The Hindu : Kerala / Thiruvananthapuram News : End of the road for district mental health programme?

Online edition of India's National Newspaper
Wednesday, Aug 25, 2004

Kerala

Kerala - Thiruvananthapuram

End of the road for district mental health programme?

By C. Maya

THIRUVANANTHAPURAM, AUG. 24. The District Mental Health Programme (DMHP), which has been delivering mental health care services to people at the community-level, may have to be wound up by the end of the month as the Government is yet to give the green signal for the continuation of the project.

Thiruvananthapuram was the first district in the State to launch DMHP on September 1, 1999 as part of the National Mental Health Programme. The Union Health Ministry had sanctioned the project for a period of five years and the programme officially winds up on August 30.

Adverse effect

S. Jayaram, Superintendent of the Mental Health Centre, Peroorkada, which is the nodal centre for the project, points out that DMHP should not be discontinued as the withdrawal of psychiatric care services in the community might adversely affect mentally ill persons who had been undergoing treatment from their homes.

"We sent letters as early as in June, apprising the Government of the need to continue the programme. It was suggested that more Central aid be sought or the Government fund the project. But we have had no response so far," says a team member.

The DMHP was planned to take psychiatric help directly to patients so that in the long run, mental health services could be integrated with general health care at the primary level. Another goal of the project was to ensure that continued psychiatric care and psychological counselling were given to patients discharged from mental hospitals so that their families would accept them.

Under the programme, 25 outreach clinics are being run in the district in all interior areas, including hilly and coastal areas, offering psychiatric consultation, counselling and free medicines. Some 2,000 patients attend the clinics every month. Mental health awareness programmes, stress management classes and life skill programmes for teachers and students have resulted in better community participation.

Early identification

"Apart from increased community awareness, the programme has resulted in improved referrals and early identification of various disorders. In the last five years, 6,913 new cases were identified from the community," says D. Raju, secretary of the State Mental Health Authority and nodal officer of the project.

"The major achievement of DMHP is that today, the number of in-patients at the Mental Health Centre here has come down from 700 to 500. Earlier, those who were discharged from the Centre often got re-admitted as there were no support services to ensure that the treatment was not neglected. Now re-admissions have reduced because there is doorstep care," Dr. Raju points out.

Goals achieved

Among the 20-odd districts in the country in which DMHP was conducted, Thiruvananthapuram was recommended as the best, as it could achieve many of the goals of the project such as imparting training to doctors, nurses, teachers and `anganawadi' workers in the community, creating self-help groups, suicide prevention initiatives and active community participation.

At a monthly review meeting of the Mental Health Centre, which was also attended by the Health Secretary, it was informally decided to continue the programme for another month till the Government makes a decision.

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