MENTAL HEALTH & MENTAL HEALTH POLICY IN TN

MENTAL HEALTH
         The World Health Organization (WHO) defines mental health as a 'state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community'
         Mental Health means not only absence of Mental Illness but also having positive sense of wellbeing Mental, Neurological, and Substance use Disorders make a substantial contribution to the Global Burden of Disease Neuropsychiatric conditions account for 14% of the global burden of disease. The most important causes of disability due to health-related conditions worldwide include Unipolar Depression, Alcoholism, Schizophrenia, Bipolar depression and Dementia. In low and middle-income countries, these conditions represent a total of 19.1% of all disability related to health conditions. It is estimated that one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Mental health first aid has been defined as "the help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional treatment is received or until the crisis resolves. Mental health first aid is an extension of the concept of first aid which is familiar with physical health crises to cover mental health. Mental health first aid is very important now to reduce the Psychiatric morbidity.
         Mental illnesses are Psycho socio biologically-based disorders which interfere with an individual's ability to think, feel, act, and relate within the standard norms of society. The American Psychiatric Association identifies hundreds of mental disorders ranging from Attention Deficit Hyperactivity Disorder to Violent/Self-Destructive Behaviours. Mental illness can be physical as well as psychological and emotional, and some are classified as "major mental illnesses" because of their propensity to seriously impair an individual's ability to function. Severe mental illnesses are more common than cancer, diabetes, or heart disease. Mental illness can strike any person at any time It was not until the 1950s that mental illness became part of mainstream medicine.

MENTAL HEALTH POLICY IN TAMIL NADU STATE
INTRODUCTION:-
         World Health Organization (WHO) defines health as physical, psychological and social well being. According to WHO, through out the world, 1% of population suffers from Severe mental disorders, 15% suffer from common mental disorders and Alcohol and substance misuse constitute 3 to 5% of the population. Nearly 4% of Geriatric population, above the age of 60 suffer from Dementia and other psychiatric illness. Among children & adolescents, 1% suffer from some degree of general intellectual functioning or learning disorders. About 5% of children suffers from Emotional & behavior disorders.
         While applying above statistics, considering the population of Tamilnadu, approximately 7 lakhs people suffer from severe mental illnesses, 70 lakhs persons suffer from common mental disorders, 23 thousand persons above the age of 60 suffer from geriatric psychiatric disorders like Dementia / Depression, 2 lakhs children suffer from subnormal intelligence and learning disorders, 11 lakhs children suffer from other childhood psychiatric problems and 15 lakhs people suffer from Alcohol abuse and Substance misuse related problems.
         While looking into the present scenario of human life, it has become more and more complex and competitive. The no of stressors are on increase and the ability to cope with the stressors and tolerance are o n decline. This in turn, leads to increase in proneness and precipitation of psychiatric problems in vulnerable individuals.
         Social stigma is common, pertaining to Mental illnesses, especially in rural areas. In addition, Ignorance, fear, misconception and faulty attitudes regarding mental illness are highly prevalent in rural and semirural areas. Superstitious beliefs that mental illnesses arecaused by Ghosts, Evil spirits, Black magic, Witch crafts are existing even today. Due to these reasons , the persons with Mental illnesses are brought to psychiatrist, after seeking help from Faith healers, mantra Vadis and magicians.
         Persons with mental illness constitute a vulnerable section of society and are subject to discrimination in our society.
         Family member of persons with mental illness face more hurdles on financial, emotional and social areas, while providing treatment & care.
         While the magnitude of problems in relation to psychiatry illness is enormous, the mental health care facilities in Tamil Nadu is not adequate, not evenly distributed with more facilities available in urban areas than in rural areas.
         So, to resolve the above issues, Mental Health Policy for Tamil nadu state has been evolved,

Aims and objectives of Mental Health Policy
  1. Mental Health care facilities have to be made available in all parts of Tamil nadu state even in most rural areas, and are to be distributed evenly both in rural and urban areas.
  2. Mental Health care professionals have to be increased in their number (psychiatrists, psychiatric social workers, clinical psychologists and psychiatric nurses).
  3. Mental health care has to be integrated into all levels of general health care.
  4. Rehabilitation services for persons with Chronic Mental illness, have to be expanded so that their maximum potential can be developed and their integration into community life can be facilitated.
  5. Since many persons with mental illness do not require hospitalization, community based psychiatric facilities have to be made available and strengthened.
  6. while providing health care to Mentally ill persons in the community / institutions, their rights and dignity should to be protected and promoted, by adhering to rules and regulations of Mental Health care Act.
  7. Mental Health care facility provided by government should go hand in hand with those provided by NGOs so that maximum quality care can be provided to wider sections of the society.
  8. To improve quality of service pertaining to Mental Health Service, all stake holders should be encouraged to actively participate in decision making.
Ways to realize the above aims and objectives
  1. Psychiatric facilities should be made available in all District head quarters hospital in near future and psychiatrists should be made available in all taluk head quarters hospital should be aimed at .
  2. No of seats in Post Graduation in Psychiatry should be increased by starting PG Courses in Psychiatry in more medical colleges
  3. All psychiatric facilities should be provided with 2 psychiatric social workers and one clinical psychologist.
  4. All medical officers belonging to other specialties should be imparted training in recognition of various mental disorders, giving first aid treatment and referral to nearby psychiatric facilities. They also have to be trained in treating common mental disorders.
  5. All staff nurses and paramedical personnel will have to be trained in recognition of psychiatric disorders.
  6. Public awareness with regard to various psychiatric problems will have to be created among public by conducting public awareness programme,and mental health exhibitions. Mass media like newspapers, magazines, and TV Channels may be used for creating awareness among the society
  7. Rehabilitation centers will have to be started in all the districts by the government individually and in collaboration with NGOs.
  8. NGOs will have to be encouraged to participate in providing best possible mental health care
  9. The forum of State Mental Health Authority may be utilized effectively to monitor and to ensure that mental health care is provided as per the regulations of mental health care act.
  10. Judicial personnel & Law enforcing authorities, school teachers have to be trained in recognition and referral of persons with mental illnesses.
Basic principles to be adopted to realize the objectives
Any health care programme, including mental health care scheme, to be successful need four areas to be taken into account
  1. Availability
  2. Accessibility
  3. Effective utilization and implementation
  4. Provision of quality of care
Important areas to be concentrated pertaining to mental health
  • Clinical services
  • Academic activities
  • Research activities
  • Creating awareness among public