• Good mental health is the ability to respond to
the many varied experiences of life with
flexibility & a sense of purpose.
• Mental health has been defined as s state of
balance between the individual & the
surrounding world, a state of harmony
between oneself & others, a co existence
between the realities of the self & that of
other people & that of the environment.
Psychologist have mentioned the
following characteristics as
attributes of a mentally healthy
MENTALLY HEALTHY PERSON
1. A mentally healthy person is free from
internal conflicts, he is not at war with
2. He is well adjusted , i.e., He is able to get
along well with others. He accepts criticism
& is not easily upset.
3. He searches for identity.
4. He has a strong sense of self esteem.
5. He knows himself; his needs, problems &
goals. (Self Actualization).
6. He has good self control balances
rationally & emotionally.
7. He faces problems & tries to solve them
intelligently, i.e., coping with stress &
WARNING SIGNS OF POOR
BY WILLIAM. C. MENINGER:
1. Are you always worried?
2. Are you unable to concentrate
because of un recognized reasons?
3. Are you continually unhappy?
4. Do you loose your temper easily &
5. Are you troubled by regular insomnia?
6. Do you have wide fluctuations in your
moods from depression to elation,
back to depression, which incapacitate
• 7. Do you continually dislike to be with
• 8. Are you upset if the routine of your
life is disturbed?
• 9. Do your children consistently get on
• 10. Are you “browned off” &
11. Are you afraid without real cause?
12. Are you always right and the
other person always wrong?
13. Do you have numerous aches &
pains for which no doctor can find a
• INFERENCE :
•HELP IS NECESSARY IF
THE ANSWER TO ANY OF
THE AFORE SAID
QUESTIONS IS DEFINITELY
• The World Bank report (1993) revealed
that the Disability Adjusted Life Year
(DALY) loss due to neuro-psychiatric
disorder is much higher than diarrhea,
malaria, worm infestations and
tuberculosis if taken individually.
• According to the estimates DALYs
loss due to mental disorders are
expected to represent 15% of the
global burden of diseases by
• The Indian Lunacy Act of 1912 was
replaced by Mental Health Act of
1987 emphasizing focus to improve
the quality of services /care and
protect the rights of mentally ill.
DR. MAHESWARI JAIKUMAR
• The Government of India has
launched the National Mental
Health Programme (NMHP) in 1982,
keeping in view the heavy burden of
mental illness in the community,
and the absolute inadequacy of
mental health care infrastructure in
the country to deal with it.
1.Prevention and treatment of
mental and neurological disorders
and their associated disabilities.
2. Use of mental health technology to
improve general health services.
• 3. Application of mental health
principles in total national
development to improve quality
1. To ensure availability and accessibility
of minimum mental health care for all
in the foreseeable future, particularly
to the most vulnerable and
underprivileged sections of population.
2. 2. To encourage application of mental
health knowledge in general health
care and in social development.
3. To promote community
participation in the mental
health services development and
to stimulate efforts towards selfhelp in the community.
1. Integration mental health with
primary health care through the
2. Provision of tertiary care
institutions for treatment of
3. Eradicating stigmatization of
mentally ill patients and
protecting their rights through
regulatory institutions like the
Central Mental Health Authority,
and State Mental health
MENTAL HEALTH CARE
1. The mental morbidity requires
priority in mental health
2. Primary health care at village
and sub centre level
3. At Primary Health Centre
4. At the District Hospital level
5. Mental Hospital and teaching
DISTRICT MENTAL HEALTH
1. Training programmes of all
workers in the mental health
team at the identified Nodal
Institute in the State.
2. Public education in the mental
health to increase awareness
and reduce stigma.
3. For early detection and
treatment, the OPD and indoor
services are provided.
4. Providing valuable data and
experience at the level of
community to the state and Centre
for future planning, improvement in
service and research.
District Mental Health Team
will provide services to the
mentally ill and their families
Daily Out-patient (OPD) services
Ten bedded in services facility (IPD)
Liaison with Primary Health Center
• Provide follow up service
• Community Survey if feasible
• Remove stigma of mental illness by
creating awareness in the community
SCHOOL MENTAL HEALTH SERVICES:
• Life skills education in school.
• Counseling services.
• Focus on educational performance
• & difficulties.
• Focus on special children.
COLLEGE COUNSELLING SERVICES
• Issues related peer group.
