PRIME Annual Meeting in India urges implementation and scaling up of treatment programmes for mental health disorders in primary and maternal health care
The fourth annual meeting of PRIME Research Program Consortium organized by Public Health Foundation of India and Sangath in Bhopal, stressed on the urgent need to implement the integrated mental health care plan comprising packages for delivery in primary and maternal health in Low and Middle Income countries, especially India, where Mental health services is an neglected area which needs immediate attention from the government, policymakers, and civil society organizations.
Presently in India, 70.2-88.3 million people have a prevalence of Mental Health problems, contributing to 5.6% of the overall burden of disease (IHME 2013) and there has been an increase of 65% new cases of mental health disorders in the past 20 years, especially in the categories of Depressive disorder (51%), Alcohol Use Disorder (10%), Substance Use Disorder (11%), Psychosis (7%), and Anxiety (15%). In Madhya Pradesh, as per PRIME data, out of all the registered cases of mental health disorders, 38.5% are of Depressive Disorders followed by Alcohol Use Disorder which is approximately 15.9%. Despite, National Mental Health Programme since 1982, there has been very little effort so far to provide mental health services in areas primary and maternal healthcare. With increase in population, changing life-style, unemployment, lack of social support and increasing insecurity, it is predicted that there would be a substantial increase in the number of people suffering from mental illness in India. Considering the mental health needs of the country and the treatment gap, the PRIME Consortium annual meet is an attempt to remind and advocate for mental health services and suggest a model to reduce the treatment gap.
According to WHO countries like India devote less than 1% of their health budget to mental health services compared to 10%, 12%, 18% in other countries. Further there are just 3,500 psychiatrists in India, which is only three psychiatrists per one million people in India, compared to 100 in Australia or 150 in other developed countries. Over 90% of people with mental illness are cared for within their communities by their families and never even receive a diagnosis. Out of Pocket expenses for treatment in private sector pushes families in the poverty trap further leading to vicious cycle between mental disorders and poverty.
Speaking at event titled “Improving Mental Health Care: Challenges and Opportunities in Low and Middle Income Countries” Dr RN Sahu, Secretary of the State Mental Health Authority, Madhya Pradesh in his address apprised the gathering that atleast 7-10 lakh people in the state are suffering from severe mental illness in the state and the number of doctors are grossly insufficient for a populous state like MP. He further added that the state will now get central funding for scaling up of mental health services in 10 districts namely – Sehore, Mandla, Shivpuri, Devas, Satna, Barwani, Damo, Guna, Chhhindwada, Ratlam respectively.
Chief Guest, Sh. Vishwas Sarang, MLA and Chairman of MP State MFP Federation said that there is an urgent need to advance towards a new strategy with the task of developing, implementing, regulation and coordination of mental health services in the state especially in the primary and maternal healthcare. With a renewed commitment from the central government, to scale up 10 districts in MP, the state will surely have the wherewithal to have enhanced infrastructure and technology to deal with the challenge of testing and treating varied mental disorders.
In his address Prof Vikram Patel, Co-Director, Centre for Chronic Conditions and Injuries, Public Health Foundation of India, stressed the importance of the PRIME program in the context of the new National Mental Health Policy launched by the Government of India in 2014 and the draft Mental Health Care Bill soon to be tabled in Parliament. PRIME is demonstrating the key strategies to improve access to care in the District Mental Health Program through a partnership between the Government, public health technical resource agencies and civil society.
As per the norms set by the MP State Mental Health Authority, there should be one psychiatrist for every 1,00,000 people, 3 clinical psychologists for every 2,00,000 people, 2 psychiatric social workers for every 1,00,000 people and one psychiatric nurse for every 10 psychiatric beds, however MP continues to battle with the shortage of trained doctors as well as evidence based research which is the need of the hour.
PRIME is a six year research program consortium funded by DFID, which aims to develop, evaluate and scale up a mental health care plan in primary and maternal health care in districts in three African (Uganda, South Africa, Ethiopia) and two South Asian countries (India and Nepal). PRIME specifically aims at:
- Developing an integrated mental health care plan comprising packages of mental health care for delivery in primary health care and maternal health care.
- Evaluating the feasibility, acceptability and impact of the packages of care in primary health care and maternal health care.
- Evaluating the scaling up of these packages of care at the level of districts
The workshop was attended by scientists and researchers from World Health Organization, the University of Cape Town, the Centre for Global Mental Health, the University of KwaZulu-Natal, the University of Addis Ababa, Public Health Foundation of India, Makerere University, HealthNet TPO, BasicNeeds and representatives from the Ministries of Health in Ethiopia, Nepal, South Africa and Uganda, Department of Health and Family Welfare, Government of Madhya Pradesh.
- Ms Kalpana Delouri, Bhopal – Mob: +919893087798
- Mr Rajiv Chhibber, Head Communications PHFI, New Delhi: Mob: +919810426698