Details for Reform Option "District Mental Health Programme, Tamil Nadu"
There are an estimated 70 million mentally ill people in India, but only 4,000 psychiatrists and 200 psychologists, meaning that just 10% get treatment.
A mobile psychiatric team, consisting of a psychiatrist, social worker, statistician and Medical Officer (MO) was established in three districts in Tamil Nadu, to visit each hospital and Primary Health Centre (PHC) in a district once a week.
The team’s aims include treatment, training and Information Education and Communication (IEC) as well as rehabilitation.
The programme also organises mental health festivals and trains PHC staff. MOs are given 15 days training, paramedicals 10 days training and non-medical personnel [eg Panchayat (local council) members and teachers] three days training. It has also set up self help groups for the relatives (mostly wives) of the mentally ill.
(Madurai and Ramnad districts, Tamil Nadu)
Number of patients treated rose from 210 in July 2002 to 1,209 in July 2004.
In 2002-3 100 PHC MOs were trained to diagnose and supervise treatment.
In 2003-2004 50 PHC MOs were trained.
For 2003 to 2004 INR 62,600 was spent on drugs. INR 98,000 was allotted for 2004-2005.
The District Administration allocated INR 24 lakhs or the construction of a rehabilitation centre for the mentally ill.
Training, IEC activities and stationery costs (2002-2003) INR 7,50,000 (€13,327) in both districts.
Funds allotted for 2003-2004: 4 lakhs (€7,103) (two lakh for each district).
Trichy district since 1998 and Madurai and Ramnad districts since 2001, Tamil Nadu.
Information not known.
Access: Increases access to care for the most needy and vulnerable.
Training: Extends training into the community.
Integrated: Decentralises care from hospital level down to community level.
Public awareness: Educates/raises public awareness in the community.
Availability of psychiatrist.
Who needs to be consulted
State Government health services departments.
Primary Health Centres and MOs.
Has been operating successfully in Tamil Nadu since 1998.
Chances of Replication
Similar schemes are ongoing in Andhra Pradesh, Assam and Rajasthan. The Government of Tamil Nadu has asked the Government of India for INR 10 Crores to extend the programme to 9 more districts in the state.
Clare Kitchen, Research Consultant, European Commission Technical Assistance, New Delhi. September 2004.