The document reviews the District Mental Health Programme (DMHP) in Uttar Pradesh, India. It provides background on the National Mental Health Programme and discusses how DMHP was launched to overcome NMHP's limitations by making districts the administrative unit. DMHP aims to provide basic mental healthcare through trained staff at primary health centers. It is now implemented across all 75 districts of UP and includes professionals in each district as well as programs in schools, colleges, and workplaces. However, government websites are not always updated and data availability is limited.

1. District Mental Health Programme
in Uttar Pradesh: A Review
By:
Syed Sajid Husain Kazmi
M.Phil. Clinical Psychology
Dept. of Clinical Psychology, AIBAS,
Amity University, Lucknow

2. Introduction
• Mental health is defined as a state of well-being in
which every individual realizes his or her own potential,
can cope with the normal stresses of life, can work
productively and fruitfully and is able to make a
contribution to his/her community. (WHO-2014)
• The lifetime prevalence rates of mental disorders in
adults range from 12.2 to 48.6% and 12-month
prevalence rates range from 8.4 to 29.1%. (WHO-2016)
• National Mental Health Survey, 2015-16 (India):
Common mental disorders (CMDs), including
depression, anxiety disorders and substance use disorders
are affecting nearly 10%.
• National Mental Health Survey, 2015-16 (U.P.): 6.1%
prevalence rate.

3. • The Government of India launched the National
Mental Health Programme (NMHP) in 1982,
keeping in view the heavy burden of mental
illness in the community and the inadequacy of
mental health care infrastructure in the country to
deal with it.
3 main components of NMHP -
• Treatment of Mentally ill
• Rehabilitation
• Prevention and promotion of positive mental
health.
National Mental Health Programme

4. Limitations of NMHP:
• Under NMHP, the unit of service delivery was
Primary Health Centres and Community Health
Centres. Hence, the extent of service delivery was
limited.
The program had some inherent conceptual flaws in
the form of:
• no budgetary estimation or provision for the
programme,
• lack of clarity regarding who should fund the
programme – the central government of India or the
state governments, which perpetually had inadequate
funds for healthcare. (Rasheed, 2015)

5. Inception of District Mental Health Program:
• To overcome the limitations of NMHP and to scale it up, it
was perceived that the district should be the administrative
and implementation unit of the program.
• The National Institute of Mental Health and Neurosciences
(NIMHANS) undertook a pilot project (1985–1990) at the
Bellary District of Karnataka to assess the feasibility of DMHP
and demonstrated that it was feasible to deliver basic mental
healthcare services at the district, taluk and at PHCs by trained
PHC staffs under the supervision/support of a district mental
health team.
• The success of the Bellary project paved the way for DMHP,
which was subsequently launched in 27 districts in 1996 with
the initial budget of 280 million INR.

6. Objectives of DMHP:
• To provide sustainable basic mental health
services to the community and to integrate these
services with other health services.
• Early detection and treatment of patients within
the community itself.
• To reduce the stigma of mental illness through
public awareness.
• To treat and rehabilitate mental patients within
the community.

7. Evolution of DMHP:
10th Five Year Plan (2002–07) 11th Five Year Plan (2007–12)
•Budget extended to 1390 million
INR
•Program officer (a psychiatrist) &
family welfare officer in each district.
• Essential drugs at PHCs and
District Hospitals.
• Training programs for Medical
Officers.
• (Scheme-A): Strengthening of
infrastructure with the establishment
of 11 Centers of Excellence &
upgradation of Mental Institutions/
Hospitals.
•(Scheme-B): Setting up/
strengthening of 30 units each of
Psychiatry, Clinical Psychology,
Social Work & Psychiatric Nursing.
•Program extended to 110
districts, with upgradation of
psychiatric wings of 71 medical
colleges/general hospitals and
modernization of 23 mental
hospitals.

8. DMHP in 12th Five Year Plan:
Mental Health Policy Group (MHPG) was
appointed by the MoHFW in 2012 to prepare a
draft of DMHP for 12th Five Year Plan (2012–17)
Objectives were:
• To reduce distress, disability and premature
mortality related to mental illness.
• To enhance recovery from mental illness by
ensuring the availability of and accessibility to
mental health care for all, particularly the most
vulnerable and underprivileged sections of the
population.

9. Method:
• Documents and websites of Ministry of Health
and Family Welfare (MoHFW), Director General
of Health Services (DGHS, U.P.) and other
government agencies were visited to obtain
relevant documents on NMHP/ DMHP such as
the document of regional workshops for NMHP
(2011–2012), policy draft document for the 12th
Five Year Plan (2012), and parliamentary
committee and NITI Aayog report on the on
going program.

10. Results:
Status of DMHP in U.P.
Implemented in all 75 districts of U.P.
• Trained Mental Health Professionals hired in
each district.
1) District Programme Officer
2) Psychiatrist
3) Clinical psychologist
4) Psychiatric Nurse
5) Psychiatric Social Worker

11. Scheme A Scheme B
Upgradation of Psychiatric Wings of
Medical Colleges:
MLN Medical College, KGMU,
GSVM, MLB Medical College Jhansi,
LLRM Medical College Meerut, S.N.
Medical College Agra, IMS BHU.
Modernisation of State Run Mental
Hospital:
Mental Hospital Bareily, IMHH Agra,
Mental Hospital Varanasi
Centre of Excellence:
Institute of Mental Health &
Hospital, Agra
KGMU for strengthening the
Psychiatry, Clinical Psychology,
Psychiatric Social work, Psychiatric
Nursing departments.
For Building, Recruitment, Books
and Journals, Equipments and tools
etc.
Total Fund utilised: Rs 37,58,59,428

12. DMHP in U.P.
3 rooms allotted at District Hospitals for DMHP.
Role of Mental Health Professionals (Psychiatrist
and Clinical Psychologist):
• 3 day OPD at District Hospital.
• 2 Day OPD at selected CHCs and PHCs.
• 1 day Awareness Campaign/programme at
school/colleges in coordination with Clinical
Psychologist, Psychiatric Social Workers and
other team members.

13. DMHP- New Components:
• School Mental Health Services: Life Skills
Education in Schools, Counseling Services.
• College Counselling Services: Through trained
teachers and counsellors.
• Work Place Stress Management.
• Suicide Prevention Services- Counseling Center
at District level, Sensitization Workshops, IEC,
Collaboration with various departments.
• Dua se Dawa Tak
• Mann Kaksh

14. Conclusion:
• DMHP has completed more than three decades, the
lessons learned from the past can bring about a lot of
insights about the future course of action.
• For example leadership at all the levels of
governance/administration, financial and human
resources have been important determinants for the
outcome of the program, so are community and
stakeholders’ participation, standardization of training
for community mental health professionals, IEC
activities, the involvement of NGOs and private
sectors.

15. Limitations
• Government websites are not updated at regular
intervals.
• Not much information/data is available in public
domain.

16. Reference:
• Roy, S., & Rasheed, N. (2015). The national
mental health programme of India. Int J Curr Med
Appl Sci, 7, 7-15.
• https://www.nhp.gov.in/national-mental-health-
programme_pg
• http://dghs.gov.in/content/1350_3_NationalMenta
lHealthProgramme.aspx
• http://www.dgmhup.gov.in/EN/MentalHealth
• World Health Organization, editor. Mental Health
Atlas 2005 Rev ed. Geneva: World Health
Organization; 2005.