Health care systems across the globe are integrating mental health services into primary care. Click here for last week’s post on collaborative care in Israel.
Recently, Dr. Manjunatha from the National Institute of Mental Health and Neurosciences in Bangalore, India, wrote a report for the Lancet describing an ambitious program to integrate mental health services into primary care systems. The program, called the Manochaitanya Programme, provides mental health services every Tuesday in taluk hospitals, community health centres, and primary health centres in Karnataka. The services are also available during the rest of the week at all primary health clinics. Check out the rest of this fascinating program by clicking on the link above.
I reached out to Dr. Manjunatha, the lead author of the article, to ask a few more questions about the state of mental health care in India.
1. What is the state of the mental health care system in India overall?
Overall, mental health care system in India predominantly depends on public mental health care institutions of the country. In the last decade, general hospital psychiatry at medical schools have begun to take up the burden of mental health care in the country. Even psychiatrists in private practice are starting to take up the significant amount of mental health care burden. But, still in-patient care predominantly lies in public mental health care institutions.
2. How did the Manochaitanya Program get started? What is the overall purpose and structure of this program?
I am not sure how this Manochaitanya program started. But the state of Karnataka in India has always been innovative in the field of mental health. For example, the Bellary model, a community based experiment at Bellary district of Karnataka, in 1970s paved the way for National Mental Health Program (NMHP)/ District Mental Health Program (DMHP) of the country. Even the World Health Organization popularized this model in many countries throughout the world.
I believe the purpose of this program is to integrate mental health care at all public health care institutions of the state with the name of Mano-Chaitanya Clinic (MCC) on every Tuesdays. This MCC will provide mental health care at all primary health centres using respective public primary care physicians and at all taluk hospitals (taluk means administratively a sub-district in a district) by a qualified psychiatrist (either government or private) which includes academic as well as non-academic psychiatrists. Psychotropic medications are provided free of cost. First time, even professional organization such as Indian Psychiatric Society- Karnataka chapter has joined in this venture for successful implementation of this program.
3. How often do mental health and medical professionals collaborate with each other to help a patient?
The collaboration of psychiatrists and other mental health professionals to help a patient is mainly at mental health care institutions. Otherwise, it is often a rare scenario to see collaboration of mental health and medical professionals (I mean, non-psychiatric physicians) to help a patient in India especially in the area of medical comorbidities (Non-communicable diseases).
4. What needs to happen for mental health treatment to become part of all regular and routine medical treatment?
This is exactly the vision of this innovative Manochaitanya program. The basic component of this program is mental health treatment should become part and parcel of all routine medical treatment at primary care institutions. I am in opinion that this is the first of kind public mental health program in the world with exclusive aim to integrate mental health in primary general practice. I hope this model will show significant success and pave the way for many countries in the world.
Dr. N. Manjunatha, MD, DPM, MBBS
Assistant Professor of Psychiatry, Department of Psychiatry
National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India