The Government of India decided to launch the National Mental Health Programme (NMHP) during the Seventh Plan period to ensure availability and accessibility of minimum mental health care for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of population; to encourage application of mental health knowledge in general health care and in social development; to promote community participation in the mental health service development; and,] to stimulate efforts towards self-help in the community.
Mental illness has been included as one of the disabilities under f the “Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation)” Act of 1995, which came into force on February 7, 1996.
A district mental health programme with a community-based approach was launched under the NMHP in 1996-97 on a pilot basis in four districts, one each in the states of Andhra Pradesh, Assam, Rajasthan, and Tamil Nadu. The programme has been extended to some other districts/states in the country.
The approach to the treatment of mental disorders is based upon the following strategy:
i. Integrating mental health with primary health care through the NMHP.
ii. Provision of tertiary care institutions for treatment of mental disorders.
iii. Eradicating stigmatisation of mentally ill patients and protecting their rights through regulatory institutions, such as the Central mental health authority (CMHA) and state mental health authority (SHMA).
The tertiary care institutions, which are well known in the public sector, are-National Institute of Mental Health and Neuro Science, Bangalore, Central Institute of Psychiatry, Ranchi and Institute of Human Behaviour and Allied Sciences, Delhi.
The Government of India has constituted CMHA to oversee the implementation of the Mental Health Act 1987. The Act provides safeguards for protecting patients suffering from mental illness from stigmatisation and discrimination. It provides for creation of State Mental Health Authority also to carry out the said functions.
The National Human Rights Commission (NHRC), along with the Government of India, also monitors the conditions in the mental health hospitals. States are currently acting on the recommendations of the joint studies conducted to ensure quality in delivery of mental care.
During the Tenth Five Year Plan (2002-07), NMHP was restrategised from a single pronged programme to a multi-pronged programme for effective reach and impact on mental illness. The strategies included the following:
i. Expansion of District Mental Health Programme (DMHP) to 100 districts all over the country;
ii. Modernisation of mental hospitals;
iii. Upgradation of psychiatry wings of Government Medical Colleges and general hospitals; and
iv. Research and training in mental health for improving service.
At the end of the Tenth Plan, the DMHP was under implementation in 123 districts throughout India. Grants were also released for upgradation of psychiatric wings of 75 government medical colleges and general hospitals and for the modernisation of 26 mental hospitals.
For the Eleventh Five Year Plan period (2008-2013), the government has proposed to decentralise the programme and synchronise with National Rural Health Mission for optimising the results.