Dharwad Institute of Mental Health And Neurosciences (DIMHANS)-Dharwad

Directorate of Medical Education

Background & Rationale

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India comprises around 18% of the global population and significantly contributes to the global burden of mental disorders. In 2019, mental disorders were the second leading cause of years lived with disability (YLDs), and self-harm and violence were the tenth leading cause of death. Evidence suggests that suicide deaths increased by 40% from 1990 to 2016 making it the third leading cause of death in several Indian states. Recent national level studies have highlighted that 15% of the adult population in India have mental health issues requiring intervention and a wide treatment gap of 70-92% exists for a range of mental disorders. Thus, a large segment of the population requires assistance for mental health and well-being.

The Government of India’s (GoI) recent mental health initiatives include the National Mental Health Policy, 2014, that envisages the provision of universal access to mental health care and the National Mental Health Policy, 2017, that recognises mental health as one of the policy thrust areas. The new Mental Healthcare Act, 2017, enshrines access to mental health as a statutory right and an entitlement, including its provision through primary healthcare.

The Government of India launched the National Mental Health Programme (NMHP) in 1982, in response to the heavy burden of mental illness and critical need of mental health care infrastructure in the community.

The District Mental Health Program (DMHP) was appended to the NMHP in 1996 to overcome the shortcomings of the programme and transitioned the districts into administrative and implementation units for NMHP. The DMHP envisages extending mental health services through the existing healthcare infrastructure and human resources at the community level. With regard to Mental Health services, providing in-person healthcare is challenging, particularly given the large geographical distances and limited resources. Therefore, the Government of India has implemented the use of telemedicine through eSanjeevani in the Ayushman Bharat Health and Wellness Centres (AB-HWCs) that saves the cost and effort, especially of rural patients, as they need not travel long distances for obtaining consultation and treatment. Mainstreaming telemedicine in the Indian health system has minimized inequity and barriers to access. The large number of daily consultations on eSanjeevani are a testament to this fact. Advocating the use of digital tools for improving the efficiency and outcome of the healthcare system, particularly in the domain of mental health care, the National Tele Mental Health Programme, Tele Mental Health Assistance and Networking Across States (Tele MANAS) was announced by the Hon’ble Union Finance Minister in the Union Budget 2022. The apex institutions (NIMHANS, IIIT-B, NHSRC), regional co-ordinating centres and mentoring institutions will be working closely with the states/UTs in all these activities by providing support for technical issues, collaborative consultations, capacity building, implementation, service provision, linkages, monitoring and evaluation, research, innovations etc.

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