Mental Health Programme in the 11th Five Year Plan.

The National Mental Health Programme (NMHP) of India was initiated in 1982 1 and this year it will be completing 25 years. The programme is at a crucial stage of expansion to cover a larger population of the country. The approach paper for the 11 th Five Year Plan 2 outlines the scope of mental health as follows: " The 11 th Five Year Plan will recognize the importance of mental health care and will concentrate on providing counselling, medical services, and establishing helplines for all , especially people affected by calamities, riots and violence " (p.72). It is also significant that the National Farmers Commission also identified the need for mental health interventions to address the growing problem of farmers suicides 3. Similarly some of the welfare programmes, like the Integrated Child Development Scheme (ICDS) are reaching a national coverage 4. This is an opportune time to review the progress of NMHP and place the future activities based on the lessons learnt in the last quarter century of the programme. There are three aspects relevant to the 11 th Five Year Plan that call for attention, (i) what is currently known about mental disorders and mental health interventions (ii) what are the salient aspects of the first 25 years of the NMHP and (iii) what should be the focus of the 11 th Five Year Plan. Mental health/Mental disorders Mental disorders form an important public health priority, both in terms of the numbers of people suffering from mental disorders and due to the burden of these disorders in the community 5,6. These conditions include the severe forms of mental disorders like psychoses, substance abuse and mental retardation. Of the health conditions contributing to the disability adjusted life years (DALYs), of the top 10 conditions, four are mental disorders. Women form a specially vulnerable group for depressive disorders. In addition, populations living under rapid social change, disasters, conflict situations, migrant populations, and poor, have higher rates of prevalence of mental disorders and psychosocial needs. The growing problem of suicides in farmers, associated with the financial problems is an indication of the way mental health gets affected by social situations. There are effective interventions to address the wide range of mental disorders that include medicines, psychological interventions, social interventions and rehabilitation. There are demonstrable projects of such cost-effective interventions from India 7. The currently accepted approach is to provide care in …