20 Jan 2012

Bangalore : Indian Vice President M. Hamid Ansari on Friday 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 on Friday, 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," he said.

Ansari said: "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:


   - twenty psychiatrists per ten million population as compared to the
   global average of 120;
   - six neurosurgeons per ten million population in comparison to the
   global average of 20;
   - five psychiatric nurses per ten million population to the global
   figure of 200;
   - five neurologists per ten million population to the global figure of
   30;
   - three psychologists per ten million population to the global figure of
   60;
   - 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:


   - 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?

   - 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?

   - 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?

   - 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?

   - 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.” (IBNS)

http://www.newkerala.com/news/2011/worldnews-147501.html

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