National Mental Health Survey of India, 2016 - Rationale, design and methods

Abstract

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.

Changing trends of suicides in Kerala and solutions

“…7 Venkoba Rao has revealed that domestic burns as a method of completing suicide by young women and most lethal one with a promise of a high degree of success. 8 Burns, in general, have reported more in younger women. 9…”

Framework and approach for measuring performance and progress of mental health systems and services in India: National Mental Health Survey 2015–2016

“…Hence NMHS-MHSA was simultaneously implemented along with NMHS in the 12 states of India with the following objectives (i) to examine the available health and health related resources for mental health activities/ programmes in the surveyed states, (ii) to examine the status of mental health services and programmes in the surveyed states through a systems assessment framework. Details of design and methodology of NMHS is published elsewhere [4,20]. The present paper describes the need, design, methods and the process implemented under NMHS-MHSA.…”

Be in Control before You Lose Control

“…Suicide is an important cause for death across the globe and the World Health Organization denotes it as the second largest contributor in mortality in between 15 and 29 years of age as well as a global phenomenon of which more than three quarters (76%) is contributed by the developing and low-income countries, but the risk factors which predispose to the same, especially in the context of mood disorders have not been studied in great detail. 1,2 This study by Subramanian et al (2020) titled "study of risk factors associated with suicide attempt in patients with bipolar I disorder" tries to look into the various risk factors which are associated with suicide attempt in patients with bipolar I disorder. 3 It has tried to comprehensively look into the role of sociodemographic characteristics, the clinical course of bipolar illness and association with type of polarity of mood episodes, stressful life events, coping skills, and personality factors.…”

“…Almost equivalent number of male and female patients were recruited and more than a third (36.3%) had a history of deliberate self-harm which points to an increased vulnerability of this population for likely suicide attempt when compared with the risk in general population which is approximately 1% as per the National Mental Health Survey (2016). 2 The study also reports of the various risk factors like a positive family history as an important risk factor for suicide in this specific population of patients with bipolar illness. The odds ratio of 13.65 (95% confidence interval: 1.28-145.38,p = 0.030) itself in this study is an important eye-opener.…”