The National Mental Health Programme was initiated by the Government of India to integrate Mental Health with other Health services at rural level. It is being implemented in the state of Maharashtra since 1982, Maharashtra was the first state to implement the National Mental Health Programme.
State level Mental Health Cell is established at Directorate of Health Services Mumbai vide Public Health Department G.R.No.MHP–1090/CR–185/Arogya–3 Dt.20/07/1990. Additional Director Health Services (Mental Health) is Programme Officer.
Since last 3 decades Occupational Therapists and Psychiatric social workers are working in full strength towards rehabilitation and counselling. Over a period of last 5 years as per the Supreme Court guidelines there is a revamp in the living condition of the inmates, so as to meet the protocal of human rights of mentally ill patients. After enactment of Mental Health Act the Board of Visitors and guidelines of State Mental Health Authority are strictly followed. All other various services in the field of Gynaecology, ENT, Dentistry are also made available with the help of Medical Officers of the Hospital. Liasion services with help of District General Hospital, District Tuberculosis Officer, District Leprosy Officer help us in giving further specialised health services to our inmates.
Objectives of National Mental Health Programme
- To take (outreach) Mental Health Services to remote village along with other health Services.
- To delegate – assign different tasks – responsibilities in Mental Health Services properly.
- To take Mental Health an indispensable component of General Health Services.
- To integrate all these schemes with other Community/Social development schemes.
- To enlist people’s participation in Mental Health Services.
Use of Mental Health Professionals within the hospital namely the Psychiatrist, Psychiatric Nurses, Psychiatric Social Workers and Occupational Therapist under the guidance of Director of Health Services and Additional Director of Health Services (Mental Health) Mumbai. The idea is to treat acutely ill/Violent/unmanageable/mentally ill patients within the institute and make them managable at home level and send them back in the society in such way so as to make them earn their own bread with due respect. To treat the chronic managable patients and chronic silent patients on OPD basis as a part of maintainance therapy.
Activities
District Mental Health Programme
Three type System
- State Mental Health Cell.
- Regional Mental Hospital.
- District Mental Health Centre at District Hospital.
Indoor
- Active pharmaco therapy.
- Necessary medical therapy.
- Modified electro convulsive therapy.
- Counselling.
- Occupational therapy for rehabilitation.
- Counselling of de–addiction.
- Art therapy/Music therapy.
- Agricultural activities.
- Celebration of all the festivals irrespective of caste & creed through out the year for hospital inmates.
- Annual sports and cultural events is celebrated in the month of February and Independance Day is also celebrated.
- Special ward for physically ill patients one each for male and female.
- Special section one each from male & female side for epileptic patients.
- One criminal ward for criminal mentally ill patients on male side.
- Pharmaco therapy.
- Counselling.
- Modified Electro Convulsive Therapy.
Services to Common People
Medical & Other Services are being provided as per the Guidelines given by H’ble High Court, Mental Health Act 1987 and Govt.
- Provisions of food.
- Shelter.
- Medicines & treatment.
- Primary Health care services.
- Village level services.
- Sub centre level.
- Primary Health Centre level.
Rural Hospitals/Sub District Hospital: Psychaitrist Cl.I Civil. Hospital visits identifie Rural Hospital and Sub District Hospitals once in a month to provide Mental Health Services to the patient from rural population.
- Other hospital.
- District Hospitals.
- Super Specialty Hospitals.
- Outreach services – Visit to Central Jail.
- Beggers Home.
4 Regional Mental Hospital in the State are functioning at the following 4 District with a bed strength of 5400
- Pune: 2400.
- Thane: 1800.
- Nagpur: 900.
- Ratnagiri: 300.
Total 77 private Licenced Psychiatric Nursing Home are functioning in the State.
