NATIONAL

Mirjam Nilsson 2015 - 2016

mirjam@contoso.com

www.contoso.com

By Dr. Monisha Mary

1 SUNDAY, APRIL 28, 2024

 METHODOLOGY
INTRODUCTION SAMPLING AND
SELECTION

PREVALENCE AND TREATMENT GAP,

PATTERN OF DISABILITIES AND
MENTAL IMPACT OF MENTAL
DISORDERS, 2016 DISORDERS, 2016

SPECIFIC LEARNING MENTAL HEALTH

SYSTEMS, RECOMMENDATIONS
RESOURCES AND
OBJECTIVES FACILITIES, 2016

2
 Call to action

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Sunday, April 28, 2024 3

3
 A COMPREHENSIVE ASSESSMENT OF
PREVALENCE OF MENTAL HEALTH
DISORDERS
SURVEY'S PRIMARY
OBJECTIVE

ESSENTIAL DATA ON THE

PREVALENCE OF MENTAL HEALTH
Introduction DISORDERS
LARGE REPRESENTATIVE
to National SAMPLE SIZE

EVIDENCE-BASED POLICIES,
Mental Health INTERVENTIONS

Survey 15-16 AWARENESS CAMPAIGNS

4
This summary delves into the key
findings and implications of the
survey, shedding light on the state
of mental health in the nation.

4/28/2024 Annual Review 5

4/28/2024 Annual Review 6
 METHODOLOGY
Sample Design and
Selection:
Multi-stage, stratified
sampling technique
with random selection
based on Probability
Proportion to Size at
each stage (MSRS-
PPS).

Sunday, April 28, 2024 7

THE SAMPLING STRATEGY

STRATIFIED PROPORTIONAL
01 03 05

(12 STATES) RANDOM ALL

02 04 INDIVIDUALS
WERE ABOVE
18 YEARS
8
THE STATES
SELECTED
N O R TH : P UN JA B A N D UTTA R P R A D E S H

N O R TH - E A S T : A S S A M A N D M A N I P UR .

CE N TR A L : M A D HY A P R A D E S H
A N D CHHA TTI S G A R H

S O UTH: TA M I L N A D U A N D K E R A L A
EAST: JHARKHAND AND WEST BENGAL

WEST: RAJASTHAN AND GUJARAT

9
 MULTI STAGE SAMPLING

LEVEL 4
.WARD
In total 34802 adults and about
LEVEL 3
1191 adolescents drawn from 12 VILLAGE
states were interviewed LEVEL 2
TALUKA

LEVEL 1
DISTRICT

10
 STANDARDIZED CAREFULLY MINI FAGERSTROM FURTHER,
TOOLS AND DESIGNED INTERNATIONAL QUESTIONNAIRE QUESTIONNAIRES
QUESTIONNAIRES AND NEURO-
VALIDATED PSYCHIATRIC
INVENTORY
(MINI) ADULT
VERSION AND
THE MINI-KID
VERSION

DATA COLLECTION TOOLS

11
SAMPLING 1 2 S TA TE S 4 3 D I S TR I CTS

AND
SELECTION 34 8 0 2 80
I N D I V IDUA L S TA L UKA S

OF
1 0 1 52 7 20
INDIVIDUALS HO US E HO L DS CL US TE R S

IN NMHS
R UR A L (4 20)
UR B A N (N ON M E TR O
( 1 35
UR B A N M E TR O (93 ) 12
 TRAINING OF FIELD DATA COLLECTORS AT STATE LEVEL

4/28/2024 Annual Review 13

 ONLINE MONITORING MEETINGS BETWEEN CENTRAL TEAM AT NIMHANS AND STATE TEAMS

4/28/2024 Annual Review 14

DATA COLLECTION SCHEME IN
NMHS-2016

4/28/2024 Annual Review 15

 SNAPSHOTS OF DATA COLLECTION IN DIFFERENT STATES

4/28/2024 Annual Review 16

 SURVEY RESPONSE THE B P L ( B E LO W MEDIAN
P O P U L AT I O N R AT E LITERACY POVERTY HOUSEHOLD
LINE) INCOME

SURVEY POPULATION
CHARACTERISTICS
PREVALENCE AND
PATTERN OF
MENTAL
DISORDERS, 2016

18
4/28/2024 Annual Review 19
PREVALENCE OF MENTAL DISORDERS

13.1%

10.6%.

