Much Needed Tele-Mental Health programme in India
A diagnosable mental health condition is considered to affect one in every seven individuals in India, making the country heavily encumbered by mental health issues. If we additionally take into account the population’s transient symptoms of psychological discomfort, which also contribute to the alarming problem of mental health, which is likely to rise even more sharply.
The most recent National Mental Health Survey, however, found that there is still a significant lack of infrastructure and qualified mental health practitioners despite the high need for mental health care services.
In addition to the traditional moral and public health justifications for increased investment in people’s mental health, it is now well-established that poor mental health significantly contributes to lost productivity and a nation’s economy. Additionally, the COVID-19 epidemic has a serious negative direct and indirect impact on everyone’s mental health. For instance, it was predicted that the COVID-19 pandemic will raise the prevalence of clinically significant anxiety and depressive disorders by about 35% in India by the year 2020.
In order to provide greater access to mental health support throughout the nation, the government is preparing to introduce a national tele-mental health programme and a toll-free helpline number soon. Nirmala Sitharaman, the Union Finance Minister, originally introduced the national tele-mental health programme (NTMHP) in the Union Budget 2022–2023.
The National Institute of Mental Health and Neurosciences (NIMHANS) will serve as the nodal center for this network of 23 tele-mental health centers of excellence, while the International Institute of Information Technology, Bengaluru (IIITB) will provide technical support. Five regional coordinating centers and at least one tele-MANAS (Tele-Mental Health Assistance and Nationally Actionable Plan) cell will be constructed as part of the initiative in each state and union territory.
However, there is uncertainty about how the government’s welcome initiative to close India’s enormous mental health treatment gap would be implemented.
Future potential
Due to non-uniform service delivery caused by local administrative issues or inability to use allocated funds, a lack of adequately trained mental health professionals at the primary healthcare level, and a lack of effective central monitoring and evaluation of the programme activities, the current National Mental Health Program (NMHP) and the District Mental Health Program (DMHP) have faced significant challenges in their successful implementation in India.
Tele-mental health can offer high-quality care to people with mental health issues in a discreet (reduce the stigma associated with mental health treatment-seeking behaviour), easily accessible (accessible from home or a nearby location without the need to visit a health center), reasonably priced (free consultation, no transport costs, and no loss of daily wages) way. Additionally, those living in remote or rural locations where qualified mental health specialists are not currently available can receive services from mental health professionals who are based in cities or far-off centres.
Through tele-mentoring and tele-monitoring efforts, can also be utilised to develop the skills of non-specialist health workers in recognising mental health issues, starting the first course of therapy, or contacting an expert.
Challenges ahead
For the recently announced NTMHP in India to be implemented successfully, a few significant obstacles must be successfully overcome.
- It is unclear how the tele-mental centres established under the NTMHP will operate in terms of their organisational structure (e.g., the first point of contact with a psychiatrist, psychologist, trained health worker, or layperson) and scope of services (counselling, structured psychotherapy over numerous scheduled sessions, tele-consultation, prescription of medications if indicated, etc.).
- India is a very diverse country in terms of socioeconomics, culture, and languages. Therefore, consideration must be given to adapting tele-mental health services to the local cultural context of various regions when planning their implementation at the national level. There is a need to combine psychoeducation on the bio-psycho-social model of mental health with beneficial indigenous therapy modalities like yoga or meditation in a way that is culturally respectful.
- In addition, a sizeable segment of the population in India lacks access to cell phones or high-speed internet, has inadequate digital literacy, and is frequently more likely to experience poor mental health and mental diseases. As a result, it’s important to plan a variety of tele-mental health services to encourage fair access to these services.
- Due to the widespread stigma associated with mental illness, many people choose not to or are afraid to seek treatment. Therefore, it is crucial to guarantee the patient’s privacy and the security of any health-related data.
- Additionally, it is necessary to create quality control systems and processes for ongoing monitoring and assessment of the delivery of tele-mental health services as well as evaluation of the results in terms of beneficiaries’ mental health.
Conclusion
The T-MANAS project should be careful to create and implement standardised, evidence-based, and culturally relevant tele-mental health services. The NTMHP is a positive step toward realising the objective of providing mental health treatment for everyone. For these tele-mental health services, standard operating procedures and quality assurance measures must also be developed. This will be crucial for assuring the success of the program’s goal of offering affordable, high-quality mental health treatments to all.
