The Vice President of India
Shri M. Hamid Ansari has said
that that there exists a huge gap between the demand for mental health service
provision and supply is not in doubt. Over two-thirds of those who suffer from mental
illnesses do not receive the treatment that they ought to. Delivering inaugural
address at the “16th Convocation of of National Institute of
Mental Health and Neuro Sciences” at Bangalore today, he said that
improving the infrastructure and human resources for supplying mental health
services is one aspect of the problem. The more serious issue relates to the
stigma of mental illness in the country. While we have made enormous strides in
de-stigmatising patients of HIV/AIDS through public education and awareness
campaigns, we have not been able to replicate the same regarding mental
disorders. We must reduce the stigma and discrimination through public
awareness.
Shri Ansari said that we must also
focus our efforts specifically on vulnerable population groups such as women,
children, those facing social or familial isolation, drug or alcohol addicts,
natural or man-made disaster victims and those working or living in conflict
zones. These population groups need proactive appraisal of their mental health
condition and timely intervention if necessary.
Following
is the text of Vice President’s inaugural address :
“It gives me great pleasure to participate in today’s
convocation at this premier multidisciplinary institute for patient care and
academic pursuit in the frontier area of Mental Health and Neuro Sciences.
With a distinguished history of over a century and a
legacy of excellence, the graduating students of NIMHANS have every reason to
be proud of their alma mater and look forward to their professional and
personal futures with confidence and optimism.
With a spectrum of activity that stretches “from the
bench to the bedside”, it has emerged as an institution of global repute in the
field of Neuroscience and Behavioural science. I extend my best wishes to
all graduating students and wish them all success in their professional and
personal endeavours.
This audience is aware that we have in place a
comprehensive framework of laws and policies pertaining to mental health. Some
of you will recall the infamous Eradi fire tragedy that evoked the conscience
of the nation to the plight of those affected with mental illness in our
society. Subsequently, the catalyzing impact of the Supreme Court intervention
resulted in greater resource allocation and enhanced policy intervention to
mental health. The National Programme was restructured in 2003 and funding
increased from around Rs. 28 crores during the Ninth Plan period to over Rs.
400 crores in the Eleventh Plan.
Despite this, our expenditure on health as a proportion
of the GDP remains at 1.27 per cent and is very low as compared to
international standards. Over three fourths of the total expenditure on health
constitutes private sector expenditure, of which over 90 per cent is borne
out-of-pocket by private households. Less than 5 per cent of such out-of-pocket
expenditure is spent on anti-psychotic or anti-depressant medication.
A review of the human resources focused on mental health
is also revealing. We have:
Ø twenty psychiatrists per ten million population as compared to the
global average of 120;
Ø six neurosurgeons per ten million population in comparison to the
global average of 20;
Ø five psychiatric nurses per ten million population to the global
figure of 200;
Ø five neurologists per ten million population to the global figure of
30;
Ø three psychologists per ten million population to the global figure
of 60;
Ø three social workers per ten million population to the global
average of 40.
Even in terms of mental health infrastructure, we have
25 psychiatric beds per million people as compared to the global average of
169.
A few questions do come to mind. Allow me to share them
with you:
Ø Have we succeeded in our attempt to integrate mental health care
provision as part of the primary health care delivery system? Are our general
physicians and paramedical staff manning the primary health centres and
sub-centres sensitized to problems of mental health?
Ø While inadequacy of specialists to staff mental health services is
recognized, have we made efforts to update undergraduate medical curricula so
that our doctors are skilled and trained in diagnosing and handling persons
suffering from common psychiatric conditions seen in general settings?
Ø Have we given attention to enlarging the pool of non-medical
professionals such as psychologists, social workers, occupational therapists
and para-medical staff such as psychiatric nurses, all of whom are key elements
of mental health service provision?
Ø Have we succeeded in evolving a community mental health service
approach where people can be effectively treated and integrated into society?
Do our mental health professionals prefer the safety of specialist institutions
to moving out into the community?
Ø Have we involved non-health sectors such as education, labour,
social welfare, urban development and law in improving the mental health of our
communities? Do we include mental health indices as part of general health
information and reporting systems to help set priorities, identify emerging
trends and direct interventions appropriately?
That there exists a huge gap between the demand for
mental health service provision and supply is not in doubt. Over two-thirds of
those who suffer from mental illnesses do not receive the treatment that they
ought to. Improving the infrastructure and human resources for supplying mental
health services is one aspect of the problem.
The more serious issue relates to the stigma of mental
illness in the country. While we have made enormous strides in de-stigmatising
patients of HIV/AIDS through public education and awareness campaigns, we have
not been able to replicate the same regarding mental disorders. We must reduce
the stigma and discrimination through public awareness.
We must also focus our efforts specifically on
vulnerable population groups such as women, children, those facing social or
familial isolation, drug or alcohol addicts, natural or man-made disaster
victims and those working or living in conflict zones. These population groups
need proactive appraisal of their mental health condition and timely
intervention if necessary.
I once again congratulate the graduating students and
thank Ghulam Nabi Azad saheb for inviting me to this Convocation.”
*****
Sanjay
Kumar/VPI/20.01.2012