national mental health policy

1. National mental health
programme
presented by –
Nurse practitioner
Srhu

2. facts
• Mental-health issues like depression are one of the
biggest triggers of suicide in India, which accounts
for more than 258,000 of the 804,000 suicide deaths
worldwide in 2012, according to the WHO.

4. aims
• To ensure treatment and prevention of mental
and neurological disorder.
• Use of mental health technology
• Application of mental health principle in total
national development to improve the quality of
life

5. Objective
• To take MHS to remote village along the health
services
• To delegate assign different task responsibility in MHS
• To take MHS an indispensible component of general
health services
• To integrate scheme with other social development
scheme
• To enlist people participation in MHS
• To encourage application of MHS knowledge in general
health services
• To ensure accessibility and availability of minimum
must health care for all in foreseeable future.

6. National mental health programme
• In 1980 government of India felt the necessity of
evolving a plan of action aimed at the mental health
component of national health programme.
• In February 1981 a drafting committee met in
lucknow and prepared the first draft for NMHP.
• In august 1982 the highest policy making body in
the field of health in the country ,the central of
health and family adopted and recommended for
implementation of national mental health
programme

7. Strategies of NMHP
• Integration of mental health with primary health
care through “national mental health programme”
• provision of tertiary care institution for treatment
of mental disorder.
• Eradication stigmatization of mentally ill patients
and protecting their right through institution like
the central mental health authority and state
mental health.

8. Approaches
Integration of the mental health care services with
existing general health services.
To utilize the existing infrastructure of health
services and also to deliver the minimum mental
health care services .
To provide appropriate task oriented training to
the existing health staff.
To link health services with the existing community
development programmes.

9. component
1. Treatment : multiple level
2. Rehabilitation
3. prevention

10. 1.Treatment: multiple levels
a) PRIMARY LEVEL:
Village and sub Centre level multiple health supervisor
under the supervision of the medical officer to be
trained for :
Management of psychiatric emergencies
Administration and supervision of maintenance
treatment for chronic psychiatric disorder
Diagnosis and management of grandmal epilepsy
especially in children.
With local school teacher and parents regarding mental
retardation and behavioral problem children
Counseling problem related to alcohol and drug abuse

11. B. SECONDARY LEVEL :
Medical officer of PHC aids by health supervisor to
be trained for :
Supervision of multiple purpose worker
performance
Elementary diagnosis ‘
Treatment of functional psychosis
Management of uncomplicated psychosocial
problem
Epidemiological surveillance of mental morbidity

12. C. TERTIARY LEVEL :
It was recognized that there should be a psychiatrist
attached to every district hospitals an integral part
of the district health services.
The district hospital would have 30 _50 psychiatric
bed
The psychiatric in a district hospital was to devote
only a part of his time to clinical care and a greater
part in training and supervision of non specialist
health worker

13. 2. rehabilitation
The component of this sub programme include
treatment of epileptic and psychotic at the
community level and development of
rehabilitations center at both the district level and
higher referral

14. 3.prevention
The prevention component is to be community
based with initial focus on prevention and control of
alcohol related problem
Later on problem like addiction juveniles
delinquency and acute adjustment problem like
suicidal attempt are to be addressed

15. Activities of national mental health
programme
• Integration of mental health services to all existing
general health services
• Early detection and follow up
• Increase the awareness of mental health
programme
• Eradication of stigmatization of mentally ill
• Providing counseling services for alcoholic , drug
addicted and delinquents

16. • Establishment of tertiary health Institution for
treatment of mental illness
• Training of mental health team at noble institute
in state
• Training the trainer from states at NIMHAMS,
Bangalore
• recommendation of mentally ill patient and their
rights

17. Five year plan NMHP 2007- 2013
1.FUNDING-
During the 11th five year plan ,there has been
substantial increase in the finding support for
national mental health programme
The total amount of funding is rs.1000 cores [a
three fold increase from previous five year plan]

19. 2.MANPOWER DEVELOPMENT
SCHEME A
Establish 11 center of
excellence in the field of
mental health by upgrading
and strengthening existing
mental health hospital and
institute .
SCHEME B
Setting up so unit of
psychiatry 30 department of
clinical psychology , 30
department of psychiatric
social work , and department
of psychiatric nursing with
the finical support to
postgraduate department

20. Together these schemes will produce 1756
qualified mental health professional annually
• 44 psychiatrist
• 176 clinical psychologist
• 176 psychiatric social
workers
• 220 psychiatric nurses
• 60 psychiatrist
• 240 clinical psychologist
• 240 psychiatric social
workers
• 600 psychiatric nurse

21. 3. MODERNIZATION OF STATE RUN MENTAL
HOSPITALS-
• Grant of up to rs. 3 cores per mental hospital for
modernization of facilities and equipment's
4. For implementation help from community based
organization could enlisted at the state and district
level

22. 5. National mental health programme will be
mainstreamed by integrating with national rural
health mission fund is routed through the state
health society
6. Importance on added component of district
mental health programme i.e. life skill training,
counseling, services in college work place stress
management and suicide prevention services.