13.7%

F10 – F49

20
PREVALENCE OF
MENTAL MORBIDITY
IS HIGH IN INDIAN
URBAN METROS
LOOKING AHEAD

21
RURAL URBAN DIFFERENTIALS IN PREVALENCE OF MENTAL
DISORDERS (%)

22
COMMON MENTAL
DISORDERS AFFECT
SIGNIFICANT SECTIONS OF
SOCIETY

23
CURRENT PREVALENCE OF COMMON AND SEVERE
MENTAL DISORDERS

24
 1 in 20 people in
India suffer from
depression

Sunday, April 28, 2024 25

PREVALENCE OF MDD AND SOCIO-DEMOGRAPHIC
DIFFERENTIALS

26
 There is a high prevalence
of psychoactive substance
use

Sunday, April 28, 2024 27

PREVALENCE OF SUBSTANCE USE DISORDERS (%)

28
PREVALENCE OF SUBSTANCE USE DISORDERS BY
GENDER (%)

29
PREVALENCE OF ALCOHOL USE DISORDER AND SOCIO-
DEMOGRAPHIC DIFFERENTIALS

30
 High suicidal risk is an
increasing concern in
India

Sunday, April 28, 2024 31

PREVALENCE OF HIGH SUICIDAL RISK : SOCIO-
DEMOGRAPHIC DIFFERENTIALS

32
 Severe mental disorders
are equally important

Sunday, April 28, 2024 33

33
 Productive age groups
are affected most

Sunday, April 28, 2024 34

PREVALENCE OF MENTAL MORBIDITY IN DIFFERENT
AGE GROUPS (%)

35
 Both genders are
affected – variation
across disorders
exists.

Sunday, April 28, 2024 36

PREVALENCE OF MENTAL DISORDER BY GENDER(%)

37
 Children and adolescents
are vulnerable to mental
disorder

Sunday, April 28, 2024 38

PREVALENCE OF MENTAL DISORDERS (%) IN 13 -
17YEARS BY AGE AND RESIDENCE

39
Neurosis and stress related
disorders affect women
disproportionately

Sunday, April 28, 2024 40

40
PREVALENCE OF NEUROSIS. SOCIO-DEMOGRAPHIC
DIFFERENTIALS

41
VARIATIONS IN PREVALENCE EXIST AT THE REGIONAL
AND STATE LEVELS

42
PREVALENCE OF MENTAL DISORDERS IN DIFFERENT
STATES (%)

43
 Epilepsy is an
important public
health problem

Sunday, April 28, 2024 44

44
 Persons with Intellectual
disability need
comprehensive
management

Sunday, April 28, 2024 45

45
TREATMENT GAP,
DISABILITIES AND IMPACT
OF MENTAL DISORDERS,
2016

Sunday, April
46
28, 2024 46
 Treatment gap for
mental disorders still
remains very high

Sunday, April 28, 2024 47

TREATMENT GAP FOR DIFFERENT MENTAL DISORDERS
(%)

48
 Three out of four persons with a
severe mental disorder
experience significant disability in
work, social and family life

Sunday, April 28, 2024 49

49
DISABILITY PROPORTION AMONG SUBJECTS WITH
MENTAL DISORDERS (%)

50
EXTREME DISABILITY (%) AMONG PERSONS WITH
MENTAL DISORDERS

51
 Persons with mental
Economic burden of
outdisorders
Threemental
of four continue
persons
disorders is
to a
with be
severe stigmatzed
mental disorder
huge
experience significant disability in
work, social and family life

Sunday, April 28, 2024 52

52
PREVALENCE OF MENTAL DISORDERS BY MEDIAN
HOUSEHOLD INCOME LEVELS

53
 Persons with mental
Three outdisorders continue
of four persons to a
with be
stigmatized
severe mental disorder
experience significant disability in
work, social and family life

Sunday, April 28, 2024 54

54
Significantly, low levels of Persons with mental
education and income areThree outdisorders
closely continue
of four persons to a
with be
stigmatized
linked to mental disorderssevere mental disorder
experience significant disability in
work, social and family life

Sunday, April 28, 2024 55

55
MENTAL HEALTH SYSTEMS,
RESOURCES AND
FACILITIES, 2016

Sunday, April
56
28, 2024 56
Mental Health Programmes
Significantly, low levels of in Persons with mental
India are aand
education lowincome
priorityare
onThree
the outdisorders
closely continue
of four persons to a
with be
public health agenda stigmatized
linked to mental disorderssevere mental disorder
experience significant disability in
work, social and family life

