Mental Health

"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 her or his community". - WHO

Mental Illness

"A mental illness is a medical condition that disrupts a person's thinking, feeling, mood, ability to relate to others and daily functioning. Mental illness are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life". - National Alliance on Mental Illness(NAMI).

National Mental Health Programme

It is estimated that 6-7 % of population suffers from mental disorders. The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuropsychiatric disorder is much higher than diarrhea, malaria, worm infestations and tuberculosis if taken individually. Together these disorders account for 12% of the global burden of disease (GBD) and an analysis of trends indicates this will increase to 15% by 2020 (World Health Report, 2001). One in four families is likely to have at least one member with a behavioral or mental disorder (WHO 2001). These families not only provide physical and emotional support, but also bear the negative impact of stigma and discrimination. Most of them (>90%) remain un-treated. Poor awareness about symptoms of mental illness, myths & stigma related to it, lack of knowledge on the treatment availability & potential benefits of seeking treatment are important causes for the high treatment gap. The Government of India has launched the National Mental Health Programme (NMHP) in 1982, with the following objectives:

     1. To ensure the availability and accessibility of minimum mental healthcare for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of the population;
     2. To encourage the application of mental health knowledge in general healthcare and in social development; and
     3. To promote community participation in the mental health service development and to stimulate efforts towards self-help in the community.

District Mental Health Programme (DMHP)

The main objective of DMHP is to provide Community Mental Health Services and integration of mental health with General health services through decentralization of treatment from Specialized Mental Hospital based care to primary health care services. On the basis of "Bellary model" District Mental Health Program was launched in 1996 in 4 districts under NMHP and was expanded to 27 districts of the country by the end of IXth Five year plan period. Presently the DMHP is being implemented in 123 districts of the country. The DMHP envisages a community based approach to the problem, which includes:

Objective

     » Training of mental health team at identified nodal institutions.

     » Increase awareness & reduce stigma related to Mental Health problems

     » Provide service for early detection & treatment of mental illness in the community (OPD/ Indoor & follow up).

     »Provide valuable data & experience at the level of community at the state & center for future planning & improvement in service & research.

In TamilNadu, District Mental Health Programme was initially started during the year 1997 on pilot basis at Tiruchirappalli and subsequently implemented in phased manner to 25 districs of Tamil Nadu namely Tiruchirappalli, Ramanathapuram, Madurai, Theni, Kanyakumari, Erode, Dharmapuri, Nagapattinam, Kanchipuram, Tiruvallur, Cuddalore, Chennai, Virudhunagar, Thiruvarur, Perambalur, Namakkal, Villupuram, Pudukottai, Tiruppur, Sivaganga, Thoothukudi, Karur, Dindigul, Tiruvannamalai and Tirunelveli It is a 100% centrally sponsered scheme for the first 4 years and subsequently under taken by State Government Budget. The professionals of District Mental Health Programme are regularly conducting the awareness programme, treatment camps, home visits in their respective districts which helps the community to overcome from their social stigma, facilitate the early identification, treatment and enhancing their coping resource in order to precent mental illness and suicide.

District Mental Health Programme is a community based mental Health care programme based on the guidelines of National Mental Health Programmesfully funded by the Government of India through National Health Mission, with the prime objective of reaching the un reached.

In Tamilnadu, District Mental Health Programme was launched in 1997 in Trichy on pilot basis and has been extended to all the 32 districts of Tamil Nadu and this is the highest numbers of DMHP implementing districts in the entire country and as far as Chennai is concerned the DMHP Team is attached to the Govt. Hospital Saidapet, , Chennai.

DMHP is implemented in the District Head Quarters Hospitals of all the Districts The team comprises of a Psychiatrist, Psychologist, Social Worker and assisted by a Nurse, Data entry operator and Multipurpose Health Worker.

The District Mental Health Programme team is regularly conducting the awareness programme, treatment camps, home visits in their respective districts which helps the community to overcome from their social stigma, facilitate the early identification, treatment and enhancing their coping resource in order to prevent mental illness and suicide.

