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Mental health problems afflicting more people in rural areas: survey

By Shambhu Boro
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TEZPUR, April 7 - �Rapid pace of globalisation and urbanisation has resulted in profound changes globally and in India too, this has affected the mental health of individuals, families and the society in a significant way.� The popular saying that �there is no health without mental health� underscores the fact that mental health is an integral and essential component of health. Recognising the growing incidence of mental health problems, the World Health Organization (WHO) has declared the theme for this year�s World Health Day, celebrated on April 7 of each year, as �Depression: Let�s talk�.

Dr Kankan Pathak, Associate Professor, Department of Psychiatry, LGBRIMH, Tezpur addressing a press meet at the conference hall of the mental health institute on Thursday, while touching upon certain serious issues related to mental health in the present day scenario said that the growth and development of health services in India have not been uniform. Nevertheless, mental health initiative is growing both in quantity and quality.

In a move to boost the mental health services, India has launched a mental health policy and has drafted a mental health action plan. Recently, a new mental health bill has also been approved. For further strengthening of the policy initiative and contribute to the development of action plans and data guided programmes, the Ministry of Health and Family Welfare (MOHFW) identified the National Mental Health Survey (NMHS) as priority area and commissioned the National Institute of Mental Health and Neuron Sciences (NIMHANS), Bengaluru to undertake a nationally representative study.

�The NMHS is one of the largest mental health surveys undertaken across 12 States and covered a nationally representative population of the country. The key objectives were to identify the prevalent patterns, outcome, treatment gap and associated disabilities of mental illness. In addition to it, the NMHS undertook the unique task of assessing the health systems available for mental health care in the individual States where the survey was undertaken.� He added that the study adapted a uniform, standard scientific methodology and data collection was done by trained staff using hand held devices.

In the State of Assam, the survey was conducted by LGBRIMH Tezpur. The survey had face to face, household based interviews, for 2603 individuals, in three randomly selected districts of Assam viz., Barpeta, Cachar and Dibrugarh.

Dr Pathak also revealed that nearly 12 lakh people in the State, above the age of 18 years, are currently having intervention for various mental health issues. �The greater proportion of those affected is in the production age group (40 to 49) and except for substance use disorder, all other mental health problems are comparatively more in rural areas. Male gender and lower income were linked to higher occurrence of a mental disorder. However, anxiety and stress related disorders were more common in women, compared to men. The prominent psychiatrist said that 27. 35 per cent of the population above 18 years suffer from substance use disorder while the tobacco use was the highest. He also said that alcohol use disorder in men was 3.05 per cent among the 18 + years population, while illicit substance use disorder was 0.69 per cent.

Giving more details on the issue, he also said that despite being in existence for more than three decades, the district mental health programme is still slow in reach and coverage and is yet to make its presence felt. It needs to be more comprehensive and should improve quality of services. �The mental health was not a priority agenda for the health systems. There is a glaring absence of a well drafted state mental health policy and action plan. The proportion of districts covered by DMHP was only 14.29 per cent. Much of the mental health care activities in the State were hospital based and were limited in their scope and spread.� He revealed that a shortage of trained professionals to deliver mental health care is seen. Systematic efforts to integrate mental health into general health care were lacking. Several system constraints including erratic supply of medicines, inadequate funding and absence of guidelines etc., were found. However, based on the study findings, actions like strengthening the district mental health programme by developing and adopting a state mental health policy, formulating explicit action plans, enhancing mechanisms for integration, dedicated financing, devising mechanisms for accelerated human resources, improving medicine supply and logistics and monitoring frameworks to provide the widest possible coverage to affected citizens, broad-basing of services, upgradation of existing facilities establishing and supporting day care centre, long term and short term residential care centres, developing a state mental health literacy strategy and a task force on mental health comprising of professionals from mental health have been taken up,� Dr Pathak stated.

Besides other dignitaries associated with the mental health institute, the press meet was also attended by Dr Sonia Pereira Deuri, Professor and Head, Department of Psychiatric Social Work, LGBRIMH.