Sunday, April 28, 2024 57

57
STATE MENTAL HEALTH SYSTEMS ASSESSMENT: AN
APPRAISAL

58
 Vision, mission and
Mental Health Programmes
Significantly, low levels of in Persons with are
mental
direction
India are aand
education lowincome
priorityare
a low outdisorders
closely
Three of four continue
persons to a
with be
critically important
priority on the public health
linked to mental disorderssevere mentalstigmatized
indisorder
mental health
agenda experience significant disability in
programmes
work, social and family life

Sunday, April 28, 2024 59

59
STATE MENTAL HEALTH SYSTEMS ASSESSMENT: AN
APPRAISAL

60
 Vision, mission and
Mental Health Programmes
Significantly, low levels of in Persons with are
mental
direction
India are aand
education lowincome
priorityare
a low A outdisorders
Mental
closely
Three Health
of four continue
Action
persons to a
with be
critically important
priority on the public health
linked to mental disorderssevere Plan stigmatized
is decisive
mental at the
indisorder
mental health
agenda State level
experience significant disability in
programmes
work, social and family life

Sunday, April 28, 2024 61

61
MENTAL HEALTH ACTION PLAN IN NMHS STATES

62
 Vision, mission and
Mental Health Programmes
Significantly, low levels of in Persons with are
mental
direction
India are ainformation
Health
education lowincome
and prioritysystems
a low
are Ado
closely
Three outdisorders
Mental Health
of four continue
Action
persons to a
with be
critically important
priority
not on the
prioritisepublic
mentalhealth
linked to mental disorders health Plan
severe stigmatized
is decisive
mental at the
indisorder
mental health
agenda State level
experience significant disability in
programmes
work, social and family life

Sunday, April 28, 2024 63

63
 Vision, mission and
Mental Health Programmes
Significantly, low levels of in Persons
Mental with mental
healthare activities at
direction
India are a low priority a low Mental
the
disorders health
state level
continue are not
Health information
education and incomesystems
areThree Ado
Mental
closely Health
out of Mental
four persons
critically
health Action theto
atwith
important
activities be
a
state level
priority on the public health information
activities at
are not information driven
the state
driven Mental health
not prioritise mental health Plan stigmatized
is decisive
linked to mental disorderssevere mentalinactivities
disorder
mental at the
health
at the state level are not
agenda State level
level aredriven
information notMental health activities
experience significant
programmes
at
disability in
the state level are not information
information driven driven
work, social and family life

Sunday, April 28, 2024 64

64
 Vision, mission and
Mental Health Programmes
Significantly, low levels of in Persons
Existing
Mental with
health mental
healthare care at
activities
direction
India are ainformation
Health
education lowincome
and prioritysystems
a low
are A Mental
do
closely the
disorders
facilitiesstate
Health
Three out of Mental
four level
should
continue
personsAction arebe not
theto
atwith be
a
critically
health
information important
activities
driven
state level
priority
not on the
prioritisepublic
mentalhealth
health Plan is are not information driven Mental health
stigmatized
engaged
decisive
linked to mental disorderssevere mentalinactivities for
disorder atmental
the health
mental health
at the state level are not
agenda State care
experience level
information driven Mental health activities
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 65

65
HEALTH CARE FACILITIES IN PUBLIC SECTOR (PER LAKH
POPULATION)

66
 Vision, mission and
Mental Health
Significantly, Programmes
lowcare
levels of in Persons
Existing
Mental with
health mental
healthare care at
activities
Institutional is still direction
India are ainformation
Health
education lowincome
and prioritysystems
a low
are A Mental
do
closely the
disorders
facilitiesstate
Health level
should
continue
Action arebe not
theto be
limited; needs capacity Three out of Mentalfour persons
critically
health
information
atwith
important
activities
driven
a
state level
priority
not on the
prioritise
linkedbuilding
to mental public
mentalhealth
health Plan is are not information driven Mental health
stigmatized
engaged
decisive
disorderssevere mentalinactivities for
disorder atmental
the health
and innovative mental health
at the state level are not
agendause of resources State care
experience level
information driven Mental health activities
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 67

