Community-Based Mental Health Services in India: Current Status and Roadmap for the Future

Abstract

An estimated 197.3 million people have mental disorders in India, and majority of the population have either no or limited access to mental health services. Thus, the country has a huge burden of mental disorders, and there is a significant treatment gap. Public mental health measures have become a developmental priority so that sustainable gains may be made in this regard. The National Mental Health Program (NMHP) was launched in 1982 as a major step forward for mental health services in India, but it has only been able to partially achieve the desired mental health outcomes. Despite efforts to energize and scale up the program from time to time, progress with development of community-based mental health services and achievement of the desired outcomes in India has been slow. Public health measures, along with integration of mental health services in primary healthcare systems, offer the most sustainable and effective model given the limited mental health resources. The main barriers to this integration include already overburdened primary health centres (PHCs), which face the following challenges: limited staff; multiple tasks; a high patient load; multiple, concurrent programs; lack of training, supervision, and referral services; and non-availability of psychotropic medications in the primary healthcare system. Thus, there is an urgent need for a fresh look at implementation of the NMHP, with a focus on achieving sustainable improvements in a timely manner.

Non-communicable diseases and the prospects of integrated behavioral health in India: current status and future directions

“…In this line, it brings the need to equip primary healthcare providers with the right skills for behavioral integration and addressing psychosocial problems (Vallis et al ., 2018). Integrating mental health services into primary care is considered a sustainable and effective model for addressing this disease burden (Monson et al ., 2012; Hans et al ., 2021). The ramping up of NCDs in India requires addressing this issue holistically (Refer to Figure 1).…”

“…There has been a trial of initiatives and upgradation in community-based programs under the initiative of the National Mental Health Program (NMHP). However, the outcomes have been poor and unstable (Hans et al ., 2021). Further, no changes in coverage and outcomes were observed even after initiating the Programs for Mental Health Care (PRIME) under the Mental Health Care Plan (MHCP) in Madhya Pradesh (Shidhaye et al ., 2019).…”

A Comprehensive Analysis of Mental Health Problems in India and the Role of Mental Asylums

“…By bringing mental health services closer to where people live, access to care can be improved, and individuals can receive timely interventions. This also helps reduce the burden on tertiary care centers and psychiatric hospitals [ 45 ].…”

Mental health resources, barriers, and intervention needs among women in rural Maharashtra, India: A qualitative study

“…The main barriers include already overburdened PHCs, which face the following challenges: limited staff; multiple tasks; a high patient load; multiple, concurrent programs; lack of training, supervision and referral services; and nonavailability of psychotropic medications in the primary healthcare system. Thus, there is an urgent need to develop more community awareness, create relevant infrastructure and work toward capacity building to solve this problem (Hans and Sharan, 2021 ).…”