Lok Sabha Question No. 1769 (UNSTARRED), answered on 2022-02-11
Subject: National Mental Health Programme
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ajay Nishad, Sanjay(Kaka) Ramchandra Patil, E. T. Mohammed Basheer

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1769 TO BE ANSWERED ON 11 TH  FEBRUARY, 2022

## NATIONAL MENTAL HEALTH PROGRAMME

## 1769.   SHRI AJAY NISHAD: SHRI E.T. MOHAMMED BASHEER: SHRI SANJAY KAKA PATIL:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the number of mental health patients is increasing and the mental health facilities are inadequate in the country, if so, the details thereof and the corrective steps taken thereon;
- (b) the  number  of  people  getting  access  to  mental  health  services  under  the  National  Mental Health  Programme  (NMHP)  during  the  last  three  years,  State/UT-wise  particularly  in Maharashtra;
- (c) the details of allocation of funds to NMHP during the said period State/UT-wise, year-wise;
- (d) the  status  of  implementation  of  NMHP  including  steps  taken  to  create  awareness  about suicide prevention, State/UT-wise particularly in Maharashtra;
- (e) whether  the  Government  proposes  to  restructure  the  NMHP  programme  to  improve  its effectiveness at primary healthcare level and to introduce the programme in those regions deprived of it, if so, the details thereof and the funds earmarked for the purpose during the current year; and
- (f) the  steps  taken  to  alleviate  psychological  distress  caused  to  people  due  to  the  COVID-19 pandemic?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a): As per the National Mental Health Survey, 2016, the prevalence of mental disorders in adults over  the  age  of  18  years  is  about  10.6  %.  For  providing  affordable  and  accessible  mental healthcare  facilities,  the  Government  is  implementing  the  National  Mental  Health  Programme (NMHP) in the  country.    The  District  Mental  Health  Programme  (DMHP)  component  of  the NMHP has been sanctioned for implementation in 704 districts for which support is provided to States/UTs through the National Health Mission.  Facilities made available under DMHP at the Community  Health  Centre(CHC)  and  Primary  Health  Centre(PHC)  levels,  inter-alia,  include outpatient  services,  assessment,  counselling/  psycho-social  interventions,  continuing  care  and support  to  persons  with  severe  mental  disorders,  drugs,  outreach  services,  ambulance  services etc.  In  addition  to  above  services  there  is  a  provision  of  10  bedded  in-patient  facility  at  the District  level.      The  service  delivery  for  mental  healthcare  through  DMHP  is  aligned with  the provisions of the Mental Healthcare Act, 2017 to provide treatment in a manner which supports persons with mental illness to live in the community and with their families.  Under the Tertiary care component of NMHP, 25 Centres of Excellence have been sanctioned to increase the intake of  students  in  PG departments in mental health specialities as well as to provide tertiary level treatment  facilities.    In  addition,  the  Government  has  also  supported  19  Government  medical colleges/institutions to strengthen 47 PG Departments in mental health specialities.

As  per  available  information,  there  are  47  Government  run  mental  health  hospitals  in  the country, including 3 Central mental health institutions, viz. National Institute of Mental Health and Neuro Sciences, Bangalore, Central Institute of Psychiatry, Ranchi and Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam.

With  a  view  to  further  increase  mental  healthcare  facilities  in  the  country,  Department  of Psychiatry  has  been  set  up  in  each  of  the  newly  established  All  India  Institute  of  Medical Sciences (AIIMS) and similar provision has been made in the upcoming new AIIMS. Similarly, many other Central as well as State Government hospitals also have Psychiatry Departments.

(b)  &  (c):  The  number  of  people  getting  access  to  mental  health  services  under  the  National Mental  Health  Programme  (NMHP) is  not  maintained  centrally.  The  State/UT-wise  details  of funds approved for implementation of the District Mental Health Programme under the National Health Mission is Annexed.

(d)  &  (e):  To  address  the  burden  of  mental  disorders,  the  Government  of  India  is  supporting implementation of the DMHP under NMHP in 704 districts of the country with the objectives to:

- (i) provide  suicide  prevention  services,  work  place  stress  management,  life  skills training and counselling in schools and colleges.
- (ii) provide  mental  health  services  including  prevention,  promotion  and  long-term continuing care at different levels of district healthcare delivery system.
- (iii) augment  institutional  capacity  in  terms  of  infrastructure,  equipment  and  human resource for mental healthcare.
- (iv) promote community awareness and participation in the delivery of mental healthcare services.

In  addition  to  the  above,  the  Government  is  also  taking  steps  to  strengthen  mental  healthcare services  at  the  primary  healthcare  level.  Mental  healthcare  services  have  been  added  in  the package of services under Comprehensive Primary Health Care under Ayushman Bharat - HWC Scheme. Operational guidelines on Mental, Neurological, and Substance Use Disorders (MNS) at Health and Wellness Centers (HWC) have been released under the ambit of Ayushman Bharat.

