By Sweta Pal:
Thirty new districts in Madhya Pradesh have now inaugurated the “Mann Kaksh” or the mental health cell in their district hospitals, in a bid to integrate mental health into routine primary health care. Strengthening delivery of mental health services is now one of the priority areas for Ministry of Health and Family Welfare, Government of Madhya Pradesh. The state became one of the first states in India to organise a state level mental health policy and planning workshop in March 2015 under the aegis of National Health Mission and took a visionary decision to scale up mental health services across all districts, moving beyond DMHP and establishing “Mann Kaksh” at all 51 district hospital facilities covering a population of around 75 million. This initiative was christened as SOHAM (Scaling up Opportunities for Healthy and Active Minds).
Prior to this, PHFI and Sangath in collaboration with Department of Public Health and Family Welfare, Government of Madhya Pradesh has been implementing a major facility based PRogramme for Improving Mental Health CarE (PRIME) in Sehore district since 2011. PRIME now is acting as a technical partner to the Department utilising findings from the Sehore model and bringing global learning at the local level to strengthen the mental health services delivery in the state which can ultimately reduce the treatment gap for mental disorders.
How SOHAM helps?
As part of the SOHAM initiative, in each district hospital, a “Mann Kaksh” with a dedicated space for mental health consultation has been created. This space of around 15 X 15 Sq. ft offers screening, documentation, delivery of evidence-based interventions, follow-up and referral facilities to all the cases coming to district hospital OPD and IPD cases which have mental disorders as a co-morbid element.
A team comprising of a trained medical officer and two nurses in provision of psychosocial interventions and supervised by a psychiatrist has been created. Two-day sensitisation workshops of all the doctors in a district hospital are currently underway to ensure that patients with mental health conditions receive coordinated care across health care delivery platforms, with integrated health care records and liaison between health care providers. Nurses will establish liaison with other paramedical staff and ASHA workers to provide long-term follow-up and continuing care.
To overcome challenges and move forward towards its goal, fortnight review and planning meetings by core management group is happening regularly. A seven-member team extend techno-managerial support to achieve its set goal.
With all efforts there remains a big evidence gap in terms of understanding the best mechanisms to improve health systems capacity, and to address the rising burden due to mental health conditions. Nevertheless, SOHAM initiative provides a beacon of hope to improve mental health service delivery for the 75 million people of Madhya Pradesh.