*MENTAL HEALTH POLICY GROUP* The Ministry of Health and Family Welfare, Government of India has appointed a Policy Group to prepare a National Mental Health Policy and Plan.
The Members of the Policy Group are : Keshav Desiraju, Jagdish Prasad, Akhileshwar Sahay, Nirmala Srinivasan, Vikram Gupta, Thelma Narayan, Sanjeev Jain, Vikram Patel, Anirudh Kala, Vandana Gopikumar, Alok Sarin and Soumitra Pathare. *The Terms of Reference of the Policy Group are :* a. To prepare a situational analysis of the need for mental health care in the country and the current provision of mental health care in the country, including issue of human resources, essential drug procurement and distribution, advocacy, prevention of mental illness, rehabilitation and care and promotion of mental health and rehabilitation. b) To carry out a systematic review of the evidence base for the policy measures proposed below. c) To take the draft Mental Health Care Act into account when drafting the National Mental Health Care Policy and Plan and recommend changes to the proposed draft Mental Health Care Act, if necessary, to support the National Mental Health Care Policy and Plan. d) To prepare an evidence based National Mental Health Care Policy for the Ministry of Health and Family Welfare stating guiding values, principles and objectives of such a policy and identifying priority areas for action. e) To prepare a National Mental Health Care Plan with specific reference to the National Mental Health Programme and the District Mental Health Programme with specific strategies and activities to implement the priority areas of action identified in the National Mental Health Care Policy and to further prepare an estimate of financial resources required to implement the Plan. f) To conduct broad-based consultations on the above issues with mental health stakeholders in the country before finalizing the Situational Analysis, the National Mental Health Care Policy and the National Mental Health Care Plan. http://mhpolicy.org/ * PROCEEDINGS OF FIRST MEETING OF POLICY GROUP TO FRAME A NATIONAL MENTAL HEALTH POLICY * The first meeting of the Policy Group to frame a National Mental Health Policy constituted by Ministry of Health & Family Welfare’s order of 15.4.2011, as amended in Ministry’s order of 2.5.2011 was held at the Ministry of Health & Family Welfare, Nirman Bhawan, New Delhi on Tuesday, 3.5.2011. The following were present: i) Dr. Vikram Gupta ii) Dr. Soumitra Pathare iii) Dr. Alok Sarin iv) Dr. Anirudh K. Kala v) Dr. S.K. Deuri vi) Prof. Sanjeev Jain vii) Dr. Nirmala Srinivasan viii) Shri Akhileshwar Sahay ix) Dr. Thelma Narayan x) Dr. Jagdish Prasad xi) Shri Keshav Desiraju 2. Dr. Vikram Patel and Ms. Vandana Gopikumar had expressed their regret at their being unable to attend the meeting. Ms. Sujaya Krishnan, Director and Dr. Jagdish Kaur, CMO were in attendance. 3. Introducing the subject, Shri Keshav Desiraju, Additional Secretary, Health presented the background against which the Policy Group has been constituted. India is unusual in not having a stated policy for mental health though there has been legislation for a very long time as also a centrally funded national programme. The need for a policy has been continuously voiced. In taking a decision to constitute the Policy Group, the Ministry also took note of the fact that the National Mental Health Programme and the District Mental Health Programme also need attention. DMHP is currently under implementation in 123 districts of the country. Activities in these districts have been recently reviewed and there is enough evidence to suggest that the programme needs substantial modification. The success of DMHP depends largely on the availability, even part time, of appropriately qualified mental health professionals; however, these professionals are not available in several districts. There is some indication that DMHP will be extended, possibly in more districts, during the period of the 12th Plan, 2012-2017. It was therefore felt that this is the most appropriate time for the structure of the DMHP, and also of NMHP, to be reviewed. Given the requirements for preparing the 12th Plan, the Policy Group has been given a period of 6 months to undertake the review, and re-drafting, of the DMHP / NMHP. The task of framing and drafting a mental health policy is expected to be completed within a period of 12 months. 4. The meeting was informed that following the constitution of the Policy Group, several requests / suggestions have been made regarding inclusion of persons in the Policy Group. Shri Javed Abidi has recommended the inclusion of Ms. Bhargavi Davar of NAAJMI and Dr. Achal Bhagat from the Disabled Rights Group (DRG). Ms. Vandana Gopikumar has suggested the association of Prof. M. Thirunavukarasu, President of the IPS. Dr. Nirmala Srinivasan has suggested the association of Shri Milesh Hamlai, caregiver working with an NGO in Gujarat. Col. Mehendiratta, who has been closely associated with the draft legislation, has suggested the name of Shri Amrit Bakshy of Pune. It was generally felt that every effort should be made to associate experts and other interested persons from a range of interests in the work to be undertaken by the Policy Group. 