23. Future of national mental health
programme
India with a population of 1.2 billion has extremely
limited trained mental health professionals , the
basic approach of NHMP is to be an acceptable and
feasible method of extending of basic mental heath
services.
For efficient work recent independent review of
the DMHP will have to be considered seriously

24. 1. Strengthening of mental health services at sub
center , PHC, CHC levels to make the services more
accessible.
2. NMHP is currently a fully centrally funded plan
programme
 the finically responsibility for the programme will
have to be shifted to state government
3. To enhance the capacity in the county to train
mental health professions.
Staff positions in DMHP will have to be more
attractive to motivate and retain the professional
staff.

25. Appropriate non pharmacological intervention will
be introduced
PHC staff trained adequately.
4. A set of specific measureable outcome indicator for
the DMHP have to developed and used for regular
and continuous reporting and monitoring of the
programme
5. Collaboration and partnership with the private and
non-government sector in NMHP will have to be
developed.

26. To support NGO indicatives especially in the areas
of-
Setting self help groups
Imparting public mental health education to reduce
stigma
Providing finical and technical support of the
establishment of a spectrum of rehabilitation
facilities such as day care long stay homes.
Promoting income generating activities by patient
and family
6.Integration of DMHP with the NHRM

27. Use of existence of infrastructure.
Involvement of NRHM infrastructure for training
related to mental health at the district level
Use of NHRM machinery for placement of drug to
be used in DMHP
7.Rehablitation
There is no provision to treat and rehabilitate
mentally ill patient discharge from the mental hospital
within the community

28. Rehabilitation and reintegration of recovering
mentally ill person on society
There are areas of mental health programmes that
are not been given adequate attention
Life skill education for children and adolescents
Increase in number of suicidal prevention center
To excellence the model of disaster mental health
care

32. Role of nurse
Care for patient experiencing acute mental distress
or who have an enduring mental illness
Assessing and talking to patient about their
problem and discussing the best way to plan and
deliver their care
Building relationship with the patient to encourage
trust ,while listening to and interpreting their needs
and concerns
Ensuring the correct administration of medication
including injection and monitoring results of
treatment

33. Organizing social event’s aimed at developing
patients social skills and helping to reduce felling of
isolation .
Preparing and maintaining patients record’s.
Working with patient’s families and careers ,
helping to educate them and the patient about thin
mental health problem’s.
Preparing and participating in group or one to one
therapy sessions , both individually and with
another health professionals
Providing evidence based individual therapy such as
cognitive behavior therapy for depression and
anxiety

34. Preparing and participating in group or one to one
therapy sessions , both individually and with
another health professionals
Providing evidence based individual therapy such as
cognitive behavior therapy for depression and
anxiety
Responding to distressed patients in a non-
threatening manner and attempting to understand
the source of distress.
Applying de-escalation techniques to help people
manage their emotion’s and behavior .

35. In The Community ( The Role May Also
Involve)
Coordinating the care of patient’s .
Liaising with patients , relatives and fellow professional
in the community treatment team and attending
regular meeting to review and monitor patient’s care
plan .
Visiting patients in their homes to monitor progress
and carrying out risk assessment with regard to their
safety and welfare.
Assessing patients , behavior and psychological needs.
Identifying whether and when patient’s are at risk of
harming themselves or others.

36. REFERENCES
• Director general of health services :– National Mental Health
Programme for India , New Delhi, Ministry of Health and Family
welfare 1882 .
• Neki J.S psychiatry in South-East Asia British Journal of psychiatry .
• Wig N.N , Srinivasa Murhty , R.S Harding T.W . A model for rural
psychiatric services Ranipur Rani experience , Indian Journal of
psychiatry , 1981,23,275-290.
• Jain , S. Jadavs . Pills that swallow policy : Clinical ethnography of a
community Mental Health program in northern india ,
Transcultural psychiatry 2009 . 46: 60-85
• National Human Rights commission Mental Health care and
Human Rights , Eds. Nagraja . D , Murthy , P. NHRC-NIMHANS New
Delhi, 2008.
• Planning commission :- Towards a faster and more inclusive
growth – an approach to the 11th five year plan , government of
India , Yojna Bhavana , November 2006.