67
 Vision, mission and
Mental Health
Significantly, Programmes
lowcare
levels of in Persons
Existing
Mental with
health
healthare mental
care
activities at
Institutional is still direction
Importance of non-specialist
India are
Health
education a low priority
information
and income a low
systems
are A Mental
do
closely the
disorders
facilities state
Health level
should
continue
Action arebe not
theto be
limited; needs capacity Three outprofessionals
of Mental
four persons
critically
health
information
activities
in atwith
important
mental
driven
a
state level
priority
not on the
prioritise
linkedbuilding
to mental public
mentalhealth
health Plan
disorderssevere mentalis are not information driven Mental health
stigmatized
engaged
decisive
disorderfor at mental
the health
and innovative health inactivities
mental
care health
delivery
at the state level are not
agendause of resources State care
experience level
information driven Mental health activities
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 68

68
 Vision, mission and
Mental Health
Significantly, Programmes
low levels of in Persons
Existing
Mental with
health
healthare mental
care
activities at
Coverage
Institutional of DMHP
care is still direction
Importance of non-specialist
India are
Health
education a low priority
information
and income a low
systems
are A Mental
do
closely
Three out of the
disorders
facilities state
Health
four level
should
continue
personsAction arebe not
theto
atwith be
a
limited;
still needs
remains capacity
low critically
Mental
professionals health
information inimportant
activities
mental
driven
state level
priority
not on the
prioritise
linkedbuilding
to mental public
mental health
health Plan
disorderssevere mentalis are not information driven Mental health
stigmatized
engaged
decisive
disorderfor at mental
the health
and innovative health inactivities
mental
care health
delivery
at the state level are not
agendause of resources State care
experience level
information driven Mental health activities
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 69

69
COVERAGE OF DMHP IN NMHS STATES

70
 Vision,
Mental mission
health and and
Mental Health
Significantly, Programmes
low levels of in Persons
Existing
Mental with
health
health mental
care
activities at
Coverage
Institutional of DMHP
care is still direction
supportive
Importance of are
legislations
non-specialist
India are
Health
education a low priority
information
and income a low
systems
are A Mental
do
closely
Three out of the
disorders
facilities state
Health
four level
should
continue
personsAction arebe not
theto
atwith be
a
limited;
still needs
remains capacity
low need critically
Mental
professionals effective
health
information inimportant
activities
mental
driven
state level
priority
not on the
prioritise
linkedbuilding
to mental public
mental health
health Plan
disorderssevere mentalis are not information driven Mental health
stigmatized
engaged
decisive
disorderfor at mental
the health
and innovative health inactivities
mental
implementation
care health
delivery
at the state level are not
agendause of resources State care
experience level
information driven Mental health activities
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 71

71
IMPLEMENTATION OF MENTAL HEALTH LEGISLATIONS IN
NMHS STATES

72
 Vision,
Mental mission
health and and
Mental Health
Significantly, Programmes
low levels of in Persons
Existing
Mental with
health
health mental
care
activities at
Coverage
Institutional of DMHP
care is still direction
supportive
Importance of are
legislations
non-specialist
India are
Health
education a low priority
information
and income a low
systems
are Ado
closely
Three out the
disorders
facilities
Mental
Mental
of state
Health
four level
should
continue
health
personsAction arebe not
theto
atwith be
a
limited;
still needs
remains capacity
low need critically
Mental
professionals effective
health
information inimportant
activities
mental
driven
state level
priority on the public health Plan is are not information driven Mental health
stigmatized
engaged
decisive
financing for at
needmental
the to health
not prioritise
linkedbuilding
to mental mental
and innovativehealth
disorderssevere mental disorder
inactivities
mental
implementation
health care health
delivery
at the state levelbe
are not
agendause of resources State care
experience level
information driven Mental health activities
streamlined
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 73

73
MENTAL HEALTH FINANCING IN NMHS STATES

74
 Public awareness
Vision,
Mental mission
health and and
Mental Health
Significantly, Programmes
low levels of in activities
Persons
Existing
Mental are mental
with
health
health still
care
activities at
Coverage
Institutional of DMHP
care is still direction
supportive
Importance of are
legislations
non-specialist
India are
Health
education a low priority
information
and income a low
systems
are A limited
Mental
do
closely
Three out the
disorders
facilities
Mental
of Health
four in
state mental
level
should
continue
health
personsAction arebe not
theto
atwith be
a
limited;
still needs
remains capacity
low need critically
Mental
professionals effective
health
information inimportant
activities
mental
driven
state level
priority on the public health Plan health
is are not information driven Mental health
stigmatized
engaged
decisive
financing for at
needmental
the to health
not prioritise
linkedbuilding
to mental mental
and innovativehealth
disorderssevere mental disorder
inactivities
mental
implementation
health care health
delivery
at the state levelbe
are not
agendause of resources State care
experience level
information driven Mental health activities
streamlined
significant disability in
programmes
at the state level are not information
work, social and family life
driven

