State and District Mental Health Program

State Mental Health Authority is constituted as per Mental Healthcare Act 2017 to regulate and coordinate the Mental Health services in the State. As mandated under section 74 of the Mental Healthcare Act, 2017, District Mental Health Review Boards have been constituted by State Mental Health authority at 13 locations encompassing all the districts in the State. The District Mental Health Review Board consist of 6 members with retired district Judge as Chairperson, one Psychiatrist, one Medical Practitioner, One Representative of District Collector and two members, who shall be persons with mental illness or care-givers or persons representing organisations of persons with mental illness or care-givers or non-governmental organisations working in the field of Mental Health. The decisions of the District Mental Health Review Board shall be by Consensus.

Opportunities and Challenges

TamilNadu has robust public health infrastructure to cater services to the remotest places in the state. This provides an excellent opportunity to deliver Mental Health services to the needy. Our state is also committed towards providing social welfare services to the underprivileged sections of the society. However, there exists various challenges in delivery of Mental Health services which include, the need for strengthening the structure and organogram for DMHP, systems to reduce the Operational Challenges, Development of performance indicators for DMHP services, multi sectoral approach to tackle Stigma related to mental illness, strengthening of inter-departmental coordination to enable the program from being a “stand alone” program into an ‘integrated’ and ‘Comprehensive’ Mental Health service delivery program.

In this regard, the following activities are envisaged for the Year 2023-24.

• To bring a uniform pattern of services and structure for DMHP across all districts in the State and organogram for DMHP to ensure seamless delivery of Mental Health Services.
• Establish Monitoring and evaluation mechanism for DMHP Services.
• To empower Persons Living with Mental Health Problems by acknowledging that the persons with mental illness are valued as ‘Experts by Experience’ and by engaging them directly in key aspects of service planning and decision making process. To create a system, in the form of Patient Support Groups (PSGs) at PHC level or Village Panchayat level with Patients included as members with due representations as per the principles of Social Justice.
• Programs to attend to the psychological needs of certain vulnerable groups- (for example, Sanitary Workers, Working Women, Pregnant and Lactating Mothers, Senior citizens, unorganised Sector Workers, First Generation Graduates) based on the principles of Proportionate Universalism (PU) which means services are universal to but with an intensity and scale that is proportionate to the level of Disadvantage or degree of Need of the vulnerable population.
• To frame the State Policy for Deaddiction services and also establishment of a dedicated Deaddiction Centre in the remaining 28 Districts to provide comprehensive Deaddiction and rehabilitation services in coordination with line departments and also horizontal integration of De-addiction services across Primary, Secondary and Tertiary level.
• Linkage of Tobacco control Program with DMHP in all Districts.
• To establish Comprehensive Counselling Centres in all districts under DMHP as a District One Point of Contact and Linkage centre for Psychological Counselling, Tele-consultation, Social Welfare services.
• To establish Mother & Baby Mental Health Promotion Units to offer maternal Mental Health services incorporating the strategies of Mother Baby Unit available in NIMHANS, Bangalore.
  
• Capacity Building Activities
  • Preparing various Training modules for Mental Health Programme covering Mental Health promotion for College students, Deaddiction services, Maternal Mental Health Services, DMHP Program, etc.
  • Symptom-based, Structured Training on Mental Health for Field level Health Care workers.
  • Conducting Leadership and Management Skill development Training for District Mental Health Programme Officers of all 38 Districts.
  • Creating exclusive building infrastructure for Psychiatry ward like DEIC in Medical College Hospitals.
  • Promoting Clinical and Community level research activities on Mental Health to address the population specific needs and provide valuable inputs for policy decisions on Mental Health Services.
  • Organizing Annual workshops to strengthen the Mental Health Service Delivery in the state under DMHP.

  District Mental Health Program

  The District Mental Health Program (DMHP) is a community level program currently implemented in all 38 Districts in Tamilnadu. DMHP has been highly successful in providing Mental Healthcare to the community, reaching the unreached through the robust health infrastructure in Tamilnadu. 805896 persons with Mental Health problems have availed the DMHP services from April 2022 to August 2023.

  The services are offered based on the Bio-Psycho-Social Approach taking into consideration the biological, psychological and sociological determinants of Mental Health of individuals. The services include creating awareness about Mental Health, workshop for the specific population like Students, Working women, training of school teachers on life skills. Also, OP services are available in all GHs and Block PHCs to provide counseling and treatment for persons with psychological problems.

  In addition, screening through RBSK doctors for early identification of students with psychological conditions, follow up of self-harm cases for 18 months and NEET counseling through 104 tele counseling center, and disability certification services are also provided free of cost to the individual under DMHP in all districts.