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Mental health problems afflicting more people in rural areas: survey

TEZPUR, April 7 - �Rapid pace of globalisation and urbanisation has resulted in profound changes globally and in India too, this has affected the mental health of individuals, families and the society in a significant way.� The popular saying that �there is no health without mental health� underscores the fact that mental health is an integral and essential component of health. Recognising the growing incidence of mental health problems, the World Health Organization (WHO) has declared the theme for this year�s World Health Day, celebrated on April 7 of each year, as �Depression: Let�s talk�.

Dr Kankan Pathak, Associate Professor, Department of Psychiatry, LGBRIMH, Tezpur addressing a press meet at the conference hall of the mental health institute on Thursday, while touching upon certain serious issues related to mental health in the present day scenario said that the growth and development of health services in India have not been uniform. Nevertheless, mental health initiative is growing both in quantity and quality.

In a move to boost the mental health services, India has launched a mental health policy and has drafted a mental health action plan. Recently, a new mental health bill has also been approved. For further strengthening of the policy initiative and contribute to the development of action plans and data guided programmes, the Ministry of Health and Family Welfare (MOHFW) identified the National Mental Health Survey (NMHS) as priority area and commissioned the National Institute of Mental Health and Neuron Sciences (NIMHANS), Bengaluru to undertake a nationally representative study.

�The NMHS is one of the largest mental health surveys undertaken across 12 States and covered a nationally representative population of the country. The key objectives were to identify the prevalent patterns, outcome, treatment gap and associated disabilities of mental illness. In addition to it, the NMHS undertook the unique task of assessing the health systems available for mental health care in the individual States where the survey was undertaken.� He added that the study adapted a uniform, standard scientific methodology and data collection was done by trained staff using hand held devices.

In the State of Assam, the survey was conducted by LGBRIMH Tezpur. The survey had face to face, household based interviews, for 2603 individuals, in three randomly selected districts of Assam viz., Barpeta, Cachar and Dibrugarh.

Dr Pathak also revealed that nearly 12 lakh people in the State, above the age of 18 years, are currently having intervention for various mental health issues. �The greater proportion of those affected is in the production age group (40 to 49) and except for substance use disorder, all other mental health problems are comparatively more in rural areas. Male gender and lower income were linked to higher occurrence of a mental disorder. However, anxiety and stress related disorders were more common in women, compared to men. The prominent psychiatrist said that 27. 35 per cent of the population above 18 years suffer from substance use disorder while the tobacco use was the highest. He also said that alcohol use disorder in men was 3.05 per cent among the 18 + years population, while illicit substance use disorder was 0.69 per cent.

Giving more details on the issue, he also said that despite being in existence for more than three decades, the district mental health programme is still slow in reach and coverage and is yet to make its presence felt. It needs to be more comprehensive and should improve quality of services. �The mental health was not a priority agenda for the health systems. There is a glaring absence of a well drafted state mental health policy and action plan. The proportion of districts covered by DMHP was only 14.29 per cent. Much of the mental health care activities in the State were hospital based and were limited in their scope and spread.� He revealed that a shortage of trained professionals to deliver mental health care is seen. Systematic efforts to integrate mental health into general health care were lacking. Several system constraints including erratic supply of medicines, inadequate funding and absence of guidelines etc., were found. However, based on the study findings, actions like strengthening the district mental health programme by developing and adopting a state mental health policy, formulating explicit action plans, enhancing mechanisms for integration, dedicated financing, devising mechanisms for accelerated human resources, improving medicine supply and logistics and monitoring frameworks to provide the widest possible coverage to affected citizens, broad-basing of services, upgradation of existing facilities establishing and supporting day care centre, long term and short term residential care centres, developing a state mental health literacy strategy and a task force on mental health comprising of professionals from mental health have been taken up,� Dr Pathak stated.

Besides other dignitaries associated with the mental health institute, the press meet was also attended by Dr Sonia Pereira Deuri, Professor and Head, Department of Psychiatric Social Work, LGBRIMH.

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