District Mental Health Programme

Madurai District

DISTRICT POPULATION

Male - 12,95,124

Female - 12,67,155

Total Population - 25,62,279

Population survey 2002

Existing services in INDIA and Prevalence Of Mental Disorders

70 million mentally ill in the Country

(1 billion population)

20,000 beds in 42 mental hospitals.

2000 to 3000 beds for psychiatric patients in general and teaching hospitals.

At the most 10% alone receive active psychiatric assistance or help.

Point prevalence is that 10 to 20/1000 population are affected by serious mental disorder.

20 to 30 million people may require mental health care .

1 bed available for psychiatric patient per 32,500 population.

10% of the patients require urgent mental health care.

Roughly 2,50,000 new psychiatric cases with serious mental disorders manifesting each year.

UNEVEN DISTRIBUTION

NEEDS SERVICES

PSYCHIATRIC SERVICES IN INDIA

Psychiatrists (4,000 )

Psychologists(200)Psychiatric Social Workers (2,000)

Psychiatric nurses (400)

CURRENT SITUATIONCURRENT SITUATION

• Based on Uneven distribution of needs & services, National mental health programme was formulated in 1982.

• DMHP was launched in 1996- 1997 in four districts, one each in Andra Pradesh, Assam, Rajasthan and TamilNadu

• In Tamilnadu, DMHP was launched in 1998 in Trichy.• • Simultaneously launched in Madurai and Ramnad in

2001

AIM OF THE IMPLEMENTATION OF DMHP

To ensure availability and accessibility of mental health care to all the most vulnerable and under-privileged.

Integration of Basic mental heath care with general health services.

To promote community participation in the mental health services and to stimulate efforts towards Self-help.

To Increase awareness about mental health in general public.

MENTAL HEALTH CARE PROGRAMMES

Phase - I - Training & I.E.C

Phase – II – Treatment

Phase – III - Rehabilitation

Phase - IIEC Activities

Carried out during the year 2002 -2004

• Colour display boards distributed to display in all Taluk hospitals and PHC

• Stickers pasted in important places of PHCs and Taluk hospitals

• Booklets distributed to the public

• News letter published bilingual

• Slides distributed and screened in Cinema Theatres of both the district.

MENTAL HEALTH FESTIVALS

Conducted during the year 2002-03 in different hamlets of Madurai District

Thiruparankundram Chellampatti Kallandiri T. Kallupatti

Street play on Alcoholism

Training programme

For effective implementation of the programme, Training plays an effective role in sustainable health care. During 2002, training was given to the following persons:

Medical Officers of PHCs Para Medicals Non- Medicals

MEDICAL OFFICERS TRAINING

Medical officers of the PHCs were given 15 days training programme.

• Books on mental Illness were distributed • Case demonstration• Field Training was also given. • Faculties from the Institute of mental health,

Chennai, Institute of Psychiatry, Madurai, Psychiatrists and Psychologists from various parts of Tamilnadu delivered lectures.

• In the year 2002 – 2003 100 PHC Medical officers from both the districts were given training

• In the year 2003 -2004 50 PHC Medical officers from both the districts were given training

• During this booklets, case demonstration and field training were given.

Because of this training programme, They will be able to..

• Recognition and management of disorders.

• Manage Psychiatric emergencies through simple crisis management skills and appropriate utilization of specified medicine.

• Administration and supervision of maintenance treatment .

PARA-MEDICAL TRAINING

• 100 Paramedical were given one week training during the year 2002.

• Another 100 paramedical were given training during the year 2003

• Books on mental illness (Tamil) were distributed. • Case demonstration.• Field Training was also given.

• Liaison with the local school teachers and parents in identifying and managing children with mental retardation and behavior problems.

• Counseling in alcohol and drug abuse

• This task will be performed in accordance with simple operations and instruction included in the MPW’S manual.

NON-MEDICAL’S TRAINING

• About 200 persons trained in the year 2002

Participants : Opinion leaders Self help group members Teachers And parents of mentally disabled

Booklets were distributed (Tamil).Case demonstration.

Field visit.

NON-MEDICAL TRAINING PROGRAMME

Phase - II

TREATMENT FACILITIES

In-patient and outpatient services is given at Usilampatti Government Hospital.

Modern ECT Equipment - Brief-pulse Therapy with ECG, EEG monitoring facility is provided at Usilampatti to improve quality of treatment.

TALUK HOSPITALS

Out Patient services is carried out by mobile psychiatric team at each Taluk hospitals on the following days

Monday – UsilampattiTuesday – ThirumangalamWednesday – MelurThursday – Usilampatti/ PeraiyurFriday – VadipattiSaturday – Sholavandan/ Manadimangalam

Areas Covered under DMHP

13%

13%

14%

14%

14%14%

13%

Usilampatti

Tirumangalam

Peraiyur

Vadipatti

Solavandan

Mannadimangalam

Melur

Madurai Corporation-Not Covered

Performance of DMHP during July 2002 - March 2003

0100200300400500600700800900

1000

No.CasesTreated

210 488 508 617 885

From April 2003 to July 2004

0

200

400

600

800

1000

1200

1400

No ofCasesTreated

801 938 1084 1153 1286 1243 1186 1209

DIAGNOSTIC BREAKDOWN- CASES REGISTERED AVERAGE OF EVERY MONTH

130

137

34

26

290

36

27

1

230

93

1

15

0 100 200 300 400

Schizophrenia

Mood Disorder

Acute Psychosis

Hysteria

OCD

Anxiety

Alcohol

Drug

Dementia

Epilepsy

MR

Childhood mental Illness

Others

In Patient

0

20

40

60

80

100

120

140

160

In patient service

A- During 2002 – March 2003 (47 cases)

B- April 2003 - July 2004 (156 cases)

A B

Phase IIIRehabilitation services in

Madurai District

• “MANASA” – A society is registered under chairmanship of District Collector.

• 6.5 acres land allotted at Thanakkankulam village

• 24 Lakhs allotted by district administration for construction of building for the treatment and rehabilitation of the wandering lunatics

• District Disabled Rehabilitation Centre a project of NIMH was taken over by “MANASA”.

Services provided by DDRC

• Issue of identity cards• Free bus pass• SpecialEducation• Vocational Training and Rehabilitation• Occupational Therapy• Physio and speech Therapy• Job placement• Supply of Aids and Appliances

• Presently we are referring patient to NGOs who are willing to render services to mentally disabled

• In collaboration with M.S.Chellamuthu Trust and Research Foundation, we formed Self Help Group comprising predominantly of mentally disabled persons

SELF HELF GROUP

Self Help Group is the small group of women (mothers) who belong to mentally disabled families

This women group comprising of 20 mothers started collecting monthly subscription and operating the accounts in the bank.

There are eight self-help groups started and they meet once a month on the day of medical camp conducted in their area. The improvement in the health of disabled members, the management of saving collected are discussed regularly. There are about 125 families benefited from this activity.

Nambikkai Group

Lone Distribution

Accounting

• 18 acres of land allotted for SHG members to involve in agricultural activities (waste land development programme)

• Members are involved in Vocational Training Activities and produce Phenyl, Soap oil, wire bags, paper cups, Toys and Greeting cards.

• A shop has been allotted in the DRDA shopping complex for selling the products produced by SHGs members

Thank You