Under DMHP, funds of Rs. 118.37 Crores have been approved for States/UTs under the National Health Mission for the year 2021-22.

(f):    Realizing  the  impact  that  COVID-19  may  have  on  the  mental  health  of  the  people,  the Government has taken a number of initiatives to provide psychosocial support during COVID19. These initiatives include:

- (i) Setting up  of a 24/7 helpline to provide  psychosocial  support, by  mental  health professionals,  to  the  entire  affected  population,  divided  into  different  target  groups  viz children, adult, elderly, women and healthcare workers.
- (ii) Issuance  of  guidelines/  advisories  on  management  of  mental  health  issues,  catering  to different segments of the society.
- (iii) Advocacy  through  various  media  platforms  in  the  form  of  creative  and  audio-visual materials on managing stress and anxiety, and promoting an environment of support and care for all.
- (iv) Issuance of detailed guidelines by the National Institute of Mental Health and Neurosciences (NIMHANS),  Bengaluru-  "Mental  Health  in  the  times  of  COVID-19 Pandemic - Guidance for General Medical and Specialized Mental Health Care Settings".
- (v) All the guidelines, advisories and advocacy material can be accessed on Ministry of Health and Family Welfare website under 'Behavioural Health -Psychosocial helpline' (https://www.mohfw.gov.in/).
- (vi) Online  capacity  building  of  health  workers  by  NIMHANS  in  providing  psychosocial support and training through (iGOT)-Diksha platform.

*****

## State/UT wise details of Approvals for National Mental Health Programme (NMHP) under Flexible Pool for Non Communicable Diseases (NCDs) under NHM during the period from F.Y. 2018-19 to 2020-21

(Rs. in lakhs)

| S.No.   | State/UT                 |   2018-19 |   2019-20 | 2020-21   |
|---------|--------------------------|-----------|-----------|-----------|
| 1       | Andaman &Nicobar Islands |      9.3  |     19.75 | 20.00     |
| 2       | Andhra Pradesh           |    267.8  |    504.3  | 300.30    |
| 3       | Arunachal Pradesh        |    134    |    111.6  | 177.40    |
| 4       | Assam                    |    596.67 |    550.84 | 341.17    |
| 5       | Bihar                    |    534.3  |    218.64 | 226.75    |
| 6       | Chandigarh               |      3.95 |      0    | 0.00      |
| 7       | Chhattisgarh             |    569.7  |    328.7  | 258.21    |
| 8       | Dadra &Nagar Haveli      |      5    |      4    |           |
| 9       | Daman &Diu               |      0.45 |      1    | 3.07      |
| 10      | Delhi                    |     90    |     60    | 84.00     |
| 11      | Goa                      |     18.94 |     25.11 | 16.60     |
| 12      | Gujarat                  |    860.5  |    558.7  | 562.70    |
| 13      | Haryana                  |    101.07 |     54.58 | 55.27     |
| 14      | Himachal Pradesh         |      3.2  |     12.86 | 30.92     |
| 15      | Jammu &Kashmir           |    330.9  |    233.64 | 219.50    |
| 16      | Jharkhand                |    605.78 |     70.37 | 18.07     |
| 17      | Karnataka                |    658.1  |    612.1  | 649.30    |
| 18      | Kerala                   |    119.7  |    200.7  | 318.75    |
| 19      | Ladakh                   |      0    |      0    | 0.00      |
| 20      | Lakshadweep              |      5.2  |      2.9  | 7.80      |
| 21      | Madhya Pradesh           |    168    |    177.34 | 214.94    |
| 22      | Maharashtra              |    387.6  |    731.9  | 471.14    |
| 23      | Manipur                  |     64.28 |    157.15 | 288.96    |
| 24      | Meghalaya                |    227.08 |    102.3  | 102.00    |
| 25      | Mizoram                  |     44.92 |     51.9  | 38.89     |
| 26      | Nagaland                 |     86.7  |    135.88 | 143.00    |
| 27      | Odisha                   |    576.28 |    301.55 | 191.10    |
| 28      | Puducherry               |     16.85 |     18.21 | 12.74     |
| 29      | Punjab                   |    209    |    142    | 305.20    |
| 30      | Rajasthan                |    160.3  |    406.24 | 577.60    |
| 31      | Sikkim                   |     31.29 |     50.02 | 50.40     |
| 32      | Tamil Nadu               |   1031.4  |   1149.7  | 155.90    |
| 33      | Telangana                |     45    |    170    | 1024.72   |
| 34      | Tripura                  |     42.8  |     43.52 | 28.80     |
| 35      | Uttar Pradesh            |   1747.9  |   1686.94 | 1382.84   |
| 36      | Uttarakhand              |    528.95 |     23.7  | 45.12     |
| 37      | West Bengal              |    244.2  |    117.63 | 89.90     |
| Total   | Total                    |  10527.1  |   9035.77 | 8413.06   |