Thiruvananthapuram: The Government is yet to take any concrete steps to ensure the continuity of the District Mental Health Programme (DMHP) which has been delivering doorstep care to the mentally ill in the community.

An estimated 10 per cent of the State's population suffers from mental illnesses requiring active intervention.

The DMHP, a Central Government-sponsored programme, which was being implemented in the district since 1999 as part of the National Mental Health Programme, has been struggling along since 2004 after the official project period ended.

Despite the undertaking it had given to the Centre, the State Government did not take over the programme in 2004 and has been keeping it running on three-month extensions, utilising the unspent balance of the Central funds.

Annual commitment

The annual commitment of the State for continuing the DMHP in a district will be about Rs.20 lakhs

The programme has been pulling on in Thiruvananthapuram because of the free medicines supplied by the Directorate of Health Services.

In Thrissur, DMHP was launched in 2000. However, the project has almost come to a standstill as the DHS has not been supplying free medicines and also because there is not even money for buying fuel for the mobile unit to conduct outreach programmes.

In the absence of any assurance from the Government regarding the future of the programme, mental health experts are worried that the continued psychiatric care that is being provided to chronic mentally ill patients in the community may be discontinued, pushing more people towards mental hospitals.

"If the State or the Central Government does not take over the programme, all the good work of the past few years could come undone. Earlier, the care of chronic mentally ill patients who need prolonged treatment used to be a major problem because treatment was often discontinued once they were out of the hospital. Through the DMHP, we could give such patients continued care in the community itself and also keep down the number of in-patients in hospitals," points out a senior psychiatrist.

Few complaints of relapses

Psychiatrists report that there have been few complaints of relapses in the past few years as the DMHP team could monitor the patients regularly and ensure that the drug supply is regular.

About 25 psychiatric outreach clinics are run by a mobile team in various parts of the district every month to monitor old patients and also to pick up new cases from the community and give prompt treatment.

Thiruvananthapuram was the first district to launch the programme in the State in 1999, followed by Thrissur in 2000. The Central Government has now given sanction for the DMHP to be launched in Kannur and Kottayam also.

No vehicles provided

While the programme has the provision for staff creation, no vehicles have been provided by the State Government for door-to-door delivery of medicines.

The long-term objective of the DMHP was the integration of mental health services with primary health care services so that the stigma of mental illnesses could be done away with.

Also, unlike before, the families of many chronic mentally ill patients are now willing to accept them as they are assured of continued psychiatric care. Community awareness on mental illnesses and the need for early treatment has also gone up.

Once the Centre gives the last instalment of the DMHP funds for Thiruvananthapuram and Thrissur, no more money would be forthcoming for the project.

It is pointed that the State would be doing disfavour to the thousands of mentally ill persons in the cmmunity if it cannot commit itself to continue the DMHP.

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