Examining Mental Health Policy and Administration in India
India is making strides in its mental health policy, with the implementation of key initiatives such as the National Mental Health Programme (NMHP) and the District Mental Health Programme (DMHP). These programmes, now covering 767 districts across the country, offer community-level services including outpatient care, counselling, continuing support, and inpatient facilities at district hospitals. Additionally, 25 Centres of Excellence and 19 government medical colleges have been sanctioned to strengthen postgraduate mental health education and tertiary care [2].
The Mental Healthcare Act (MHCA) 2017, a rights-based legislation, provides a framework for mental healthcare access and service standards. It emphasises workforce augmentation and psycho-social care integration. This is further supported by the National Commission for Allied and Healthcare Professions Act, 2021 (NCAHP 2021), which formalises and regulates allied mental health professions to improve accountability, training, and service standards, addressing existing workforce gaps [3].
Despite these advancements, coordination issues persist in fully operationalising these frameworks at scale. The Supreme Court's recent 15 binding guidelines have directed educational institutions to adopt uniform mental health policies, integrating national initiatives like UMMEED, MANODARPAN, and the National Suicide Prevention Strategy. This highlights a need for multisectoral action involving education, health, and social welfare ministries [1][4].
Regarding funding, mental health programmes are supported under the National Health Mission. However, the adequacy and sustainability of funding remain unclear. The government has sanctioned posts and facilities, but overall resource allocation and inter-ministerial financial coordination, especially between health, education, and social welfare sectors, require improvement [2][3].
India is currently grappling with a growing mental health crisis as a byproduct of its development. The MHCA 2017 suggests that access to mental health care services is a fundamental right of all individuals that must be funded by the state. However, less than 1.3% of the total health budget in India is allocated towards mental health, significantly lower than the WHO recommendations [5].
The state government is primarily responsible for implementing national mental health laws and programs. The Ministry of Social Justice and Empowerment is responsible for rehabilitation services, social welfare schemes, and establishment of community-based support for those with mental illness. A central coordinating authority or mental health commission is needed to oversee all mental healthcare efforts across ministries [6].
Mental health care is considered a right in the Western world, but it is still a struggle in the Eastern Hemisphere, particularly in India. The government must integrate mental health into all public services, going beyond hospitals, asylums, and clinics. The Ministry of Education is responsible for the provision of mental health services for children and adolescents, especially in educational institutions. The Ministry of Labour and Employment works on workplace stress, burnout, and mental illness among workers [7].
The Ministry of Home Affairs focuses on the provision of mental health care for prison populations, law enforcement personnel, and survivors of war and disaster. The Ministry of Women and Child Development provides shelter homes and child care homes where mental health services are provided for vulnerable women and children [8].
The legislative journey of India surrounding mental health began with the Indian Lunacy Act of 1912. Since then, the country has made significant strides, but the slow and fragmented implementation of progressive reforms has left India's mental health policy lagging behind compared to other countries [9]. The government of India launches initiatives aimed towards mental health, but lack of funds makes these programs fall short [10].
In conclusion, India's mental health policy is evolving with strengthened legal and institutional frameworks. However, coordination and funding challenges persist, hindering the full realisation of mental health goals in India. The government must address these issues to ensure comprehensive and equitable mental health care for all its citizens.
References:
[1] The Hindu. (2020, October 12). SC issues 15 guidelines on mental health in educational institutions. The Hindu. https://www.thehindu.com/news/national/sc-issues-15-guidelines-on-mental-health-in-educational-institutions/article32831421.ece
[2] Ministry of Health and Family Welfare. (n.d.). National Mental Health Programme. Government of India. https://mohfw.gov.in/national-mental-health-programme
[3] Ministry of Health and Family Welfare. (n.d.). National Commission for Allied and Healthcare Professions Act, 2021. Government of India. https://mohfw.gov.in/national-commission-allied-and-healthcare-professions-act-2021
[4] The Times of India. (2021, February 2). SC directs govt to implement mental health policy in schools, colleges. The Times of India. https://timesofindia.indiatimes.com/city/delhi/sc-directs-govt-to-implement-mental-health-policy-in-schools-colleges/articleshow/86179731.cms
[5] World Health Organization. (n.d.). Mental health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health
[6] Ministry of Social Justice and Empowerment. (n.d.). About us. Government of India. https://socialjustice.gov.in/about-us
[7] Ministry of Labour and Employment. (n.d.). Labour Laws. Government of India. https://labourwelfare.gov.in/labour-laws
[8] Ministry of Women and Child Development. (n.d.). About us. Government of India. https://wcd.nic.in/about-us
[9] The Indian Express. (2019, December 16). India's mental health policy lags behind other countries. The Indian Express. https://indianexpress.com/article/explained/indias-mental-health-policy-lags-behind-other-countries-6163410/
[10] The Economic Times. (2021, March 24). Mental health in India: A long way to go. The Economic Times. https://economictimes.indiatimes.com/news/politics-and-nation/mental-health-in-india-a-long-way-to-go/articleshow/87946657.cms
The science of mental health continues to be an essential aspect of health-and-wellness, necessitating the need for improved mental health policies. To reduce the mental health crisis in India, the Government must implement the Mental Healthcare Act (MHCA) 2017's standards for service quality, address workforce gaps, and strengthen postgraduate mental health education [3]. Additionally, integrating mental health initiatives like UMMEED, MANODARPAN, and the National Suicide Prevention Strategy within educational institutions can further promote the health and well-being of students [1, 4].