5. The meeting was also informed that the WHO (Dr. Shekhar Saxena, Director, Department of Mental Health & Substance Abuse) has expressed its willingness to provide technical support to the Policy Group with support in the following possible ways: i) WHO Normative Guidance on Mental Health Policy; ii) Joining specific Sessions of the meetings of the Group either by phone or in person; iii) Reviewing and providing inputs on the draft outline and text of the Policy. 6. The meeting was also informed of the progress made in the drafting of a Mental Health Care Bill, 2010 following a National Consultation on 22.3.2011. The major task of re-visiting the draft circulated to all State Governments has commenced. During discussion on the subject, the point also noted that the Ministry of Social Justice and Empowerment has undertaken a major review of the Persons with Disabilities Act, 1995. The Ministry of Health is awaiting the receipt of the draft of the revised Act from the Ministry of Social Justice and Empowerment. 7. Several issues were raised with regard to DMHP as it exists and relating to suggestions for the future. These included, i) The need to learn from community experiences; ii) An assessment of the availability of qualified psychiatrists in the country; iii) An understanding of the infirmities in the DMHP districts at present; iv) Relationship between State Health Departments & DMHP in various states; v) In the context of integration into NRHM, the need for deliverables to be fixed; vi) Linkages between each of the 314 medical colleges (167 private and 147 government) with one or more of the DMHP districts; 8. It was generally agreed that while DMHP may well need restructuring, there was no alternative to organized interventions with the districts as to the focal area. It was also emphasized that if no review or restricting of DMHP was done at the present stage, the likelihood is that we will go into the 12th Plan with the DMHP as it presently stands but with many more than the present 123. The focus of the Policy Group, therefore, needs to be on restructuring DMHP without losing the district level focus. It was also highlighted that districts tend to be geographically large and many persons find it difficult to access services at the district level. Therefore it was suggested that when restructuring DMHP provision should be made for some services at the Taluka level to improve access for persons with mental illness. There was a discussion about utilizing ASHA or a similar health workers for provision of mental health services in the community. It was felt that if ASHA or a similar health worker was proposed to be utilized for delivery of mental health services, then their roles, responsibilities and training needs should be clearly defined as such. 9. The members discussed the issue of integrating mental health services into general health services especially at the primary and secondary health care level. Concerns regarding integration were highlighted during this discussion. It was pointed that most of the other integrated programmes initially started off as standalone programmes and only when they had developed very robust structures, they were integrated into general health care. The need for adequate training of general health workers before integration was also highlighted during this discussion. 10. The meeting was also informed that in the year 2011-12, the last year of the 11th Plan, DMHP will continue to be implemented in the identified 123 districts as per current guidelines. With a view towards ensuring a better level of performance, various regional meetings have been called at LHBRIMH, Tezpur on 25 and 26.5.2011, at CIP, Ranchi on 1&2.6.2011 at IPHB, Goa on 7&8.6.2011, at Government Medical College, Srinagar on 14&15.6.2011 and at NIMHANS Bangalore on 20&21.6.2011. Members of the Policy Group were requested to attend one or more of these review meetings with a view to discussions with State Government representatives on implementation issues, suggestions for DMHP restructuring and also to suggest better performance even within the current guidelines in this last year of the Plan period. The Ministry will support the travel of Policy Group members to these meetings. 11. During discussion on the framing of Mental Health Policy it was noted that several countries (Chile, Sri Lanka, Egypt, Portugal) have stated policy documents. It was agreed that these were need to be systematically studied. It was also noted that within the country Gujarat has framed a Mental Health Policy. The consensus was that the Policy Group members should attempt to put together as a wide range of material as possible. 