Performance – Region Wise
Types of Mental Illness treated in Regional Mental Hospitals
Outdoor (As on 31–12–2007)
Sr.No. | Diagnosis | Male | Female | Child | Total | Monthly | Prog. | |
1 | Organic Mental Disorder | New | 22 | 12 | 0 | 34 | 34 | 287 |
Old | 50 | 136 | 1 | 187 | 187 | 1235 | ||
2 | Affective Psychosis | New | 121 | 72 | 0 | 193 | 193 | 1260 |
Old | 1107 | 566 | 1 | 1674 | 1674 | 12530 | ||
3 | Schizophrenia | New | 236 | 161 | 3 | 400 | 400 | 2522 |
Old | 3062 | 2046 | 2 | 5110 | 5110 | 35748 | ||
4 | Neurosis | New | 31 | 38 | 0 | 69 | 69 | 425 |
Old | 549 | 673 | 1 | 1223 | 1223 | 2346 | ||
5 | Mental Retardation | New | 26 | 12 | 22 | 60 | 60 | 495 |
Old | 112 | 126 | 4 | 242 | 242 | 1816 | ||
6 | Epilepsy | New | 19 | 11 | 5 | 35 | 35 | 454 |
Old | 267 | 116 | 3 | 386 | 386 | 969 | ||
7 | Addiction | New | 26 | 5 | 0 | 31 | 31 | 242 |
Old | 117 | 14 | 0 | 131 | 131 | 593 | ||
8 | Other | New | 16 | 7 | 1 | 24 | 24 | 508 |
Old | 16 | 3 | 0 | 19 | 19 | 4430 | ||
9 | Total | New | 497 | 318 | 31 | 846 | 846 | 6193 |
Old | 5280 | 3680 | 12 | 8972 | 8972 | 59667 |
Indoor (As on 31–12–2007)
Sr.No. | Diagnosis | Male | Female | Child | Total | Monthly | Prog. | |
1 | Organic Mental Disorder | New | 4 | 0 | 0 | 4 | 4 | 22 |
Old | 3 | 2 | 0 | 5 | 5 | 33 | ||
2 | Affective Psychosis | New | 53 | 11 | 0 | 64 | 64 | 498 |
Old | 404 | 208 | 0 | 612 | 612 | 1814 | ||
3 | Schizophernia | New | 198 | 89 | 1 | 288 | 288 | 1830 |
Old | 1030 | 900 | 0 | 1930 | 1930 | 9711 | ||
4 | Neurosis | New | 0 | 0 | 0 | 0 | 0 | 15 |
Old | 2 | 0 | 0 | 2 | 2 | 43 | ||
5 | Mental Retradation | New | 6 | 2 | 0 | 8 | 8 | 65 |
Old | 274 | 179 | 3 | 456 | 456 | 3062 | ||
6 | Epilepsy | New | 3 | 2 | 0 | 5 | 5 | 71 |
Old | 219 | 175 | 0 | 394 | 394 | 2747 | ||
7 | Addiction | New | 17 | 0 | 0 | 17 | 17 | 67 |
Old | 59 | 0 | 0 | 59 | 59 | 186 | ||
8 | Other | New | 3 | 0 | 0 | 3 | 3 | 38 |
Old | 29 | 7 | 0 | 36 | 36 | 473 | ||
9 | Total | New | 284 | 104 | 1 | 389 | 389 | 2606 |
Old | 2020 | 1471 | 3 | 3494 | 3494 | 18069 |
Special Features of National Mental Health Programme
Provision of Mental Health within the premises of general Health care system and not apart from it to reduce stigma. Provision of Mental Health through out the life span.
Expected Community Participation
By giving them rights for information and maintaining transparency in the Administration.
Encouraging them in participating in Mental Health Educational activities. Community bared rehabilitation of mentally ill persons.
Role of NGOs
In provision of health in form of Material for occupational rehabilitation of inmates and cultural activities for inmates. To disseminate knowledge on early diagnosis and prompt community support toward mental illness.
Important Health Education Messages
As per the WHO slogan Physical & Mental Health through out life span.
Role of the other Sectors
Participation of the Judiciary and NGO’s in Mental Health Educational Camps & Exhibitions, to make legal aid and guidance available to the needy free of cost.
Impact
Reduction in stigma and increase awareness towards mental health & hygiene.
Achievements
District Mental Health Programme being implemented with District Mental Health Centre at Raigad. Full time Psychiatrist available at Dist. Thane, Raigad, Nashik, Dhulia, Jalgaon who visit the rural hospitals within their area or zone.
Goals Achieved
To reduce the stigma, Mental health Education programme as such are conducted in various sections of society viz.in school, colleges and within the premises of court of law, encouraging the relatives to provide in house treatment in their houses.
Provision of newer antidepressant and atypical antipsychotic drugs.
This favours better outcome of the chronic mentally ill patients. Maximum provision of occupational rehabilitation skill in form of gardening , painting, stationery making, seasonal items etc. to the inmates for the better outcome of the patients. To work and motivate the staff to achieve in maintaining basic human rights of the mentally ill patients by improving and maintaining the infrastructure.
Future plans
To start Day Care Centre & Half way homes at Regional Mental Hospitals Centre for Geriatric Health and Mental Illness in Maharashtra.