoring & Evaluation:

• Standard formats for recording and reporting have been developed and circulated.
• These will be used by medical colleges/institutes (under Manpower Development Scheme), District, CHC and PHC.
• Continuous evaluation of the activities of the program is being done.

6. Central IEC:

• The central level dedicated website will be introduced to provide on hands information on mental health resources, activities, plans, policy and programmes.
• Extensive mass media activities will be supported at district and sub-district level. The support for TV /RADIO programs and innovative media campaigns on mental health in vernacular languages through local channels and other media.

7. Central Mental Health Team:

• A Central Mental Health Team would supervise and implement the programme and provide support to the Central Mental Health Authority.
• Team would consist of one Consultant (Mental Health) with salary of Rs 70,000 pm, one Consultant (Public Health) with salary of Rs 60,000 pm, two Research Associates with salary of Rs 35,000 pm & one DEO with salary of Rs 15,000 pm.
• Budget Provision for Central Mental Health Team for a period of 3 years is Rs 1.17 cr

8. Mental Health Information System:

• An online data monitoring system and will also facilitate bilateral communication between participating units.
• is expected to bring significant improvement in the implementation as there shall be possibility of mid course correction based on the feedback.

9. Training/Workshops:

• Trainings will be provided to master trainers from each state/UT who shall further train DMHP team and other staff working in the field of mental health.
• Trainings will be standardised and delivered at identified centres.
• The standardized training manuals are being formulated and circulated to all stakeholders.
•  Budget for the remaining Plan period is Rs. 15.00 cr (Rs. 5.00 cr per year).

Manpower Development Schemes 189 Kb
RELEASE OF FUNDS TO VARIOUS STATES/ UTs UNDER DISTRICT MENTAL HEALTH PROGRAMME 189 Kb

Living Life Positively(Facilitator Guide) 1 Mb

Training manual doctors(abridged) 48 Kb

Training manual doctors 516 Kb

Training manual psychologist 2 Mb

Training manual SW(abridged) 6 Mb