12. After substantial discussion both on programme and policy aspects, it was decided as follows: i) A Sub-Group of the Policy Group consisting of Dr. Anirudh Kala, Dr. Vikram Patel, Ms. Vandana Gopikumar, Dr. Vikram Gupta Prof. Sanjeev Jain and Dr. Alok Sarin, assisted by Dr. Jagdish Kaur, CMO, MoHFW would address issues related to DMHP and NMHP. It was also agreed that Dr. R. Kishore Kumar of NIMHANS, Bangalore would be prominently associated with work of this Sub-Group in the light of his very extensive experience of DMHP on the ground. In the first instance, the Sub-Group would review available material, to be followed by visits as necessary to DMHP districts and to medical colleges supported under NMHP. It is expected that along with other Policy Group members they would participate in the DMHP workshops in May and June, 2011. It was also made clear that the Sub-Group should feel free to reach out to as many persons / institutions as may be necessary with a view to securing a better understanding of DMHP activities. Dr. Anirudh Kala has kindly agreed to convene the work of this Sub-Group. ii) Shri Akhileshwar Sahay and Dr. Vikram Gupta, with the assistance of Dr. Simmi, WHO Consultant, MoHFW will work on collecting and studying mental health policy documents from around the world. iii) A Sub-Group to the Policy Group consisting of Dr. Soumitra Pathare, Ms Vandana Gopikumar, Dr. S.K. Deuri, Prof. Sanjeev Jain and Dr. Nirmala Srinivasan will work specifically on drafting the norms and standards for mental health facilities for inclusion in the Rules section of the draft Mental Health Care Bill, 2010. iv) With a view to securing as wide a range of suggestions as is possible on ideas for inclusion in the Mental Health Policy, it was agreed that a standalone website would be created, with links to the website of Ministry of Health, and a dedicated email address. The Policy Group would then circulate, initially to a larger group of about 250 to 300 persons known to have an interest in the subject, a statement of objectives and intent. This statement will be drafted by the Ministry and shared with all the members of the Policy Group before final approval and should be used by all members of the Policy Group in reaching out to interested persons. This statement will encourage people to send to the Policy group their suggestions regarding the national mental health policy, suggestions for the mental health plan, changes to the DMHP and suggestions for priority areas of action to be considered by the Policy Group. The statement will also request people to send any information that they consider relevant for consideration by the Policy Group. Such information includes data about mental illness, service provision and any other reports or research papers, published as well as unpublished. It was particularly noted that an exercise of this type runs the danger of reaching out to only those persons with access to email and to the English language. The need for including other opinions and other voices was emphasized. Members of the Policy Group were, therefore, requested to use their own networks and resources, and also their connections with other language groupings, to seek feedback. It is anticipated that the Policy Group would be able to finalize its proposed statement within the next 15 days with an expectation of receiving feedback until the end of June, 2011. Once this feedback is received a few members of the Policy Group will sift through the responses and summarize the key points made by respondents which will be circulated to all members of the Policy Group and also to the respondents. v) All members of the Policy Group were requested to share with each other and with the general public information / reports / documents likely to be relevant to the general discussion. It is expected that this would become a publically available resource which would last beyond the life of the Policy Group itself. Some material circulated at the meeting will be put on to this site at the earliest. vi) Travel costs of the members of the Policy Group to attend meetings of the Policy Group as also other activities related to the work of the Policy Group will be reimbursed on a regular basis by the Ministry of Health. All members were requested to contact Ms. Sujaya Krishnan, Director (Tel: 011-23062426, Email: [email protected]) in this matter. It was also recognized that the Centre for Mental Health Law and Policy at the Indian Law Society will be the Secretariat for the Policy Group. The Ministry and the Centre will separately sort out the exact nature of assistance which the Centre is expected to provide and the manner in which reimbursements, etc. are to be made. vii) The Policy group took note of the fact that there is considerable public interest, including the press, in the constitution and activities of the Policy Group. It was agreed that for the present any statement to be made on behalf of the Policy Group would be made by the Ministry. viii) It was agreed that the next meeting of the Policy Group would be in Bangalore on Thursday, 1.7.2011. The location of the meeting will be decided in consultation with Bangalore based members of the Policy Group. ***** http://mhpolicy.org/2011/05/10/minutes-of-1st-meeting-of-policy-group/ -- You received this message because you are subscribed to the Google Groups "Mental Health Advocacy (News 'N Views) India" group. 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