Inorder to mitigate suicide rate, 104 Tele-counselling serviceshas been implemented from the year 2018-19, where a centralized exclusive suicide prevention helpline through 104 counselling service is run by psychologist trained in suicide prevention techniques at Institute of Mental Health. Based on the consent of the suicide attempters they will be given counseling for a period of 18 months.

This Programme further has been broadened through major activities as follows:

1.De-Addiction centers

Considering the steep increase of addiction related social and health issues, and based on Our Hon’ble Chief Minister’s 110 Announcement made for the year2016-2017 in the Assembly. The Government of India approved the State PIPs for Financial Year 2016-2017 for establishing De-Addiction Centres in Tiruppur, Kancheepuram and Cuddalore

The main objective of this centers are
     » To provide treatment and rehabilitation services for persons with alcohol and substance abuse problems.

     » To create awareness and educate people about the ill-effects of alcoholism and substance abuse on the individual, the family, the workplace and societyat large.

     » To provide whole range of community based services for the identification, motivation, counselling, after care and rehabilitation for Whole Person Recovery (WPR) with alcohol and substance abuse related problems and to make the person drug free, crime free and employed.

     » To alleviate the consequences and burden of drug and alcohol dependence amongst the individual, the family and society at large.

Each of the center has been provided with 30 bedded ward with the following staff pattern: Psychiatrist, Psychologist,Social worker, Staff nurse,Data entry operator, Sanitory worker, Hospital worker and Security.

Separate funds are being provided for Diet,Medicine and other miscellaneous activities.

The total number of patients treated so far is 4780.

De-Addiction Wards

Ramanathapuram,Nagapattinam, Tiruvarur,Thanjavur

2.Emergency Care and Recovery Centre

Emergency Care and Recovery Centre has been implemented in Vellore, Tiruppur, Theni, Villupuram and Tiruvannamalai. The main objective of this programme is to cater the needs of mentally ill wandering patients,by providing treatment and rehabilitation.

Emergency Care and Recovery Centre is provided with 50 bedded ward, for which the following posts are sanctioned: Psychiatrist, Psychologist, Social worker, Pharmacist, Staff nurse, Data entry operator Multipurpose health worker, and Security.

In Addition to this, separate funds are being provided for Diet, Medicine, Furniture and other miscellaneous expenses. Mentally ill patients are shifted through JSSK drop back vehicles for effective implementation of the programme.

So far is 205 Wandering mentally ill patients have been treated and reunited with their families.

Due to the implementation of these centers large numbers of wandering mentally ill patients are being well treated and rehabilitated for their future well being.

For the year 2019-20, Emergency Care and Recovery Centre is being extended to Chennai and Pudukottai in phased manner.

Satellite Clinics

Further, in order to provide services at the door step of the needy, the programme has been enhanced with Satellite clinics for which, one Psychiatrist exclusively in all 32 districts has been sanction vide G.O.(Ms).No.14,Health and Familywelfare Department, Dated.25.01.2019, for conducting Outreach Satellite Psychiatric clinic, to conduct activities such as

     » Prison/ Sub jail visit and participate in camps organised by Department of Differently Able Welfare Office once in a week.

     » Conducting Life skill education in Schools and Colleges.

     » Conducting special clinic on Suicide prevention, De-addiction, Geriatric , Child and Adolescent Clinic once in a week at the Head quarters Hospital.

     » Conducting Satellite clinic covering all PHC, CHC and SDH.

“Markkam & Maruthuvam” Pilot Project at Earwadi Dhargah Ramnad District ;

This innovative programme is based on the Dava & Dua Model at Ahmedabad being implemented in the name of “Markkam & Maruthuvam” Pilot Project at Earwadi Dhargah Ramnad District

The mentally ill patients who are coming for religious treatment to Dhargah is being sensitized and will be referred to Psychiatric team at the nearby 50 bedded Government Hospital at Earwadi for Counseling and medical management along with free medicines if required. This helps in rectifying the affected people at the early stage itself with Psychological support, both religiously and with proper medical care.