Background: Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was implemented by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, in the year 2015–2016. Aim: To estimate the prevalence, socio-demographic correlates and treatment gap of mental morbidity in a representative population of India. Methods: NMHS was conducted across 12 Indian states where trained field investigators completed 34,802 interviews using tablet-assisted personal interviews. Eligible study subjects (18+ years) in households were selected by a multi-stage, stratified, random cluster sampling technique. Mental morbidity was assessed using MINI 6. Three-tier data monitoring system was adopted for quality assurance. Weighted and specific prevalence estimates were derived (current and lifetime) for different mental disorders. Mental morbidity was defined as those disorders as per the International Statistical Classification of Diseases, Tenth Revision Diagnostic Criteria for Research (ICD-10 DCR). Multivariate logistic regression was conducted to examine risk for mental morbidity by different socio-demographic factors. Survey was approved by central and state-level institutional ethical committees. Results: The weighted lifetime prevalence of ‘any mental morbidity’ was estimated at 13.67% (95% confidence interval (CI) = 13.61, 13.73) and current prevalence was 10.56% (95% CI = 10.51, 10.61). Mental and behavioural problems due to psychoactive substance use (F10–F19; 22.44%), mood disorders (F30–F39; 5.61%) and neurotic and stress-related disorders (F40–F48; 3.70%) were the most commonly prevalent mental morbidity in India. The overall prevalence was estimated to be higher among males, middle-aged individuals, in urban-metros, among less educated and in households with lower income. Treatment gap for overall mental morbidity was 84.5%. Conclusion: NMHS is the largest reported survey of mental morbidity in India. Survey estimated that nearly 150 million individuals suffer from one or the other mental morbidity in India. This information is to be used for planning, delivery and evaluating mental health programming in the country.
Understanding the burden and pattern of mental disorders as well as mapping the existing resources for delivery of mental health services in India, has been a felt need over decades. Recognizing this necessity, the Ministry of Health and Family Welfare, Government of India, commissioned the National Mental Health Survey (NMHS) in the year 2014–15. The NMHS aimed to estimate the prevalence and burden of mental health disorders in India and identify current treatment gaps, existing patterns of health-care seeking, service utilization patterns, along with an understanding of the impact and disability due to these disorders. This paper describes the design, steps and the methodology adopted for phase 1 of the NMHS conducted in India. The NMHS phase 1 covered a representative population of 39,532 from 12 states across 6 regions of India, namely, the states of Punjab and Uttar Pradesh (North); Tamil Nadu and Kerala (South); Jharkhand and West Bengal (East); Rajasthan and Gujarat (West); Madhya Pradesh and Chhattisgarh (Central) and Assam and Manipur (North East). The NMHS of India (2015–16) is a unique representative survey which adopted a uniform and standardized methodology which sought to overcome limitations of previous surveys. It employed a multi-stage, stratified, random cluster sampling technique, with random selection of clusters based on Probability Proportionate to Size. It was expected that the findings from the NMHS 2015–16 would reveal the burden of mental disorders, the magnitude of the treatment gap, existing challenges and prevailing barriers in the mental-health delivery systems in the country at a single point in time. It is hoped that the results of NMHS will provide the evidence to strengthen and implement mental health policies and programs in the near future and provide the rationale to enhance investment in mental health care in India. It is also hoped that the NMHS will provide a framework for conducting similar population based surveys on mental health and other public health problems in low and middle-income countries.
Issues To review the burden of alcohol use in India, examine current policy initiatives and programs specific to India and provide a roadmap for future actions. Approach A literature search was undertaken to review available published research papers, unpublished reports and anecdotal media information in the period 2000–2020 to assess the burden and pattern of alcohol use and appraise alcohol control policies in India. Key Findings The per‐capita alcohol consumption among individuals aged 15+ years was 5.7 L, which increased over time. Prevalence of alcohol use varied across states with considerable impact on the nation. Regulatory policies and alcohol control programs vary across Indian states, with poor enforcement and implementation. Taxation and pricing policies are revenue oriented. Policies are needed to address the aggressive and innovative marketing strategies of the alcohol industry. The system for regular monitoring of alcohol burden and conducting alcohol policy analysis needs strengthening. Implications Alcohol use and its public health impact would continue to increase in India in the absence of effective policy and programs; the country may not achieve its stated goal of relative reduction of alcohol use prevalence by 10% by 2025. Conclusion The prevailing alcohol control policies and programs in India have been less than fully effective in controlling the burden of alcohol use and its associated impact. There is a need for comprehensive, evidence‐based and consensus‐driven national alcohol control policy to appropriately guide and support the Indian states in regulating alcohol and reducing the associated burden. Effective implementations of such policies are central to its success.
Depression among elderly is emerging as an important public health issue in developing countries like India. Published evidence regarding the magnitude and determinants of depression among elderly hailing from urban slum is currently limited. Hence, the current study was conducted to assess magnitude of the problem and identify factors associated with depression among the elderly in an urban slum. A cross-sectional study was done to cover total of473 elderly persons from an urban slum in Bangalore, India. They were assessed for depression using Center for Epidemiologic Studies Depression scale. The overall prevalence of depression was found to be 37.8 (95 % CI= 33. 43-42.16). Multivariate analysis revealed that unemployment (self or children) (odds ratio (OR) 2.6; 95 % confidence interval (CI) 1.41-4.72), illness of self (OR 2.2; 95 % CI 1.45-3.21), female gender (OR 1.9; 95 % CI 1.19-2.89), conflicts in family (OR 1.6; 95 % CI 1.03-2.43), and marriage of children or grandchildren (OR 1.6; 95 % CI 1.02-2.68) as independent risk factors. Depression among elderly is an important health issue of this area. Psychological intervention need to be provided for all elderly persons especially at the time of being diagnosed with any kind of illness. Strategies should be targeted to the females. The stressful life events need to be identified and remedial actions taken. This facility should be made available to them at the primary level of health care. There is a need to include screening of depression in our national health programs.
Injuries now rank among the leading causes of morbidity and mortality the world over. Injuries are steadily increasing in developing countries like India. Systematic and scientific efforts in injury prevention and control are yet to begin in India. Data on injuries are very essential to plan preventive and control measures. The objective of this study is to know the profile of the injury cases admitted to M S Ramaiah hospital, Bangalore, India, using a cross-sectional study design for six months, i.e. from Oct 2008 to April 2009. The mean age of the study population was 35.3 years (SD = 15.38), 69.1% were injured in road traffic accidents (RTA), 28.7% due to falls and 2.2% due to burns. Nearly 14.4% were under the influence of alcohol. Nearly 73.6% of RTA cases were two-wheeler users, 48.5% had not followed sign boards and 56.5% had not obeyed the one-way rules, 63.5% of the two-wheeler users did not use helmets. Also, 38% of two wheelers had two pillion riders, whereas 57% of four-wheeler users had not used a seat belt. Among falls, 58% occurred at home, 49% occurred due to slippery surface. Road traffic accidents were the most common cause for injuries, in which two wheelers were most commonly involved. Strict enforcement of traffic rules and education on road safety are very essential to prevent injuries.
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