It has been proposed to extend the District Mental Health programme (DMHP) to cover six more districts in Tamil Nadu, taking the total number of districts thus served to 22.

The new districts in the proposal are Coimbatore, Dindigul, Sivaganga, Pudukottai, Tuticorin and Villupuram. The State Nodal Officer of the DMHP C. Ramasubramaniam said that the decision to propose extension was taken in view of the success of the existing DMHP services in the other districts. Of the 16 projects already initiated, three (Madurai, Tiruchi, Ramanathapuram) had been completed, while they are ongoing in 13 (Theni, Kanyakumari, Erode, Dharmapuri, Tiruvallur, Cuddalore, Virudhunagar, Kancheepuram, Perambalur, Namakkal, Tiruvarur, Nagapattinam and Chennai) districts.

“When we say three projects have been completed, it means Central Government funding has ceased, and the State Government is ready to take over, or has already taken over the project,” Dr. Ramasubramaniam explained.

“Even at the commencement of the project, the State provides an undertaking that at the end of the four-year term, it would adopt, and continue to fund the DMHP in that district.” Tiruchi has already been taken over, while the districts of Madurai and Ramanathapuram will soon come under the wings of the State's health care services. The idea is to cover the entire State under the DMHP, he added.

The basic philosophy of the DMHP is to reach the unreached with mental health care. DMHP integrates mental health care with general health care by setting up a ten-bedded psychiatric care unit within the district government hospital.

“Most mental illness problems begin as mild psychiatric disorders. At the beginning, they are also manifested as somatic (physical) complaints. Usually, these complaints include numbness, burning sensation, loss of appetite, and they go to the general physician,” Dr. Ramasubramaniam said.

If this physician is trained to identify basic psychiatric symptoms, they can immediately start treatment. “The thing with disability caused by mental illness is that, if detected and treated early, the recovery can be nearly 100 per cent,” he added. Besides, locating the mental healthcare institution within a general health care institution contributes in no small measure to removing stigma.

The Centre allocates a sum of Rs.89 lakh per district for four years, to be spent on awareness building, training medics, paramedics and non-medical personnel. Trained psychologists and psychiatric social workers will also be appointed. Some of the funds will also go into setting up the infrastructure.

Tamil Nadu has also focussed on the rehabilitation aspect of people who have been cured, Dr. Ramasubramaniam explained. Relationships have been established with the poverty-alleviation oriented ‘Vaazhnthu Kattuvom' project of the State Government, and efforts are on to ensure some work under the Mahatma Gandhi National Rural Employment Guarantee Scheme for those who have recovered.

Keywords: mental health