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1. Mental Health Problems,
National Mental Health
Programme and Substance
Use Disorders
Co-ordinator: Dr. M S Shivaswamy
Presented by: Dr. Gautam Babu
2. A Question of the Mind
Q) Where does thought come from?
3. What is the ultimate aim of human life
– the goal of all goals
4. With all our advances in science,
commerce and technology are we
happier now than we were 20 years
ago?
5. A Burning Problem
The Hindu (Oct 12, 2008) Over 2 crore
people suffer from a serious mental disorder,
and 5 crore from a common mental illness
An estimated 30 lakh people need
hospitalization, while only 29 000 beds are
available
Prevalence of mental illness (2005 NIC)
80.6% - Urban
48.9% - Rural
Worldwide – 1 in 4 is mentally ill
6. Mental health is more than the
absence of mental illness
Mental health is described by WHO as:
... a state of well-being in which the
individual realizes his or her own abilities,
can cope with the normal stresses of life,
can work productively and fruitfully, and
is able to make a contribution to his or
her community
7. Mental Health
Ability to think and learn, and the
ability to live with one’s own emotions
and the reactions of others
A state of balance, many factors
Inseparable from physical health
9. Determinants of Mental Illnesses
Social and economic factors
Demographic factors eg sex, age
Serious threats eg conflicts, disasters
Major physical illness
12. Determinants: Gender
Women and depression
Higher risk because of lower education,
social roles and multiple stresses
Domestic and social violence
Men and substance use disorders
14. Solutions for the New Millennium – The
WHO Approach
1.Mental Health is everybody’s business
2.Focus on Health Promotion
3.Priority to be given to low and middle income
group countries
4. Identifying vulnerable groups – children,
elderly, minorities
15. Serious mental disorders -
Schizophrenia, Epilepsy and Depression
Combination of medication and
psychological individual/family
intervention
Treatment period usually extends over
1 yr and requires supervision
Treatment of Mental Illness
16. Prevention of Mental Illnesses
Conduct disorders, depression, anxiety
disorders, substance related disorders and
psychotic disorders
Multiple actions at several levels
Several forms of developmental and
intellectual disabilities eg
cretinism due to iodine deficiency
disorders due to brain injury
17. Mental Health Promotion
WHO global project for promotion of mental health
launched in 2005
Salient features
• Recognizes that mental, social, behavioral
problems influence and intensify each other
• Provision of basic civil, political, economic, social
and cultural rights are fundamental to good mental
health
• Inter-sector linkage – education, labor, justice,
transport, environment,
18. Mental Health Program
Reduce the human, social and
economic burden from mental and
neurological illnesses and suicide
Promote mental health
19. Mental Health Program: Components
Advocacy
Treatment services
Mental health promotion
Policy and legislation
Research and evaluation
Suicide prevention
20. National Mental Health
Program
Started in 1982 – NIMHANS
Objectives
1)Availability and accessibility of mental
health care to all
2)Application of mental health knowledge
in general health care and social
development
3)Community participation
21. NMHP Strategy
(a) Integration of the mental health care service with
the existing general health services;
(b) to utilize the existing infrastructure of health
services and also to deliver the minimum mental
health care services;
(c) to provide appropriate task oriented training to
the existing health staff;
(d) to link mental health services with the existing
community development program.
22. Operating at 3 levels
Medical College – Strengthening the
department of Psychiatry
Medical Institutions – Upgrading
facilities
Primary Health Care-IEC, training,
ICDS,Indian systems of medicine
23. Drawbacks
Prioritized Severe Medical Illnesses –
Epilepsy, MR and psychoses
Biased towards medical model of
treatment (pharmacotherapy and ECT)
and neglected other methods
(eg.psychotherapy)
24. Results?
Lack of political commitment and
resources
Very slow implementation and
expansion of programme
Bottom line :Not been successful so far
25. District Mental Health
Program(DMHP)
Recently revised for the 11th 5 year
plan
Deinstitutionalization of mental health
care and Community based intervention
Aims to cover 125 districts
Budget of 1 crore for each district for 5
years
26. Strategy
Training of Medical Officer and other
health care workers in the PHC to
recognize and treat common medical
illnesses
Involvement of school and college
teachers in counseling of students
Life skills training for young children
Emphasis on suicide prevention
27. WHO Mental Health Global
Action Plan (GAP)
Launched on 9th Oct 2008
Presently countries spend less than 2 %
of health budget on mental health
Taking action makes good economic
sense
‘Inspire the action’
28. Salient features
Proposes an intervention package-
emphasis on Primary Health Care and
training
Partnerships- Government, NGOs,
Donors
Policy – Influencing health planners and
decision makers
Prioritizaton- ‘pro-poor’
29. What do you think?
Consciousness and Conscience -’Spiritual
well being’ now officially recognized in
the new WHO definition of health
Can one have mental health without
spiritual health? Integrity therapy
