This report is an executive summary on State Training and Research Institute of Mental Health and Neurosciences (STRIMHANS).
In India, there is a tremendous gap between the needs of mental health care and the availability of hospital beds and human resources. While reviewing the development of mental health services in Maharashtra and the country this chapter highlights the repeatedly ignored recommendations made by several health committees regarding manpower development.
It is estimated that 10 to 20 persons per thousand of the general population require mental health care and an additional 20 to 60 persons per thousand require attention from mental health experts. The total availability of hospital beds for mental health care is only 1/30th of the beds per thousand population which has improved from 1/40th bed per thousand in 1946. In Maharashtra, the ratio works out to 1/10th beds per thousand population, which is three times better than the country’s average though highly inadequate compared to the need.
In addition to the 5,830 government hospital beds, there are 1,279 beds in municipal and private hospitals. The concentration of available facilities is only in Mumbai, Thane and Pune regions followed by Nagpur, Ratnagiri and Sholapur. As against the present need for 2,633 trained personnel required for manning the existing government beds, only 107 are available in the state. The requirement is going to increase to 2,691 in the next five years and 2,702 at the end of 10 years to man fully the presently available bed strength. The cases for adding to trained manpower in the state to take care of the existing hospital bed capacity is forcefully established showing the need to train nearly 2,500 persons to meet immediate need of existing hospitals. It must be noted that existing beds themselves have been catering to only 1 per cent of the actual needs.
This chapter records the inadequate implementation of National Mental Health Program (NMHP) in Maharashtra. It also highlights the fact that NMHP at best is a temporary arrangement to meet the exigency and has to be replaced by an ongoing organizational arrangement for developing professional personnel to man the mental health services in the state.
Chapters 4 and 5
Chapter 4 identifies problem areas and suggests specific solutions. Chapter 5 graphically shows the present and ideal district wise position of mental health services in the state and also projects graphically the change in future scenario if the proposed solutions are implemented.
Chapter 6 is a case study of the National Institute of Mental Health and Neuro–Sciences (NIMHANS), highlighting its activities, training courses, achievements, experiences and insights and makes out a case for establishing more training and research institutes. NIMHANS founded by the Government of Karnataka in collaboration with the Government of India on 75/25 (plan) and 45/55 (non–plan) expenditure, has a capacity of 72 trainees and 131 faculty members. The institute has collaboration with USA and can be looked upon a source of learning and as a forerunner of the proposed STRIMHANS at Pune.
Chapter 7 justifies the location of the institute at Pune with its available Central Mental Hospital with a 2,600 bed capacity, medical college with its Department of Psychiatry and the Sassoon Hospital with 30–bed ward as well as the availability of the Karve Institute of Social Sciences, the SNDT College and the University of Pune as academic infrastructure.
Chapter 8 describes the capacity of STRIMHANS increasing from 18 students in the first year to 78 students every year from the fifth to the tenth year. The total turnout of students will certainly make an impact, though partially, serving the needs of the population due to the decentralized structure manned by trained personnel.
Chapter 9 describes the development of the Regional (Satellite) Mental Health Centers (RMHC), the District Mental Health Centers (DMHC) and other activities of the institute. It highlights the point that the DMHC becomes the key element in the delivery of mental health care supported by RMHC, and 25 out of 30 districts in Maharashtra will have mental health services, as against only four districts as of today.
Chapter 10 describes the organizational details of the formation of STRIMHANS by combining the Department of Psychiatry and the 30–bed ward of the B J Medical College and Sassoon General Hospital, Pune, with academic affiliation of child guidance clinic of KEM Hospital, Pune. This STRIMHANS would be located in two different places.
- The undergraduate wing without patient services and the 60–bed component in the Sassoon General Hospitals and
- The postgraduate and research wing of the institute along with the 190–bed component in the current campus of the Central Mental Hospital, Yerawada, Pune or an alternative land given by the Government.
- Department of Psychiatry, B J Medical College.
- Psychiatry ward of 30 beds at the Sassoon Hospital.
- De–addiction Center of 40 beds at the Mental Hospital, Pune.
- About 180 beds at the Mental Hospital Pune.
- The Child Guidance Clinic, KEM Hospital Pune.
- Undergraduate and Community Wing with a 60–bed complement in the campus of Sassoon Hospitals, Pune, where the present Department of Psychiatry and wards are located.
- The Postgraduate and Research Wing with a 190–bed Complement on the land belonging to the Mental Hospital, Pune or alternate land provided for by the Government.
Chapter 11 sheds light on the financial outlay for STRIMHANS separately for the institute and its 250 bed hospital, for both recurring and non–recurring items over the 8th Plan period. The funding pattern has also been suggested.
Chapters 12 and 13
Chapters 12 and 13 explain the need for autonomy and the plan of action for implementing the project.