1. District Mental Health Programme Madurai District

2. DISTRICT POPULATION Male-12,95,124 Female-12,67,155 Total Population-25,62,279 Population survey 2002

3. 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.

4.  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.

5. UNEVEN DISTRIBUTION NEEDS SERVICES PSYCHIATRIC SERVICES IN INDIA Psychiatrists (4,000 ) Psychologists(200) Psychiatric Social Workers (2,000) Psychiatric nurses (400) CURRENT SITUATION

6. 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

7. 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.

8. MENTAL HEALTH CARE PROGRAMMES Phase - I - Training & I.E.C Phase – II – Treatment Phase – III - Rehabilitation

9. Phase - I IEC 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.

10. MENTAL HEALTH FESTIVALS  Conducted during the year 2002-03 in different hamlets of Madurai District  Thiruparankundram  Chellampatti  Kallandiri  T. Kallupatti

11. Street play on Alcoholism

12. 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

13. 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.

15. 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.

16. 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.

17. 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.

18. 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.

20. 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.

21. NON-MEDICAL TRAINING PROGRAMME

23. 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.

24. TALUK HOSPITALS Out Patient services is carried out by mobile psychiatric team at each Taluk hospitals on the following days Monday–Usilampatti Tuesday–Thirumangalam Wednesday–Melur Thursday–Usilampatti/ Peraiyur Friday–Vadipatti Saturday– Sholavandan/ Manadimangalam

25. Areas Covered under DMHP

26. Performance of DMHP during July 2002 - March 2003 210 488 508 617 885

27. From April 2003 to July 2004 801 938 1084 1153 1286 1243 1186 1209

29. 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

30. Phase III Rehabilitation 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”.

31. 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

32. 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

33. 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.

34. Nambikkai Group Lone Distribution Accounting

35. 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

36. Thank You