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Journalism of Courage
The inhuman conditions of mental asylums and the fact that the inmates find it impossible to get accepted back in the society after treatment is prompting the government to provide the treatment within the community. Starting early next year, the Health Ministry will start mobile mental health outreach clinics in 100 districts where no facilities available now.
The 100 districts are the neglected areas that have been identified in the Empowered Action Group (EAG) states like Bihar, Uttar Pradesh, Rajasthan, Orissa and Madhya Pradesh.
The steps have been taken in the first phase of the programme for which a budget of Rs 190 crore has been allocated. The remaining 493 districts are likely to be covered by the end of 2007.
Revamping the mental health policy has been based on the premise that nearly 1 to 5 per cent of the general population in India need mental health care. With just 4,000 psychiatrists in the country, the task according to the government officials, was becoming impossible.
Recommending family involvement in taking care of the mentally ill at home, the government envisages a changed mental health policy which includes:
• Hospitalisation of mentally ill patients to be avoided as far as possible. They should be admitted in a general hospital psychiatric unit (GHPU). • The mobile unit will have a psychiatrist, a psychiatric social worker, a nurse and a nursing orderly who will reach remote areas on rotatory basis. • A family member would be asked to stay with the patient admitted at a mental hospital. Family stay wards are being created in these hospitals. • The hospital stay should not exceed 30 days, which is more than adequate. Follow up treatment can be continued as outpatients. • No new mental hospitals will be established. More resources to be given to established GHPUs. • Giving all the MBBS doctors, including those in the primary health centres, a three months orientation course in psychiatry. • Under domiciliary aftercare programme, the discharged patient would be given medicines for a fortnight/month or three months during his OPD check-ups. In the interim period, a social worker will visit the patient every week to supervise medication.
‘‘The advent of newer antipsychotic drugs has rendered hospitalisation virtually redundant. A vast majority of cases including those suffering from acute psychotic depression illness or severe depression, can be safely and swiftly treated at home with oral medication,’’ said Dr (Col) D.S. Goel, National Consultant for Mental Health, Health Ministry.