Sunday, April 28, 2024 75

75
IEC ACTIVITIES FOR MENTAL HEALTH IN NMHS
STATES

76
 Vision, mission and
Mental Health Programmes in
Significantly, low levels of Interrupted Persons with mental
direction
Drug are
Supply
India are ainformation
Health
education lowincome
and prioritysystems
a low
are Ado
closely
Three outdisorders
Mental Health
of four continue
Action
persons to a
with be
Continues critically important
priority
not on the
prioritisepublic
mentalhealth
linked to mental disorders health Plan
severe stigmatized
is decisive
mental at the
indisorder
mental health
agenda State level
experience significant disability in
programmes
work, social and family life

Sunday, April 28, 2024 77

77
AVAILABILITY OF DRUGS FOR MENTAL HEALTH
CARE

78
 Vision, mission and
Mental Health Programmes in Persons
Significantly, low levels of Public awareness with mentalare
direction are
activities
India Collaboration
are a low
Health information within
priority a low andA Mental Rehabilitation
disorders
Health continue
Action to a be
education and incomesystems
areThree
stilldo
closely out of four
limited persons
critically
in mental with
important
health
priority
not outside
on the
prioritisethe health
public
mentalhealth
health Plan programmes
stigmatized
is decisive at the are
linked to mental disorders severe mental indisorder
mental health
agendasector is minimal experience State level minimal
Rehabilitation
significant
programmes are minimal
disability in
programmes
work, social and family life

Sunday, April 28, 2024 79

79
INTRA AND INTER-SECTORAL COLLABORATION FOR
MENTAL HEALTH

80
 Vision, mission and
Mental Health Programmes in Persons
Significantly, low levels of Public awareness with mentalare
direction are
activities
India are ainformation
Health
education lowincome
and prioritysystems
a low
are Ado
closely
Three Rehabilitation
disorders
Mental Health
out of four continue
persons Action to a
with be
still limited critically
in mental important
health
priority
not on the
Programme
prioritisepublic
mentalhealth
monitoring
linked to mental disorders health and
severePlan programmes
stigmatized
is decisive
mental disorder at the are
in mental health
agendaevaluation are totallyexperience
State level minimal
Rehabilitation
significant
programmes are minimal
disability in
programmes
missing work, social and family life

Sunday, April 28, 2024 81

81
STATUS OF MONITORING IN NMHS STATES

82
 Vision, mission and
Mental Health Programmes in Persons
Significantly, low levels of Public awareness with mentalare
direction are
activities
India are ainformation
Health
education lowincome
and prioritysystems
a low
are Ado
closely
Three disorders
Mental
out Health
of four continue
persons Action to a
with be
still limited critically
in mental important
health
priority
not on the
prioritisepublic
mentalhealth
linked to mental disorders health
severePlan Mental
stigmatized
is decisive
mental disorderhealth
at the
in mental health
agenda State level
experience
Rehabilitationis
research
significant
programmes
limited are minimal
disability in
programmes
work, social and family life

Sunday, April 28, 2024 83

83
 DISTRICT PLANNING OF INTEGRATION
MENTAL SERVICES OF MENTAL
HEALTH HEALTH INTO POLICY MAKERS
PROGRAMME PRIMARY CARE

HUMAN MENTAL UPGRADATION DRUG

RESOURCE HEALTH OF EXISTING LOGISTICS
DEVELOPMENT PROMOTION FACILITIES SYSTEM

Recommendations
84
 PREVALENCE
FUNDING FOR NATIONAL OF MENTAL
MENTAL REGISTRY REHABILITATION DISORDERS IN
HEALTH URBAN AREAS

NATIONAL
MENTAL MENTAL
HEALTH RESEARCH NATIONAL
HEALTH BASE AGENCIES
LITERACY ACTIVITIES

Recommendations
85
Person with a mental disorder
can be creative and productive
with good care, caring society
and availability of opportunities

4/28/2024 Annual Review 86 86

 LETS WORK
TOGETHER TO
NORMALISE
CONVERSATIONS
ON MENTAL
HEALTH

THANK YOU
Sunday, April 28, 2024 87
87