• Issues related to family
• interfering with education.
• Drug abuse.
• Sex experimentation.
• Issues related with job & future plans.
WORK PLACE STRESS MANAGEMENT
• Stress in formal & informal sectors.
• Stress of various group of
SUICIDE PREVENTION CENTERS
• Counseling centers at Dt level.
• Sensitization workshops.
• IEC help.
• Help Lines
THRUST AREAS FOR 10TH FIVE
1. District mental health programme in
an enlarged and more effective form
covering the entire country.
2. Streamlining/ modernization of
mental hospitals in order to modify
their present custodial role.
3. Upgrading department of
psychiatry in medical colleges
and enhancing the psychiatry
content of the medical
curriculum at the undergraduate
as well as postgraduate level.
4. Strengthening the Central and
State Mental Health Authorities
with a permanent secretariat.
Appointment of medical officers
at state headquarters in order to
make their monitoring role more
5. Research and training in the field
of community mental health,
substance abuse and child/
adolescent psychiatric clinics.
ACTIVITIES OF NMHP
1. Integration of Mental health
Services to all existing general health
2. Early detection & follow up of cases.
3. Increase the awareness of mental
4. Eradicating stigmatization of mentally ill.
5. Providing rehabilitative services for
6. Providing counseling services for the
alcoholic, drug addicts & delinquents.
7. Establishment of tertiary care institutions
for treatment of mental disorders.
8. Training mental health team at
nodal institutions in the state.
9. Training the trainers from states at
10. Protection of mentally ill patients
& their rights.
11. Providing rehabilitative services
for chronically disabled mental
12. Providing counseling services for
alcoholics, drug addicts &
COMPONENTS OF MENTAL
• The treatment programme is
planned in keeping the PRIMARY
HEALTH CARE as the sheet of
• It consists of an appropriate referral
• Rehabilitation of patients with
mental disorders will be facilitated
at the community level
• This component of the service
programme will be community
based with a united involvement of
the health service personnel
TERTIARY CARE INSTITUTIONS
1. National Institute of Mental
Health & Neuro Sciences
2. Central institute of Psychiatry,
3. Institute of Human Behaviour &
Allied Sciences, New Delhi.
INTEGRATION OF MENTAL
HEALTH CARTE INTO PHC
• This was initiated by training health care
personnel in PHC services to detect &
manage mental illness.
• Active liaison with the government
health & medical services departments
established (well sustained efforts at
ensuring a supply of basic psycho tropic
medicines at PHC)
• Awareness programmes held
periodically using local folklore,
dance & music.
• The emphasis was is on early
recognition of mental illness &
• Community volunteers are to be
identified & trained.
• Involvement & training lay
community workers facilitates
easier acceptance by the patients
& their families.
• The interventions offered as a part
of this programme have
facilitated community integration
of the mentally ill.
• Establishment of rapport with the family
& the community through the
involvement of local village leaders
ensures the acceptance of such a
programme by the population
11 TH FIVE YEAR PLAN: NATIONAL
MENTAL HEALTH PROGRAMME
1. Up gradation of Psychiatric Wings of Govt.
Medical Colleges/General Hospitals:
Establishment of a psychiatry wing in
Government Medical Colleges
2. Modernization of State-run Mental
grant of up to Rs. 3 crores per mental
hospital for modernization of facilities and
3. District Mental Health Programme:
DMHP is presently under
4. Programme Officer will represent the
Programme in the District Health
Society and facilitate proposals related
to running of DMHP.
• 5. For effective implementation help of
credible and community based
organizations could be enlisted at the
state and district level.
• 6. NMHP will be mainstreamed by
integrating with NRHM. funds is routed
through the State Health Society.
8. The Steering Committee on NMHP
under the chairmanship of Secretary
(H&FW) is authorized to carry out -any
INTEGRATION OF MNHP
• Optimal use of existing
infrastructure at various level.
• Use of NRHM platform for transfer
of funds to the states /UT
• Increased role of state / district level
health authorities in the programme
monitoring & implementation.
• Integrated IEC activities under NRHM.
• Involvement of NRHN infrastructure for
training related to mental health in
• Use of NRHM machinery for
procurement of drugs for use in NMHP.
• Involvement of community/PRI.
• Building of credible referral chains for
appropriate management of cases
detected at lower levels of health care
• Using improved linkages /
communication under NRHM for
MIS in respect of NMHP